Special Pregnancy Concerns for Older Moms

Question: "I'm 40 years old and pregnant with my first baby. My doctor has ordered some tests that my younger sister never had when she was pregnant. Why the extra scrutiny? What are the pregnancy risks associated with being an older mom?"

Ask Heidi Murkoff

Congratulations on your pregnancy! With birthrates soaring for the over-40 set, there's never been a more popular time to be an older mom. Fortunately, there's also never been a better time — or a safer one. A mom-to-be in your age bracket has nearly the same odds of having a healthy pregnancy and a healthy baby as her much younger counterparts. Why "nearly"? Call it age discrimination (of course, in this case you'd have to sue your own body), but as we move into the golden years of baby-making — "advanced maternal age" in doctor-speak — our chances of pregnancy complications creep up ever-so-slightly.

First, we have to deal with the fact that our eggs aren't spring chickens. You, me, and every other woman on Earth were born with a lifetime supply of eggs (talk about putting all your eggs in one basket!). And while we only get better with age (at least, if we're to believe those Olay commercials — and I choose to), the same can't always be said for our eggs as they approach their use-by date. Though the vast majority of older eggs continue ripening without incident, each passing year very slightly increases the risk of certain problems.  For instance, while a 20-year-old mom-to-be has a one in 10,000 chance of delivering a baby with Down syndrome — a genetic condition caused by the presence of an extra copy of chromosomes — a 40-year-old's odds are one in 100. While the odds of having a completely normal baby are still in your favor, you'll be scheduled for prenatal testing that can identify Down syndrome and other chromosomal abnormalities (and that's routinely ordered for older moms) — just to be on the safe side.

Second, we have to deal with the fact that we're not spring chickens. Older bodies are, in general, somewhat more susceptible to a variety of health issues, including high blood pressure and diabetes — which puts older expectant bodies at a slightly greater risk for the pregnancy-related forms of these conditions (preeclampsia and gestational diabetes) — and which gives your practitioner another reason to pay closer attention to your pregnancy. Preterm labor is also slightly more common in over-40 moms (as it is in expectant moms under 17), as is having a baby that's small for gestational age, yet another reason for all the extra scrutiny. Other risks the advanced maternal age set might have to confront:  slightly longer labor and a higher chance of cesarean section or assisted delivery (vacuum extraction or forceps, for example), probably due to having poorer muscle tone and less flexible joints (remember how limber you were at 22?). The good news is that if you start off your pregnancy in good shape and keep yourself in tip-top form throughout (and you know how to do that: eating well, exercising regularly, getting all those tests your practitioner recommends), you'll do just as well as your younger pregnant pals — and, once the delivery is behind you, you'll have years more experience and wisdom to offer that precious little person you've brought into the world.

Here's to a healthy pregnancy (at any age!),

Heidi Murkoff