It’s not too late at 40, but there are nuances: the dangers of late childbirth

Now childbirth after 35 years is considered late, and the increase in their number is a trend of recent decades. Is it good or bad to give birth after 30? On the one hand, pregnancy and childbirth is a natural process programmed by nature, on the other hand, it places increased demands on a woman’s body.

Age makes itself felt
All its organs and systems increase their work by 20-45%. For example, the heart of the expectant mother pumps 1.5–2 million liters of blood during 40 weeks of pregnancy. The body is able to cope with such loads, but in a situation where the first birth of a woman falls at the age of over 35 years, all sorts of problems arise more often. For example, disorders in the work of the placenta (placental insufficiency), due to which the baby is experiencing a lack of oxygen (hypoxia); failures in the development of labor activity when contractions become weak, ineffective; overgrowth of pregnancy; injuries (ruptures) of the soft birth canal of the expectant mother due to a decrease in tissue elasticity; premature birth; inflammatory complications after them due to age-related decreased immunity and chronic problems, including gynecological (fibroids, inflammation of appendages) and infectious (chlamydia, mycoplasmosis).

In 30-35% of cases for expectant mothers over 35 years of age, the first birth ends with a caesarean section. This is partly due to the fact that with the appearance of problems, such as weak contractions, surgery will be a safer solution than using stimulant drugs and generally any medical treatments that can aggravate a woman’s chronic diseases.

That’s why women over 35 need to plan their first pregnancy: it is recommended to undergo an examination in advance to identify possible risks. Then it is important not to make a mistake in choosing a women’s consultation for its management. It is desirable that local doctors already have such experience and do not consider late pregnancy and then childbirth a problem.

What should be considered when choosing a maternity hospital?
It is better if its level is high (as, for example, in perinatal centers and clinics): you will be guaranteed the attention of specialists of different specialties who can help in case of exacerbation of chronic problems (cardiologists, urologists, etc.). Preferably, the availability of round-the-clock ultrasound diagnostics, boxes equipped with «maternal» heart monitors (measuring the pulse, the pressure of the expectant mother) and, finally, the children’s intensive care unit. It is very important that the doctor leading the delivery is experienced enough to correctly assess the situation and with the appearance of problems during childbirth, do not delay the decision to send a woman for surgery.

But do not think that the first pregnancy for women over 35 is a continuous test. There are many chances that it will proceed quite normally, without complications. And pregnancy hormones, especially estrogens, rejuvenate the body, tone muscle tissues, give them elasticity, strengthen the bone system, reduce cholesterol levels and the risk of hypertension.

For the successful development of childbirth, the most important thing is not the age of the expectant mother, but the state of her health. Comparing women on these indicators does not always go in favor of the young.

It's not too late at 40, but there are nuances: the dangers of late childbirth

You can give birth without a caesarean
Of course, it is known that there are problems that mature expectant mothers face more often than others: for example, the hormonal readiness of the body really becomes lower with age, which makes childbirth more difficult; it becomes more difficult to push, because the elasticity of muscles and ligaments is no longer so high; hypertension, joint problems appear more often against the background of pregnancy and the spine. And yet these and many other «signs of age» for doctors are not a reason to immediately send a woman to a planned cesarean section, even if we are talking about the first birth, despite the fact that in practice in this situation, an «operational» decision is made more often than when it comes to the second birth, even if it follows with a large a break.

There must be good reasons for referral to surgery: the expectant mother’s pelvis is too narrow, a large baby, weak contractions. If there are no such problems and the mother is set up for natural childbirth, everything is possible.

Inner determination plays a big role in this matter.

Out of the whole list of possible (but not mandatory) problems that they may encounter, those that do not arise during childbirth are more difficult to solve. It’s easier to prevent them. For this reason, such expectant mothers need more attention from specialists. It is desirable that obstetricians and gynecologists who have already had such experience, and a lot, should be engaged in the management of late pregnancy. For example, many reproductive centers now have offices that specialize in monitoring women from the «risk group». There is an opportunity to conduct more in-depth studies (for example, the blood clotting system), which are not provided for by the standard program of women’s consultations. Expectant mothers also need to be more attentive to themselves: follow the prescribed schedule of examinations and take tests on time.

It will not be superfluous
During pregnancy, expectant mothers over 35 should visit a doctor more often: in the first half — at least 2 times a month, and after the 30th week – 1 time every 7 days. There is no need to be surprised by the expanded list of mandatory consultations and examinations: a visit to a geneticist, hormonal tests, studies of the blood coagulation system. All these measures will help prevent problems that, as we know from medical experience, may appear in patients with age.

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