Many couples are nowadays choosing to start their families a little later in life. In the past decade or two we have seen the profile of women having children gradually shift from an average age of 26 to 28, to between 30 and 32 years, and in quite a few instances beyond the age of 35,” observes Dr Gerhard Dempers, a gynaecologist and obstetrician practising at Netcare Femina Hospital in Pretoria.
According to Dr Dempers, every pregnancy requires care and monitoring, even more so for mothers over the age of 30 and especially over 35 years of age. While opting to have a baby later in life can hold many benefits, it can also pose some risks and the pregnancy therefore requires even greater care and careful planning.
“Fortunately, medical science has evolved and there is now also more information available that not only helps women over the age of 35 to make a more informed decision about having children, but also protects her from some of the dangers with which older mothers may be faced,” he adds.
One of the more significant issues to consider in opting for a later pregnancy is the decreasing possibility of falling pregnant. “Fertility starts to decrease in women in their thirties for several reasons. Firstly and most notably, women over 35 tend to ovulate less frequently than younger women, meaning that their chances of conception can be reduced.”
Some of the problems that contribute to infertility, particularly in older women, include endometriosis where the endometrial cells grow or fuse abnormally, blocked fallopian tubes and fibroids which are benign ovarian tumours.”
“Most of the time this decrease in fertility simply means that it may take women over 35 a little longer to conceive. Fertility treatments are also available, making pregnancy over 35 a possibility for most women,” notes Dr Dempers.
So while falling pregnant is not always a major obstacle for older women, there are some risks that need to be taken into account. “Women over 35 are somewhat more susceptible to miscarriage, premature birth and stillbirth, as well as other pregnancy related complications such as gestational diabetes. Gestational diabetes is a condition that may manifest in pregnant women who were previously undiagnosed with diabetes. This condition could lead to birth complications but can be treated.”
“There is also a greater risk of pregnancy-induced hypertension, which can be dangerous to the foetus. This condition should be closely monitored and it is advisable to choose a facility with neonatal intensive care facilities for giving birth, in case your baby is born prematurely or needs specialised care in case of complications,” says Dr Dempers.
“It is important to remember that the health of the woman in question will greatly impact the success of her pregnancy. Women who smoke, drink excessively, take prescription medicine on a regular basis or suffer from obesity are unfortunately more likely to encounter difficulties during pregnancy.”
“What all this means is that women over 35 have to take more precautions than their younger counterparts and one of the best ways to determine your risks is through careful medical screening,” explains Dr Dempers.
“All women should undergo a screening test at 12 weeks along with nucal fold thickness and blood tests, whereby the risks of birth defects and complications can be determined. If the tests show that your baby is at high risk of having chromosomal birth defects the next step would be to have an amniocentesis, which is a diagnostic birth defect test. It is worth remembering that such a test could leave expectant parents with the tremendously difficult choice of having to decide whether or not to terminate the pregnancy. It is therefore wise to carefully consider this difficult choice even before undergoing an amniocentesis.”
“Fastidious antenatal care is important for all pregnant women but especially for over 35s. Your doctor will tell you exactly what you need to do to optimise your chance of a healthy pregnancy.I If you follow advice closely it should be a fairly normal pregnancy and delivery.”
“While there are some extra precautions one needs to take when having children later in life, there are also some great advantages to being slightly older parents. By having a child when you have established your career and are financially more stable, you reduce a lot of the pressure and stress that is commonly experienced by younger mothers, enabling you to enjoy your pregnancy and your child even more.”
“Mothers in their twenties and early thirties sometimes feel overwhelmed and mentally under-prepared when their babies arrive in the world. It is also often the case that younger mothers feel like they’ve missed out on a part of their lives that they can never get back. Being older, you have already achieved many of your life goals and will probably feel far more confident and content in settling down with children.”
As with most big decisions in life, it is worthwhile weighing up the pros and cons carefully when considering whether to embark on the journey to parenthood,” concludes Dr Dempers.
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Femina Hospital
Contact : Martina Nicholson, Graeme Swinney, Meggan Saville and Pieter Rossouw
Telephone: (011) 469 3016
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