If a woman gives birth before the age of 35. - How to reduce the risks of infant mortality? "If it hurts to give birth, they'll give you anesthesia."

20.09.2019

1 year ago

Angelina Jolie gave birth to her children after 30 years. Daughter Shyla - at 31. And twins Knox and Vivien - at 33.

At what age do experts consider critical for pregnancy and why is it better to give birth before 35? Obstetrician-gynecologist of the Clinical Hospital Lapino "Mother and Child" Elena Silantieva told what risks are possible with late pregnancy.

Elena Silantieva Obstetrician-gynecologist, Deputy Chief Physician for Rehabilitation of the Clinical Hospital Lapino "Mother and Child"

The period of maximum reproductive activity of a woman is limited to 35 years. According to statistics, at 35 you can get pregnant just as easily as at 25. But after 35, the probability of conceiving a child drops sharply and after 40 becomes critically small. That is why women are advised to get pregnant before 35. Of course, there are also positive stories. For example, there were 15 births in Lapino yesterday. Of these, 3 - in women over 40. Moreover, all childbirth was repeated and natural. But risks also appear with age. I talk about them in the material.

Diseases that manifest with age

Closer to the age of 40, women often develop hypertension, cholelithiasis, and varicose veins. All of them can cause complications during pregnancy. From this point of view, giving birth late is not very good. Let me give you an example.

A patient came to me today, she is 43 years old. After several unsuccessful IVFs, she tried to cure infertility for 6 years. Finally, she decided to use donor oocytes (eggs), pregnancy began, and at 16-18 weeks it became obvious that the fetus was lagging behind in development. It turned out that the patient sometimes has hypertensive crises: the pressure rises once a month, she takes a pill and considers herself a healthy woman. During pregnancy, the pressure also rose, but she did not pay attention. Against the background of mild hypertension, a severe pathology developed - preeclampsia.

As a result - a pre-stroke state and termination of pregnancy in order to save the woman. During the next pregnancy, her pressure was regulated, the work of the kidneys and liver was tightly controlled, and she gave birth to a baby.

The story that a seemingly insignificant disease at the age of 43 can "come back to haunt" in pregnancy. You need to know all your illnesses and be sure to report them to the doctor.

In February, singer Shakira turned 40. She gave birth to her first son Milan at 36 years old, the second Sasha at 38.

Early ovarian wasting syndrome

At the beginning of the article, I said that childbirth before 35 does not differ from childbirth at 25. Adjusted for one fact. Now the ovarian wasting syndrome is "getting younger." may occur at the age of 30-35 (the normal variant is 45-55). Previously, such cases were considered incidents, now there are more of them - the influence of chronic stress, autoimmune diseases. But this is a completely unexplored story - none of the theories fully explains this phenomenon.

If you are planning to give birth after 35

There is such a deception of fate - the technology of delayed fertility. At the age of 20-25, a woman can freeze (vitrify) eggs in order to use them in the distant future, when she is about to give birth. This is a popular procedure in the United States. The earlier vitrification of oocytes (oocytes) is done, the better they will be.

Mila Jovovich gave birth to her first daughter, Ever, at the age of 32, and the youngest, Dashiel, was only 2 years old. At the time of her birth, Mila was 39.

For example, young people in Western Europe believe that the time for the birth of children occurs after 30-35 years, without thinking about the existing risks. If girls in their youth froze their eggs, this would be a guarantee of their reproductive future. However, there is another side of the coin - the procedure involves hormonal therapy, and this is not a harmless intake of vitamins.

By the way, a similar method is used if a woman is diagnosed with cancer in order to maintain her fertility after chemotherapy and radiation therapy. Many children have already been born in Russia in this way. This is a reality, in contrast to the situation with stem cells, the range of clinical applications of which is much already expected (but they are used in the treatment of leukemia, and this is still a socially significant story!).

If you have a couple

A logical option is cryopreservation (freezing) of the embryo. But there is an ethical point here. In some countries like Germany and Italy, this is prohibited, because the embryo, unlike the egg, is considered an organism. The advantage of this procedure is that embryos are “thawed” in 100% of cases. There is statistics that with the transfer of cryoembrins, the frequency of pregnancy after IVF is higher.

Genetic abnormalities in the fetus

The higher the woman's age, the greater the threat of having a child with genetic disabilities. And the likelihood of a miscarriage increases.

This is true after 40 in the same way as ovarian depletion. But it happens that a girl waits until she turns 30, then at 33 she starts planning, after a year she realizes that she is not working and begins to get treatment, falling into a “gray zone” with reduced fertility.

Second and subsequent childbirth

This year, Beyoncé gave birth to twins Sir and Rami. And the eldest daughter, Blue Ivy, is 5 years old, the singer gave birth to her at 30.

The same mechanisms work here. Second and subsequent pregnancies after 35 are safer, although risks remain.

Childbirth itself is the least vulnerable part of this story, but there is a threat of premature birth (age-related difficulties with hormonal support), weakness and discoordination of labor in women of age.

Similar materials from the rubric

Modern age tendencies of women in labor are divided into two parts. On the one hand, there are more and more very young mothers who decide to give birth to their first child at the age of 17-18, while earlier this was not welcomed. On the other hand, women are increasingly at risk of giving birth to a baby after 35 years. Let's figure out how safe childbirth after 35 is and what doctors say about it.

35 - is it late or not?

Just twenty years ago, pregnant women over the age of 25, when registering with an antenatal clinic, were marked “old-born” on their card. A few years later, this age began to be considered almost the most optimal for the birth of a child, and thirty-year-old pregnant women began to be called old-born. At this time, in Western countries, women after forty were safely giving birth to their first-borns.

Madonna and Kim Bassinger gave birth to their first child at almost forty-two years old, and John Travolta's wife gave the joy of fatherhood for the third time when she was 48 years old! With the development of domestic medicine, childbirth after forty has become quite commonplace in our country. Women who are pregnant with their first child at the age of 35 are now called “age-old first-borns”, and the term “old-born” is no longer used.

The tendency to give birth to a child at a more conscious age, which gradually came from the West to us, has led to the fact that over the past thirty years the number of women who dared to give birth to a baby after 40 has grown by almost 90%. At this age, the decision to become a mother is very conscious and responsible. Many women have already been able to achieve certain career success and high social status by this age. They can afford to pamper the baby, buy him expensive things and toys, and later help in diversified development and give a good education. In addition, at this age, a woman perceives the birth of a child in a completely different way from an emotional point of view. She gives birth to a child not because it just "happened" or all her friends have already had children, but because she is ready and really wants to give her love and warmth to the little man.

There are other reasons due to which the birth of a child is postponed to a later age. Among them, unfortunately, the main one is the health problems existing in many young women. The percentage of girls suffering from infertility is increasing every year. And his treatment can take from 2 to 10 years! And not always, after long-term treatment, such women manage to safely bear a child from the very first pregnancy. Therefore, it turns out that only by the age of 30-35 they can finally become mothers.

When you can show your newborn to friends and family

The desire to have a child after 35 is often found in women who have re-created a family at this age. They really want to have a common child with a loved one, which will help to further strengthen the relationship.

So, if the decision on motherhood has been made, where to start and what to pay special attention to?

Physiological features

Unfortunately, often by the age of 35, a woman has already acquired a number of chronic diseases.

Therefore, at the stage of pregnancy planning, she should definitely consult a doctor, pass all the necessary tests and undergo examinations, including from narrow specialists.

The body of a twenty-year-old mother has a significantly greater resistance and degree of health than the body of a thirty-five-year-old woman. In addition, medical statistics indicate a greater risk of giving birth to babies with congenital abnormalities, including genetic disorders, in older mothers. This is due to the fact that with age, the chromosomes are more and more influenced by frequent illnesses, toxins accumulated by the body, internal viral infections, and frequently used drugs.

Muscle tone in women after 35 years of age is weaker, and the musculoskeletal system often has dysfunction, which can also cause complications during pregnancy or childbirth. However, with proper preparation for pregnancy, adherence to dietary rules and performing the necessary physical exercises, all these problems can be minimized or even completely avoided. In addition, medicine does not stand still, the level of early diagnosis of abnormalities and pathologies in the fetus is sufficiently developed, which helps to take the necessary measures in a timely manner.

Possibility of conception

After 35 years, reproductive functions in women are weakened, so it becomes very difficult to get pregnant at this age. The life span of the egg is shortened, due to which the likelihood of its fertilization is sharply reduced. About half of the fertilized eggs die in the very early period, which the woman often does not even suspect. If, after a year or two active attempts at fertilization, pregnancy still does not occur, a woman should seek help from a doctor who will help identify the causes of the problem and advise ways to resolve it.

Why after the birth of a child for many women the husband becomes a stranger

Pregnancy

Pregnant women over 35 years old are on special account in antenatal clinics. This is because they are more likely to have complications, such as placental abruption, premature miscarriages, problems during childbirth.

It is very important to prepare for pregnancy in advance by getting rid of bad habits: smoking, drinking alcohol or drugs, addiction to caffeine. Even before conception, a woman should normalize her weight, establish proper nutrition.

In the first three months of pregnancy, the main organs are formed in the fetus. Therefore, any disease or unnecessary stress on the female body can lead to a disruption in the functionality of the baby's life support systems. At the same time, with the onset of pregnancy, all chronic diseases present in the body can manifest themselves. And the use of medications can greatly harm an unborn child. Therefore, a few months before the planned conception, a woman should carefully treat all the diseases in her history.

Women with late pregnancy should not neglect the recommended examinations, since it is with the help of ultrasound and other modern methods of early diagnosis carried out in the first trimester of pregnancy that it is possible to identify existing fetal health anomalies, determine the presence of genetic abnormalities, and assess the level of embryo development.

Late pregnancy does not at all mean mandatory medical procedures or the use of drugs. If the daily routine recommended by the doctor is fulfilled, there is no stress, full and regular nutrition, the refusal of bad habits, it is quite possible for a woman after 35 years to safely endure and give birth to such a desired baby. And the existing experience, the ability to cope with non-standard situations, worldly wisdom will become the best helpers at the same time.

Doctors note that women with late pregnancy are much more responsible for their health and doctor's prescriptions. In addition, at this age, parents can devote much more time and attention to the baby. Mothers who become pregnant after 35 years become calmer and more peaceful, less prone to postpartum depression, and often even become more attentive and sensitive to older children.

Well, and the most important argument in favor of late pregnancy is that it rejuvenates the mother's body.

Intensive production of estrogen and other hormones helps to increase muscle tone, elasticity of the ligaments, and normalize blood pressure.

In addition, under the influence of "pregnancy hormones", women undergo mastopathy, and breast fibroadenoma resolves, which quite often develops with age.

I don’t want a husband or how general frigidity covers after childbirth

Childbirth

Late childbirth can cause a number of complications, and therefore should be carried out in a medical institution under the supervision of an experienced doctor. Despite the large number of newfangled methods of delivery, such as water birth, home birth, ball birth and others, a pregnant woman should not risk her health and her baby's health. Since, according to medical statistics, the likelihood of acute fetal hypoxia, lack of amniotic fluid, weak labor in such women in labor is much higher, you should be prepared for the fact that a woman will need urgent surgical assistance during childbirth.

Natural childbirth is considered more beneficial for both the baby and the mother. However, during late childbirth in women after 35 years, fetal asphyxia occurs 7 times more often than in twenty-year-old mothers, which requires immediate surgical intervention. At this age, the ligaments become less elastic, the muscles weaken and lose their tone, therefore, at the final stage of delivery, the failure of labor is possible, which, in turn, causes a threat to the life of the newborn due to hypoxia.

Various factors influence the choice of anesthesia method; the doctor makes the final decision on this issue together with the woman in labor, weighing all the pros and cons of each of the methods.

However, childbirth after 30-40 years has its advantages.

There have been significant changes in the age bracket for women who are able to conceive and successfully bear a baby. Now primiparous after 35 is a common occurrence. What are the pros and cons of late motherhood?

To be happy or to be afraid?

The public view of marriageable age, sexual activity, and regular sex life has changed.

The women themselves have changed. Nowadays, giving birth after 30 is a common thing, and this is not surprising to anyone. The fashion for late pregnancy came to the post-Soviet space from Western countries. It was there that the woman considered it necessary to first realize herself in her profession and career, gain financial stability, solve the housing issue and only then devote herself to motherhood. Fashion has taken root, and modern young parents have noticeably "aged".

Pregnancy after 35 as a trend is also associated with an increased divorce rate. Many women at this age remarry and dream of a second and third child in a new marriage.

Those who decide to get pregnant may face certain difficulties, because physiologically it develops so that with age after thirty, the ability to conceive rapidly decreases. Why? There are several reasons:

The egg cell gradually enters the stage of biological aging. The number of ovulations decreases, and the chances of getting pregnant are decreasing. If at the time of the first menstruation, 400,000 eggs are formed, then 40 years - only 1000.
A woman by this time may already have a "bouquet" of endometriosis, obstruction of the fallopian tubes, and other extragenital diseases.

Of course, this does not mean infertility. Pregnancy 35 and older is real. Most at this age carry and give birth to healthy children, and modern medicine helps them.

There is undoubtedly a risk, but on average it is not much higher than during pregnancy under 30.

The obstetric diagnosis "age-related primiparous" is recorded in the history of the disease only in the countries of the post-Soviet space. In European states and America, such a diagnosis does not exist.

Problems

If by the age of thirty it will take about 4 months to conceive, by thirty-five - about 8, and after 40 - a year and a half.

What are the difficulties of pregnancy after 35 years:

With a decrease in the number of eggs, the process of their implantation in the uterus is disrupted. Physiologists say that at this age only one in eight eggs is attached.
The rate of miscarriages is getting higher.
Acquired gynecological conditions also affect fertility.
With age, the body is affected by many unfavorable pathogenic and toxic factors.

Age people are more likely to suffer from placental problems: chronic placental insufficiency, premature detachment, presentation. With conception, there is an exacerbation of chronic general diseases. A woman with chronic pathologies of the kidneys, cardiovascular and respiratory systems, diabetes mellitus will be under continuous medical supervision. In elderly patients, high blood pressure is often observed, and this serves as an impetus for the development of preeclampsia and eclampsia.

By the age of 35-40, the peak of multiple pregnancy occurs, which makes it more likely to develop complications: weakness of labor, ruptures, bleeding, placental problems.

The future baby is also at risk: premature birth, low weight, hypoxia, chromosomal abnormalities.

Age women are referred to a risk group and examined more closely, in the last weeks of gestation, they are hospitalized and the process of preparing for childbirth is monitored.

If a woman decides to give birth in adulthood, she should be careful about her health before, during and after childbirth.

pros

On the other hand, age-related pregnancy has many advantages. By this time, the woman becomes more attentive to her health. She is careful, reasonable, keeps a pregnancy calendar. She is consciously and seriously planning a pregnancy.

A woman quickly gives up bad habits, eats right, regularly visits and fulfills all the prescriptions of her doctor. For a healthy and easy delivery, this is the main thing.

A mature woman is financially, morally and physically ready for the birth of her child. The age when you want to go away and get the most of your free time is passing. Older parents are more involved with their children, they are patient and responsible, attentive. They have more capable and talented children who are ahead of their peers in psychological and emotional development. With a high likelihood of multiple pregnancies, adult parents get "double happiness."

How late pregnancy positively affects the female body:

The onset of menopause is postponed.
Postpartum depression rarely develops.
Carrying out, labor and lactation rejuvenate, inhibit physical and spiritual aging.
Reduces the risk of stroke, osteoporosis, genitourinary infections.
The increased amount of the hormone estrogen tones the muscles and makes the skin elastic.

Psychologists say that the age of 30 is a transitional line, after which a woman's maternal instincts prevail over material and personal desires. A woman giving birth after 35 feels younger than her peers.

Preparation plan

The life and health of the unborn baby depends on the woman. Therefore, first of all, she should visit a gynecologist. Modern medicine has all the means to foresee and prevent unwanted consequences. It is important to undergo a complete examination and get an accurate picture of the general condition of the body. What actions to take in terms of preparation for the first pregnancy after 35 years:

Lead a healthy lifestyle with a balanced diet, good sleep, moderate physical activity, and a positive attitude. Psychological readiness is important. In women who have matured psychologically, after the birth of a baby, life is better established.
Control your weight.
Start taking folic acid and special multivitamin complexes 2-3 months before the planned conception.
Complete a complete medical, laboratory and medical genetic examination.
Get all the vaccinations prescribed by the gynecologist.
If the woman is taking medication, discuss with her doctor how to continue taking them and the possibility of switching to alternative and safe medications.
Cure chronic and infectious diseases.
Attend parenting courses from an early date.
Create a favorable and comfortable psychological atmosphere: go to theaters, concerts and exhibitions, sign up for yoga.

If at the reception a woman hears "age primiparous", do not be offended, take this phrase to heart. The doctor does not remind about age, and this has nothing to do with the personality. This is not a diagnosis, but a reason to be attentive to your health.

“Obstetrics and gynecology is really a male specialty, it’s hard physical labor,” says Sergei Vasiliev, deputy chief physician for medical work at Minsk maternity hospital No. 2.

In his opinion, a woman should treat herself as well as her jewelry and car, and be examined by a gynecologist at least once a year.

“So that in five years not to catch up with myoma up to the navel,” Sergei Vasiliev directly notes and absolutely frankly talks about childbirth, contraception and women's health.

Sergei Vasiliev, Deputy Chief Physician for Medical Work at Clinical Maternity Hospital No. 2 in Minsk. He stood at the origins of laparoscopy in gynecology in Belarus. He is married and has three daughters.

"Soon in Belarus, as in the West, the first child will be born at the age of 30"

- Do women hesitate to be examined by a male gynecologist?

- Not. Now the attitude towards this issue has changed. Previously, I worked part-time in private medical centers, and, I remember, back in the early 2000s, a French woman contacted us. She asked to be watched by a male doctor during her pregnancy. Perhaps this western wave has already reached us, when a woman is not ashamed of a male doctor. Moreover, women tend to listen to male doctors more often.

- Has the fashion become late mothers before us already? Up to what age can you give birth?

- It is best to give birth to a child between 21 and 35 years old. Optimally, if this happens at the age of 25-28. According to the classification of the World Health Organization, the reproductive age in our country is up to 49 years. But from the age of 35, there are risks associated with genetic abnormalities, the same Down syndrome. At the age of 40-45, a woman already becomes overgrown with fibroids, endometriosis, arterial hypertension, impaired fat metabolism, liver and kidney diseases ...

If she is going to give birth after 40 years, she must approach this consciously. Prepare, eliminate all risks, consult with specialists. If all her organs and systems are functioning properly, there are no questions.

- If you are 30 years old and have no children yet, moreover, you don't have a suitable partner either ... You need to quickly look for him and give birth in an emergency?

- Of course not. In Germany, for example, the average age of a primiparous mother is 31 years. We are also gradually approaching such indicators: first, a woman must get an education, find a job, get on her feet, and then plan a pregnancy.

We used to have such terms as "young primiparous" and "age primiparous". A 30-year-old woman was considered "age". Now there are no such concepts. 30 years old - what kind of old age is it? The very youth!

- What affects a woman's ability to get pregnant and bear a healthy baby?

- Her state of health. It is important how her body was formed by reproductive age. How she, while still a teenager, fed and developed. Take today's 16-year-old schoolgirl - she has a bunch of diseases: chronic gastritis, scoliosis, vegetative-vascular dystonia ...

- Are there more complicated pregnancies now?

- Yes. And this is connected, in fact, with progress. For example, 40 years ago, a woman with complex hormonal dysfunctions simply would not have had children. Further, this genetic branch would be removed. Today we help such women to get pregnant and give birth.

"If it hurts to give birth, they'll give you anesthesia."

- Today many women are afraid to give birth. What should they do?

- Unfortunately, childbirth is a painful process. And to make sure that a woman does not feel anything at all will not work even with the help of modern methods. But it is possible to partially anesthetize both through injections and, for example, a jacuzzi in which the patient can lie down during childbirth.

Ours is not the same as in America. Where, as soon as a woman entered to give birth, like it or not, she is given regional anesthesia.

Our approach is more balanced. Regional anesthesia is an intervention. During it, an anesthetic is injected into the spine. Pain sensitivity disappears, and deep tactile sensitivity remains. That is, if with such anesthesia they cut with a knife, the woman will feel only some kind of pressure. But in order to do such anesthesia, there must be indications: painful and active contractions when the cervix is dilated at least four centimeters.

In a primiparous pregnant woman, the average duration of labor is 12-14 hours, in multiparous women - 10-12 hours. The woman lies in the prenatal ward, she is being watched by midwives and doctors. They, like the woman herself, rate the pain of contractions on a 10-point scale. Depending on the situation, a decision is made on pain relief.

If the contractions are so-so, regional anesthesia will weaken them even more - and this will not end well.

- And if the pregnant woman herself wants to be injected with anesthetic and just ask the doctor ...

- All pregnant women in anticipation of childbirth want anesthesia. This is a natural desire. If she really hurts and she wants to - they will.

But it is possible to anesthetize not only due to regional anesthesia. Massage, jumping on rubber balls, common antispasmodics also help.

- Are there many pregnant women today who use regional anesthesia during childbirth?

- In our maternity hospital - up to 10% of women with natural childbirth. In case of caesarean section during elective operations, we perform regional anesthesia for up to 88% of patients. The woman remains conscious with her. If childbirth has begun and a cesarean is urgently needed, then most often we resort to general anesthesia.

- What if a woman asks for a caesarean without testimony?

- In Colombia and Venezuela, 80-90% of pregnant women are cesarean. For this, they have one indication - the desire of a woman. We don't have that. There must be good reasons, a situation where a woman really cannot give birth on her own.

"Before pregnancy, you even need to go to the dentist."

- How do you feel about partner childbirth?

- Positively. And we choose such births more and more often. They are important for a woman who has never given birth. The husband, whom she loves and whom she trusts, in this case creates a very good psycho-emotional background.

- And for the birth at home?

- There is only one good moment in childbirth at home - the home environment. This is where the positive ends. Childbirth is an unpredictable process, and the stakes are very high: a woman can die or lose a child. Fortunately, this rarely happens. But again, how can you control the baby's condition during childbirth at home?

For example, a pathology such as an umbilical cord entanglement occurs in 30% of pregnant women. In most cases, it goes unnoticed: the child is born, and we see that there was a cord entanglement. But it may be that during the advancement of the head, the umbilical cord is tightened around the neck, like a loop. Everything here will depend on how quickly you help and save the child. If a woman lies in the delivery room, five to seven minutes - and the baby was taken out. At home, the baby is left to fate.

But, for example, a child was born, and a woman had tissue tears during childbirth. Bleeding may be profuse. It's like you open the water in the tap, and it starts pouring, already gurgling. God forbid, at home someone will reach there with his hand to tear something off without anesthesia. This can lead to shock associated with blood loss. What happened next? It is good if a woman lives in the city and an ambulance will come to her in 15 minutes.

- Have you ever had cases when a woman tried to give birth at home and was urgently brought to the hospital?

- There was a case when an ambulance was carrying an already giving birth woman, bleeding, with a pressure of 60 to 40. And once a patient was admitted with a clinically narrow pelvis and an incipient rupture of the uterus. She had already given birth for four to six hours. The child was large - 4.5 kg, the pelvis did not allow him to pass. All internal organs have already swollen there. We took her straight from the emergency room to the operating room.

This happens, but rarely. But if during childbirth at home you lose your wife or child, who will you blame? A neighbor who advised you to give birth at home? Of course not. Then all your life you will not forgive yourself. So why experiment?

- Supporters of childbirth at home often cite grandmothers and great-grandmothers as an example, who also gave birth like that?

- Do you know how much infant and maternal mortality was during the time of our grandmothers and great-grandmothers? Lots of. And today we have an infant mortality rate of about 3 ppm. That means three cases in a thousand. At the same time, there are about 120 thousand births in the country per year.

- Despite this indicator, not so long ago there were three high-profile stories related to the death of children in Slutsk and Novopolotsk. How can this be?

- It is impossible to reduce mortality to zero. And such cases are rare. As a rule, healthy children under the condition of physiologically proceeding pregnancy in a healthy mother do not die. This is nonsense. Most often, there are objective reasons for an unfavorable outcome.

Most infant deaths are associated with abnormalities in the placenta. The placenta is the feeding surface for the baby. If you look at it under a microscope, in perfect condition it should look like a new long pile carpet. Each villi is a nourishing vessel for a child. The more of these vessels, the more the child receives oxygen, amino acids and other important substances.

But if, during the fertilization of the egg, a defective fertilized egg is obtained, a high-quality placenta cannot form from it. Its villi will be thin and small, and will not be able to feed the baby properly.

Therefore, the health of the baby is influenced by the secretory phase and hormonal background of the pregnancy, whether the woman had stress. During the war, there was even such a concept - stressful amenorrhea, when a woman simply did not have periods. The body perceived the war as unfavorable conditions, and ovulation did not occur. Nature protected women from pregnancy.

- How to reduce the risks of infant mortality?

- Prepare for pregnancy and behave correctly during it. Doing everything that is called three letters - healthy lifestyle (healthy lifestyle). It is also important to avoid stress and eat a complete and balanced diet.

Brain stress is like a chronic poison. The centers that regulate the functioning of the female genital organs are located in the brain.

- How to live without stress?

- To resort to psychotherapy, physical activity ... When the brain receives impulses from the muscles, stress is blocked. When a person swims and runs, he thus avoids problems.

- How often do our people plan pregnancy?

- Almost always.

- Yes?

- There are fewer and fewer weddings now.

- But I somehow RSPTs "Mother and Child", and they said the opposite ...

- The Republican Scientific and Practical Center “Mother and Child” is a republican institution. They work a lot with women from the regions. And our patients are from Minsk. According to statistics, in our maternity hospital, pregnancy is most often planned. At least minimally, before getting pregnant, the girl goes to a gynecologist for an examination.

- But what exactly should a man and a woman do when planning a pregnancy?

- A man should go to a urologist, and a woman should go to a gynecologist and get tested. If one of the parents had diabetes mellitus, it makes sense to pass tests for this part and go to an endocrinologist. If the pressure rises periodically, you need to visit a cardiologist.

And what else must be done - go to the dentist and put your teeth in order. Caries is an infection, and against the background of pregnancy, immunity is suppressed. Under certain circumstances, this infection can enter the bloodstream and cause severe flare-ups such as periodontitis or sepsis. How can a child develop normally against this background?

"Combined oral contraceptives can be taken for years."

- Let's talk about contraception. Coitus interruptus ... Doesn't it seem strange to you that today, when people have access to other methods of contraception, someone else is using it?

- I have never met a more stupid, senseless and unreliable method of contraception in my life. You need to understand that the release of sperm during intercourse occurs even before the main ejaculation. That is, sperm cells begin to be released at the very beginning, and in 10-20 seconds they can penetrate not only the vagina, but also the uterine cavity. And to get pregnant, one sperm is enough.

At the same time, interrupted intercourse is not enjoyable. Because of him, a man has an orgasm not to the end, a woman - even more so. The female genital organs, which are responsible for receiving positive emotions, are concentrated in both the vagina and the cervix. A woman just starts to taste - here everything is extracted and stopped. What is the pleasure of this?

Fortunately, coitus interruptus is becoming less common as a method of contraception. People are becoming more responsible and use condoms, local contraceptive drugs: vaginal creams, balls, tampons. And all this can be bought at the pharmacy without a prescription. There should be a more balanced approach to the use of oral contraceptives.

- Do combined oral contraceptives harm a woman's health?

- Modern oral contraceptives, with the correct selection, are the best option. If you follow the instructions and recommendations of the doctor, there will be no side effects. Moreover, such drugs have not only a contraceptive effect, but also a therapeutic one.

Oral contraceptives are like a sanatorium for the ovaries. When a woman accepts them, her ovaries are dormant. The condition can be compared to how the car is idling.

Previously, our grandmothers at the age of 18-19 got married, had a sex life, and got pregnant. Then the child was carried, breastfed and pregnant again. A woman for her entire reproductive age had at most 20-30 ovulations. That is, her ovary worked 20-30 times in her entire life. Now what? Eggs ripen every month in vain - pregnancy does not occur. And today a woman who does not get pregnant has not 20-30 ovulations, but 200-300. The more the organ works, the more likely it is to break. Where do you think uterine fibroids and endometriosis come from?

- How long can I take combined oral contraceptives?

- For years, until a woman decides to become pregnant and in the absence of contraindications.

- And while not taking a break?

- It makes sense to take breaks. But not a single woman, purely psychologically, will be able to take oral contraceptives for six years without a break. After six months or a year, she will need to make sure that the female reproductive system is working properly, and she herself will interrupt the appointment.

In any case, such drugs should be taken under medical supervision. So that if something happens, the doctor can cancel them.

- They say that a woman should not wash her genitals with soap. Like, this is how she kills the natural environment ...

- You can and should wash with soap, but not with household soap, but with toilet soap. Laundry soap is 70% alkali, which corrodes not only the external genitals, but dirty laundry. But it is important to understand that you should not wash yourself with soap every day. A lactic acid environment must be maintained in the vagina. If you douche and wash yourself with soap every day, this will finally destroy the microflora of the vagina.

Intimate hygiene gels are milder detergents. And, of course, if you have a choice, it is better to use them, not soap.

- How often should genital hygiene be carried out?

- As it gets dirty. One to three times a day - with ordinary water, including after using the toilet. You can do this with soap and water no more than once a day.

- Does a cytology smear really reveal cancer?

- With the help of cytology, we can detect cervical cancer at an early stage and cure it. Cancer arises from a tumor, not two centimeters, but several cells. Therefore, every healthy woman in Belarus should undergo an oncocytology examination once a year.

Recently, women have had quite a few reasons to postpone the moment when they decide to become a mother - a career, the search for a partner and worries about material well-being are coming to the fore. And it often happens that when all the goals have already been achieved, a new problem arises - pregnancy does not occur.

According to experts, the conception and course of pregnancy in women over 35 years old depends not so much on age as on the physiological state of the body of the expectant mother and her partner.

Georgy Lebedenko, general practitioner, chief physician at the Clinic of Professor Yutskovskaya, curator of the YU-Life project:

“Women aged 35+ should be very careful about pregnancy. In our practice, we are faced with the fact that many of these patients simply do not have time for pre-conception preparation. And in this case, preparation for pregnancy takes a certain period, because, as a rule, patients after 35 years old accumulate a certain amount of genetic "breakdowns". This may be due to the presence of chronic diseases, all kinds of viral infections, and so on. It is important to understand that the problem of conception is not the only one, because the period of pregnancy itself is a very important stage for a woman's body, and at the age of 35+ it is more difficult to bear ”

In addition, the reproductive health of the potential father of the unborn child is an important factor. Indeed, in men after 35 years, the function of producing high-quality sperm decreases, sperm become less active, and their morphological qualities decrease.

Elvira, 41 years old

“My husband and I have been together for 8 years, and despite the fact that we have never used contraception, I never got pregnant. I underwent a full medical examination, received medical treatment for little things, I drank vitamins, but I still can't get pregnant. I constantly cry when my period comes ... Also, there is constant pressure from relatives and friends that I cannot give birth ... "

“When choosing an IVF method, a woman goes through a hormonal stimulation protocol, but you need to understand that a partner plays an equally important role in the effectiveness of conception. There are couples who, between the ages of 25 and 35, try to get pregnant on their own, and they fail. Often in such cases, the problem is in the man. Therefore, you need to competently approach the examination and pre-conception preparation, which both partners must undergo. It is also important to note that it is necessary to consult several specialists, at least three: a urologist-andrologist, a gynecologist-endocrinologist and a general practitioner. Only this approach can increase the chances of getting the desired pregnancy. And of course, the pregnancy period should be monitored by several specialists. "

Tatiana N, 38 years old

“I am 38 years old, there are no children, but I would very much like to have it already. The problem is, I'm just afraid of pregnancy. It seems to me that I simply cannot bear a child. After all, I have constant weakness, always lack of vitamins of some kind, then something is wrong with the blood, and so on. I, of course, understand that they carry and give birth not with such problems. But, after reading articles and forums, I was horrified - after all, if I already have health problems, then how can I even walk during pregnancy ... Girls who do not "suffer" from good health, but nevertheless tolerated gave birth? "

Lilia Farrakhova, Candidate of Medical Sciences, obstetrician-gynecologist at the Clinic of Professor Yutskovskaya, member of the Russian Society of Obstetricians and Gynecologists:

“The psychological factor plays an important role - fears are well-founded and not so much. The imaginary unpreparedness of a woman can lead to infertility at the level of self-hypnosis. As for physiology, the reason for the decrease in the ability to conceive in elderly patients is the quality of the follicles remaining in the ovaries. The likelihood of chromosomal abnormalities in oocytes begins to increase sharply after 35 years. And accordingly, from this age, the number of normal embryos with a normal chromosome set, capable of giving a normally developing pregnancy, decreases. Already at 43, the percentage of normal embryos does not exceed 15% "

Let's take a look at the main risks and complications associated with late pregnancy:

There is a high risk of having a "late" baby with congenital anomalies (such as Down's syndrome);
Miscarriages, ectopic pregnancies are also common complications of pregnancy in women over 35;
Exacerbation of chronic diseases that can be caused by pregnancy.

Nevertheless, advances in modern medicine make it possible to diagnose birth defects even before the birth of a child. For example, amniopuncture, chorionic biopsy, and other methods. Also, with the help of special equipment, it is possible during childbirth to assess the existing threats to the fetus, take the necessary actions and prevent possible birth injuries.

“Not a single achievement of medicine for the normal course of pregnancy and childbirth can be equated with what depends on the mother herself, so that the outcome of pregnancy is successful both for herself and for her child. It's about exercising, following a special diet, and high quality antenatal care. "

Having considered some of the disadvantages of giving birth after 35, we must not forget about the pros:

Pregnancy at this age contributes to the rejuvenation of the body;
Mothers in this age group (over 35) are better at parenting due to their maturity and "knowledge" of life. They are more patient, restrained, balanced.

Maria, 37 years old

“At 32, I divorced my husband, who did not want children. Left without housing, without special financial reserves. I was already giving up on myself. But a year later she met a man on a dating site. We both wanted to have a family and children. She got married in the fourth month of pregnancy. She gave birth to her first child for almost 35 years. The pregnancy was complicated by fibromyoma, and I was kept in the hospital 5 times. But I never doubted the birth of a healthy child. It was caesarean. But now, at 37, I have a two-year-old baby, a good husband and a desire to have a second child. In general, the main thing in this matter is a good doctor, or rather a few, a non-drinking husband with brains who loves you, and a positive attitude. And everything will work out! "

There is only one conclusion - when planning the conception of a child after 35-40 years, a woman is recommended to be examined by specialist doctors. It is then that the result of pregnancy will be the birth of a healthy child, which will grow and develop to the delight of mom and dad.