Pregnancy Challenges and Risks When You're Over 45

Pregnancy over 45 is still relatively rare, but women in this age group are becoming mothers more than ever before. Even though medical science can't undo the effects of aging, fertility treatments are still available to help women in their 40s achieve their dreams of motherhood.

Menopause and Fertility

The average age of menopause is 51 years old. However, it is important to keep in mind that no two women are exactly alike and natural menopause can actually occur anywhere between the ages of 40 and 58. While getting pregnant after 45 is unlikely, it is still a possibility even without the use of fertility treatments.

Menopause and Unintended Pregnancies

Menopause is not considered complete until you've gone a full 12 months without menstruating. If you are sexually active and have not finished menopause, you still need to use birth control if you do not want to become pregnant. Data on unplanned pregnancy rates among older women has found that 48 percent of pregnancies among women age 40 and older were unintended. Many of these women incorrectly assumed that the early signs of menopause indicated they were too old to become pregnant.

Family Planning Considerations

Even though pregnancy at 45 is rare, there are many reasons a woman might want to have a baby at this age. Some women spent their 20s and 30s building a career, while others simply never met the right person until their 40s. It is also common for women to want to have a child if they have remarried after divorce. Questions you should ask yourself if you're considering trying to get pregnant include:

• What type of maternity coverage does your health insurance offer? Older women often have pregnancy complications that may require expensive medical care.
• How do you feel about fertility treatments? Unfortunately, chances are very low that you will conceive with your own eggs. IVF with donor eggs is the most common way to conceive over age 45.
• Do you feel financially able to raise a child? Can you handle the expense of a baby and manage to save for retirement?
• Do you feel like you will be able to physically keep up with the demands of raising a child? Can you see yourself having the energy to play sports with a teenager?
• Have you thought about what would happen if you became seriously ill while your child was still at home?
• Do you have a strong support system in place? How will you handle questions or concerns from friends and family members regarding your age?

Managing the Risks for Pregnancy Over 45

For older mothers, pregnancy does carry some potential risks. If you are considering trying to conceive, it is important that you are aware of these factors.

Potential Risk Factors

For a woman in her mid-forties:

• Half of pregnancies for women over age 45 end in miscarriage.
• You are more likely to have a cesarean birth due to the increase in potential complications.
• You have a greater risk of developing gestational diabetes.
• You have an increased chance of developing high blood pressure.
• The risk of having a baby with Down Syndrome rises to 1 in 35 at age 45. Other genetic defects become more prevalent as well.

Reduce Your Risks

To reduce the pregnancy risks associated with advanced maternal age, doctors recommend:

• Eating a well-balanced diet
• Getting regular exercise
• Maintaining a healthy body weight
• Abstaining from alcohol
• Not smoking

If You Desire Pregnancy

If you are trying to become pregnant, your doctor can provide you with more specific information after evaluating your general health and family medical history. He can also refer you to a fertility specialist who will discuss the fertility treatment options that are available to you.