It is not uncommon for women these days to think about starting a family at a later age. Busy lives, booming careers and a variety of hobbies now mean people get married a little later in life.
A concern many women have is about getting pregnant later in life, particularly in the late 30’s. Many are aware there is a bit of a risk, but there is a lot of false information floating around.
I spoke with Dr Aruna Muralidhar, a reputed obstetrician and gynaecologist in Bangalore, who was kind enough to answer some of the commonly asked questions regarding this aspect of pregnancy.
Over to Dr Aruna.
Is It Okay To Postpone Pregnancy?
Embarking on a pregnancy in late thirties is becoming common for various reasons such as, finding a partner late, career stabilisation etc.
Many concerns may arise in one’s mind when considering delaying pregnancy. Am I likely to have some difficulty in falling pregnant? Am I more likely to have a miscarriage? Will the baby be okay? Are there any risks that I can avert? Will it be a high risk pregnancy? Will I have a cesarean section invariably? The list goes on….
With people around you painting a negative picture, it is but natural to feel gloomy. However, it is not true that all odds are stacked against you.
Is It Difficult To Fall Pregnant In Late Thirties?
Most women in their late thirties with regular cycles have about 25% chances of conceiving per cycle.
The most important factor seems to be hitting the bull’s eye at the time of ovulation which is a window of about 6 days (5 days prior to ovulation and a day after ovulation).
However, getting stressed about finding when one has ovulated is not going to help. Enjoying regular sex and increasing the frequency during the fertile days of 10-15th day would certainly help increase the chances of a conception.
About 70-80% women fall pregnant in their first year of trying without protection.
Should I Consult A Doctor Before Pregnancy?
Preconceptional counselling is extremely important for someone considering pregnancy especially so, if in late thirties.
It involves the following:
1. Folic acid tablets to prevent neural tube defects (defects in the brain and spine) in the baby. Ideally, the tablets have to be taken at least one month prior to conceiving.
2. Screen for any pre-existing conditions and optimise control such as hypothyroidism (underactive thyroid gland) etc.
3. Vaccinations for certain infections such as Rubella ( German measles) etc.
4. Advice regarding balanced and regular meals.
5. Focus on fitness and improving core muscle strength
6. Advice about avoiding smoking (both active and passive), alcohol and drugs
Is It Likely That My Pregnancy Will Be At A Higher Risk?
Although there are concerns that there is a higher chance of pregnancy complications, they seem to be related to pre-existing conditions rather than increased age alone.
In other words, it is not just the age that matters, but also your general health as well.
There are some important aspects to consider in a pregnant woman over 35 years of age.
Some clinical studies say that there may be a higher risk of miscarriages (general population about 1 in 4). However this may be related to other factors such as obesity, stress, and other pre-existing conditions.
Baseline parameters such as weight, BMI, BP etc are checked and some routine blood tests are advised. These parameters will help decide the frequency of visits during pregnancy and the need for any additional tests during pregnancy.
In advanced age, certain tests will be performed at the third month in order to determine the risk of the baby having a chromosomal abnormality like Down’s syndrome.
Also, screening for risks like development of hypertension in pregnancy and small babies is done.
Otherwise, the course of the pregnancy will be managed similar to a younger woman.
There is some evidence to say that woman over the age of 35 is more likely to have a cesarean section but this is not a certainty due to other contributing issues such as obesity.
Pregnancy And Work
Depending on the type and place of work that the woman does, appropriate advice is given regarding certain issues like avoiding exposure to harmful chemicals/ radiation etc.
Also, certain ergonomic and commute-related advice may be given.
But in general, the woman is encouraged to be as physically active as possible. There is no reason to avoid work or the commute if all is normal.
Informing your boss/ manager / colleagues can be done once the pregnancy is confirmed and the scan shows a normally developing fetus. There are advantages of informing early as everyone would be more accommodating and considerate.
In general, work may be continued until the last few weeks of pregnancy as long as the woman is able to manage and there are no concerns with the pregnancy. However, stress of any kind is to be avoided.
Pregnancy in the late thirties is certainly more common and can be managed with appropriate care just before and during pregnancy.
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