Having a Healthy Pregnancy in Your 40s

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There is no one perfect time to get pregnant. Many people, though, have often been told that having a baby after you are 35 increases many risks. This might have led you to believe that there are not many people who have babies after this point. However, the truth of the matter is that many people are having babies in their 40s.

If you're pregnant at 41, 43, or older, you may understandably worry about how your age may impact your pregnancy. Luckily, while the risks of complications are lower in your 20s and 30s, you can have a healthy pregnancy in your 40s, particularly if you are otherwise in good health and get regular prenatal care. Learn more about having a healthy pregnancy in your 40s.

How Many People Have Babies in Their 40s?

You might be surprised to learn that not only do women have babies in their 40s, but the rate of people having babies in this decade of life has been on the rise since 1985. In 2018, women between the age of 40 and 45 gave birth at the rate of 11.8 babies for every 1,000 women.

Overall the U.S. birth rate is declining, but this age category is bucking the trend. This means that you are very likely to find other parents your age in your childbirth class, prenatal groups, and parenting circles.

Getting Pregnant in Your 40s

One of the biggest barriers to pregnancy in your 40s is your fertility. Certainly, there are women who have no issues getting pregnant well into their 40s. Though statistically speaking, you are less likely to get pregnant and more likely to need the aid of fertility treatments the older you are when you are trying to conceive.

Your chance of getting pregnant in one year without fertility help in your late 30s is about 60%. This equates to a 13.2% chance of pregnancy in any one cycle for women ages 38 to 39 years compared with 20% in each cycle at age 30 to 31. This pregnancy per cycle rate drops to 6.6% for those up to 44 years. Rates of pregnancy decline significantly with each year, particularly steeply for those who have never had a child.

Fertility Treatment

Fertility treatment means different things for different people. It can mean anything from conceiving while taking oral medications and having regular intercourse to using donor eggs and trying to conceive with in vitro fertilization (IVF).

About one-third of women over 35 will get help from a fertility specialist, and that number increases with age—half of the women trying to conceive in their early 40s will do so. It is also important to note that the age of your partner does impact the health of your pregnancy.

One thing of particular interest will be the supply and quality of your eggs. The number of eggs and the health of said eggs diminishes the older you get. There are tests your doctor can do that can estimate how well your eggs are holding up, and this would be a part of your fertility testing.

In general, after the age of 35, if you have not conceived after 6 months of well-timed intercourse with no birth control, you should seek the help of a fertility specialist.

Staying Pregnant in Your 40s

Every pregnancy carries the risk of miscarriage, and that risk does go up with age. Part of that risk in your 40s is that you are more likely to have a chronic condition at this point in your life than previously.

A chronic condition like diabetes, high blood pressure, or thyroid disease can complicate your pregnancy and potentially increase the risks of miscarriage and pregnancy loss, including stillbirth. This is one of the reasons that preconception care is very important.

By meeting with your practitioner prior to pregnancy, you can minimize these risks by getting a chronic condition under control. You may also have a medication review to see which medications you're taking would be compatible with pregnancy. You may find newer medications to switch to and take time to ensure they work for you before attempting a pregnancy.

Physical Changes During Pregnancy

Pregnancy certainly changes your body. Women who have children both earlier and later in life are quick to note that pregnancy in their 40s was often more physically challenging than it was in their 20s or 30s.

One of the biggest risks to your comfort with a midlife pregnancy will be your overall fitness level. Someone who has been very active and has few daily aches and pains, in general, is more likely to have a fairly normal course with pregnancy-related physical symptoms.

If you are already experiencing the aches and pains commonly associated with midlife, you may find that some of the physical symptoms of a changing pregnant body to be more pronounced.

The good news is that if you are already exercising, there is usually no reason to stop. Prenatal exercise classes can help you have a safe and easy pregnancy. Your doctor or midwife can advise you on what alterations you need to make to your scheduled workouts.

Keep in mind that moving is one way to alleviate the stress and strain of pregnancy on your body. Even if you are new to exercise, you can still reap the benefits. Swimming, walking, and yoga are three things that many practitioners recommend to women who have not been exercising much prior to pregnancy or for women who are having some setbacks in the workout schedules.

Emotional Changes During Pregnancy

Pregnancy alters your emotion via hormones. The mood swings that can accompany pregnancy are well known. This should not be much different due to age. Though, as a more mature woman, you probably have something your younger counterparts do not—the ability to cope with these changes more effectively.

Financial and relationship concerns can lead to emotional irritability during pregnancy. While age is certainly not a cure-all for these woes, with age comes a certain amount of stability. This might mean that some of the stress many young people feel about finding a house or a stable job is something that you may not be dealing with at this stage of the game.

Financial Stability in Your 40s

One of the main reasons women say that they have delayed having children into their 40s is to ensure that they are financially stable. This may mean different things to different people.

Perhaps you had a job that required a lot of travel when you were younger. Maybe you wanted to reach a certain level in your company before you felt like you could have a baby. There might also be a certain level of financial status you wanted to be able to achieve first—a home, a college fund, a certain amount in your retirement account. There are many reasons you may have intentionally delayed childbearing.

Finding other women who are close to your age and are having babies can provide a big benefit. While you may be one of the older mothers in playgroup, you won't be alone. Make friends with other older mothers in addition to other mothers. This will help you have someone to share your unique issues with.

Pregnancy Risks After 40

Pregnancy in your 40s is potentially more complicated. The healthier you are at the beginning, the less likely you are to experience complications. But even healthy women can have complications in pregnancy.

Women pregnant over 40 are more likely to experience:

Women in their 40s also have a higher chance of having multiples, such as twins or triplets. While it may be easy to chalk this up to fertility treatments, there is also a natural increase in the rates of multiple pregnancies, even without using fertility medications or treatments. This is something to keep in mind as you plan for pregnancy.

Talking to your doctor about your medical history and staying on top of your prenatal checkups can minimize some of these risks by allowing them to spot or manage potential complications before they become serious.

Screening for Down Syndrome

Genetic tests are recommended for pregnant women of all ages. However, in your 40s, genetic screening becomes even more prominent. This is because maternal age is one of the key risk factors for Down syndrome.

A 25-year-old woman has a 1 in 1,2000 chance of having a baby with Down syndrome; by age 40, the risk has increased to 1 in 100, according to the National Down Syndrome Society. That number jumps to 1 in 10 by age 49.

Genetic screenings will be offered during your prenatal care appointments. The test results are given in a way that would tell you about the likelihood of your baby being born with a genetic problem in comparison to your age.

For example, your screening results might say that your risk of having a child with Down syndrome is 1 in 200. This would be considered a "negative" result because your actual risk was better than your statistical risk (1 in 100 for a woman at 40).

If your test said you had a 1 in 80 chance of having a baby with Down syndrome, this is considered a "positive" result. This means that your risk of giving birth to a baby with Down syndrome is higher than your statistical risk.

Genetic screening does not say with certainty that your baby has a genetic problem, it merely calculates the risks compared to your age group.

Genetic screening is great because it does not pose any risk to the mother or the baby. It can also help you decide if genetic testing is more appropriate for your family.

Genetic testing provides you with an accurate picture of your baby's genetics and a diagnosis. The trade-off is that there is a potential risk to your baby from amniocentesis or chorionic villus sampling (CVS).

Labor and Birth in Your 40s

With getting pregnant and staying pregnant out of the way, it's time to think about having the baby. The news is similar—labor has a higher risk of being more complicated and resulting in more complications for you. One good bit of news is that if this is not your first baby, the risk of preterm labor and birth is less than a mother having her first baby over 40.

What makes labor and birth more complicated in your 40s is largely your health. A woman who has a chronic condition is more likely to experience complications than a woman who does not. Though chronic conditions are only a piece of the puzzle.

There is some belief that a soon-to-be mother's age and mental state increase the risk of complications during labor, including induction of labor and cesarean section. Specifically, in addition to pregnancy-related complications, you are more likely to be induced because of concern over the continuing pregnancy.

Research also shows that the overall need for cesarean section increases with increasing maternal age. Research shows that the overall rate for a woman is about 32%. This number jumps to 48% for women over 40. This is not to say that you will absolutely be induced or have a cesarean section, but simply that it is more likely.

This is something that you will want to talk to your doctor or midwife about. Finding a practitioner who is experienced in birth with older mothers might be helpful. Your attitude also matters. Using positive pregnancy affirmations can be helpful in reminding yourself about your goals for this pregnancy.

Postpartum Health

The main thing most people are concerned about is the health of the baby. While a baby resulting from pregnancy in your 40s is more likely to have some complications, the good news is that with good care, watchful eyes, and modern technology, the vast majority of these babies are born healthy.

Again, it is important to keep in mind that an increased risk of a complication is not the same thing as having that complication guaranteed.

A Word From Verywell

While there are certainly some challenges to overcome in your 40s when it comes to getting pregnant and having a baby, you are not alone. The number of women who are having babies at this age is increasing. With proper prenatal care, the chances of you having a healthy baby are still great. Take that to heart and enjoy your pregnancy as much as you can.

7 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • Bayrampour H, Heaman M, Duncan KA, Tough S. Advanced maternal age and risk perception: a qualitative study. BMC Pregnancy Childbirth. 2012 Sep 19;12:100. doi: 10.1186/1471-2393-12-100.
  • Lisonkova, S., Potts, J., Muraca, G. M., Razaz, N., Sabr, Y., Chan, W.-S., & Kramer, M. S. (2017). Maternal age and severe maternal morbidity: A population-based retrospective cohort study. PLoS Medicine, 14(5), e1002307. http://doi.org/10.1371/journal.pmed.1002307
  • Lisonkova S, Janssen PA, Sheps SB, Lee SK, Dahlgren L. The effect of maternal age on adverse birth outcomes: does parity matter? J Obstet Gynaecol Can. 2010 Jun;32(6):541-8.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.