How to Prepare for Pregnancy After 40

Many women decide to have children later in life, but pregnancy after 40 can pose additional risks and complications to the mother and baby. Although a healthy pregnancy after 40 is very likely, preparing yourself before you become pregnant can help you get your body in optimum condition for a successful pregnancy. Women who want to conceive after 40 also need to prepare for a higher risk of complications during the birth, difficulty conceiving, and the greater likelihood that their babies may experience Down syndrome or other chromosomal birth defects.

·        Schedule a physical or pre-conception consultation with your primary caregiver or gynecologist. 

As people age, the likelihood of suffering from common health conditions such as high blood pressure and diabetes increases, and older women may also be more likely to have conditions that impair fertility such as polycystic ovary syndrome or endometriosis. A doctor can help you identify health problems.

·         Make sure you tell your doctor you want to conceive. Ask for a realistic time frame in which you can resolve or manage any existing health issues before trying to conceive.

·         Discuss whether you will be able to continue using any medications you are currently taking while you try to conceive and while pregnant or breastfeeding. Ask your doctor about alternate therapies or medications safe during pregnancy, and be realistic about whether you can manage your health problems without medication if that is the only option for a safe pregnancy.

·         Evaluate with your doctor which health problems are most important for you to address before pregnancy. Because fertility begins to decline after 35 years in most women, many women preparing for pregnancy after 40 are balancing the need to manage health problems with a rapidly diminishing fertile period.

·         Get any immunizations your doctor recommends. Your doctor may perform blood work to check for immunity to diseases such as rubella and chickenpox--wait 1 month to try conceiving after you get a vaccine.

·        Manage any existing health problems before conceiving. 

Health issues that have a mild effect on your everyday life currently may become major complications once you are pregnant. For example, unmanaged diabetes can greatly increase your risk for miscarriage and moderate high blood pressure can quickly worsen.

·         Get treatment for sexually transmitted infections and diseases immediately as these can lead to infertility.

·         Work on getting to a healthy weight. Overweight and underweight can both cause significant problems while pregnant or trying to conceive. For example, women with unhealthily low weights can have anovulatory cycles making it impossible for them to conceive.

·        Improve your nutrition. 

Good nutrition is especially important during the preconception period as healthy levels of folic acid and other vitamins can help prevent certain birth defects.

·         Although vitamin supplements are available, try to increase your intake of foods naturally containing folate including citrus fruit, legumes, and dark leafy greens. Folate can help prevent anemia and birth defects.

·         Eat whole grain, complex carbohydrates and cut down on the amount of refined carbohydrates you consume.

·         Get protein from lean meats and fatty fish rich in omega-3 such as salmon, eggs, and low-fat dairy.

·        Reduce the amount of sugar you eat.

Begin exercising or increase your activity level. 

Exercise can help you maintain a healthy weight and may allow you to have a more comfortable pregnancy and labor.

·         Include both aerobic and resistance training in your exercise program.

·        Stop smoking and avoid secondhand smoke. 

Smoking can lower fertility, even leading to early menopause, and causes a number of complications during pregnancy such as low birth weight and increased rates of respiratory distress in infants.

·         Talk to your partner about quitting-secondhand smoke is also harmful, and men who smoke have lower fertility than their non-smoking counterparts.

·        Consider the risk of chromosomal birth defects. 

Although many older women have healthy pregnancies, the reality is that the rate of chromosomal birth defects is much higher in infants born to women over 40. One out of 100 women who are 40 years old will have a baby with Down syndrome, and the risk increases with age, rising to 1 in 30 women at age 45.

·         Discuss the possibility of birth defects with your partner and/or family. Decide whether you want to take the risk, and plan out how you would cope with a diagnosis.

·         Research the additional diagnostic tests available during pregnancy. You may be interested in amniocentesis or chronic villus sampling (CVS), but both tests do carry a slight risk for miscarriage.

·        Take into account the higher rate of pregnancy loss. 

The estimated miscarriage rate for women between 40 and 45 is 35 percent and this rises to over 50 percent for women over 45. Older women also experience a rate of stillbirth 2 to 3 times higher than that for women in their 20s. Stillbirth is death of the fetus after 20 weeks. Evaluate whether you feel emotionally prepared to experience pregnancy loss, possibly multiple times, while trying to have a baby.

·        Make an appointment with a genetic counselor. 

If you are especially concerned with the risk for birth defects or other health problems for the infant, a genetic counselor can help you assess the likelihood of problems.

·         Gather together information on maternal and paternal family members including any illnesses, health conditions or reproductive issues. The counselor will review your family history as part of the assessment.

·        Follow up with your doctor while trying to conceive. 

Since the probability of fertility problems is so much higher for women over 40, you should consult a doctor if you do not conceive within 6 months of trying to conceive. Waiting longer may diminish your chances of conceiving, as your fertility may be declining and alternate treatments also become less successful as you age.