Health Risks Associated With Having a Baby at 40 and Older

An older pregnant woman drinking a hot drink

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If you're considering having a baby in your 40s, you’re not alone. Data from the CDC and National Center for Health Statistics shows the number of parents having babies in their 40s is at an all-time high.

Having a baby in your 40s has some perks, like more financial stability. However, having a baby after 40 increases health risks for both you and your baby. It can also be more challenging to get pregnant after 40.

Thankfully, research shows good prenatal care can mitigate some of the risks associated with getting pregnant later in life. 

Challenges Getting Pregnant

Getting pregnant and staying pregnant after 40 can be difficult. Here are some of the challenges:

  • People born with ovaries have a limited supply of eggs at birth, and that supply dwindles considerably after 35.
  • As you age, your eggs are also more prone to genetic abnormalities
  • Older people are more likely to deal with disorders affecting fertility, like endometriosis or uterine fibroids.
  • Studies show your risk of miscarriage is about 10% in your 20s, and your risk goes up to 53% in your 40s. 
  • After 45, fertility has also declined to a point where it's unlikely you'll get pregnant naturally.    

If you want to get pregnant after 40, the American College of Obstetricians and Gynecologists (ACOG) recommends seeing a healthcare provider before you get pregnant to assess your fertility and health risks.

If you have trouble conceiving naturally, or you have age-related infertility, there are other fertility options to start or extend your family, including: 

  • Fertility medications that can help induce ovulation, such as Clomid
  • Intrauterine insemination (IUI), or artificial insemination
  • Assisted reproductive technology (ART), such as in vitro fertilization (IVF)
  • IVF using donor eggs (eggs from another person) or embryos 
  • Surrogacy or gestational carriers

As you get older, the success rates of methods like IVF also begin to decline. According to ACOG, people aged 41-42 have a 12% chance of achieving a live birth via IVF, and people aged 43-44 have a 5% chance. However, using a donor egg from a younger donor can substantially increase the chances of a successful IVF cycle — with a 51% IVF success rate.

Age-Related Pregnancy Risks

If you're able to get pregnant, a pregnancy after 40 increases your risk of complications like gestational diabetes, gestational hypertension (high blood pressure during pregnancy), and preeclampsia. 

A 2016 study found 8.5% of pregnant people over 40 developed gestational diabetes — more than double the risk compared to people under 35. People with gestational diabetes are more likely to deal with low blood sugar, delivering a large baby via cesarean section, and high blood pressure.

Gestational diabetes and high blood pressure also increase your risk of developing preeclampsia, a high blood pressure disorder that can lead to life-threatening complications for the birth parent and baby.

Fortunately, many of these risks can be mitigated. A 2015 study found older pregnant people who had proper prenatal care did not have significantly different pregnancy outcomes compared to those under 40.

Prenatal care included:

  • Treating any underlying medical conditions
  • Attending regular prenatal checkups
  • Adopting a healthy lifestyle during pregnancy
  • Giving birth in a perinatal center

Childbirth Over 40

Pregnant people over 40 are more likely to give birth prematurely or need a C-section. Since a C-section is major surgery, it often comes with a slower recovery time for the birthing parent. While rare, having a C-section can also increase your risk of blood loss, infection, or blood clots.

However, giving birth after 40 doesn't guarantee you'll have childbirth complications. A 2016 study found about 17% of older pregnant people have C-sections and only 1 in a thousand had a preterm birth. Again, the same research shows that older parents who have consistent prenatal care, and younger parents, have similar birth outcomes.

Additional risk factors also influence your personal risk of childbirth complications in your 40s. The risk of C-section and preterm delivery increases substantially in people over 43 who use IVF and carry twins. Since people over 40 are less likely to get pregnant naturally, many use IVF to get pregnant, which can also result in multiples. 

How many children you've birthed may also affect your childbirth risks after 40. Older parents who have already given birth may be more likely to have C-sections than younger birthing parents with children. However, people having their first baby after 40 are more likely to have a C-section than older parents who have already given birth. Having a past C-section, C-section popularity in certain regions, and hospital practices can also increase your risk of having a C-section at any age. 

Babies Born to Older Parents

Babies born to parents over 40 have a higher risk of genetic conditions like Down syndrome. Children may also face health issues related to an increased risk of premature birth, fetal growth restriction (slower growth during gestation), and fetal macrosomia (high birth weight). However, keep in mind that being at a high-risk age does not mean you can't have a healthy baby. 

According to ACOG, Down syndrome (Trisomy 21) is the most common chromosomal condition associated with older birthing parents. When you're in your 20s, your chances of having a baby with Down syndrome is 1 in 1,480. That risk increases to 1 in 85 when you are 40 and to 1 in 35 after you've turned 45. Aging eggs may increase this risk since they are more prone to chromosomal abnormalities.

These days, preterm babies have an increased likelihood of surviving and going on to live healthy lives. However, premature babies are more likely to have breathing issues, feeding problems, cerebral palsy, developmental delays, hearing issues, and vision problems.

Research has shown older parents have a 17.4% chance of having a baby with fetal growth restriction and a 15.4% chance of high birth weight. Babies with fetal growth restriction are also more likely to deal with respiratory issues, eye development issues, and increased vulnerability to infections. Being born with a higher-than-normal birth weight (more than 9 pounds) can lead to complicated births that result in injury or trauma to the birthing parent and baby. Large babies are also more likely to be delivered via a C-section. 

Where To Go From Here

It may feel overwhelming sifting through the risks of having a baby after 40. Having a baby later in life does increase your risk of complications like preterm birth, C-section, gestational diabetes, and high blood pressure, but many people have healthy babies and pregnancies after 40. Everyone's individual risk and pregnancy is unique, and having a baby after 40 doesn't mean you'll automatically encounter health problems. 

Although it may be challenging to get pregnant after 40 in the first place, advancements in reproductive technology like IVF and using egg donors or surrogacy can help make pregnancy and childbirth possible for older parents.

If you're ready to get pregnant after 40, reach out to your healthcare provider before you start trying. The sooner you begin receiving care and preparing for pregnancy after 40, the better your outcome of having a healthy pregnancy and baby. 

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