How to get pregnant second at 39 years old. Late pregnancy. Medical aspects of late pregnancy

In many countries, it is customary to have children after 30 years. This is due to the desire of parents to achieve a stable financial condition and achieve success in the professional field. However, the opinion of doctors in relation to such pregnancy and childbirth is ambiguous.

A woman can become pregnant from the onset of the first menstruation to the onset of menopause. But it would be wrong to say that any age is suitable for bearing a child.

Most gynecologists agree that conception at the age of 15-18 is dangerous for both the young mother and the unborn baby. Late pregnancy is also fraught with various complications.

According to doctors, the optimal age for the birth of the first child is 22–30 years. As for subsequent children, it is quite acceptable to give birth to them later.

However, you should be aware that every year pregnancy can be more difficult. This often creates new risks and dangers. Despite this, in recent years more and more women have become pregnant at the age of 39–40, and sometimes even later.

Late pregnancy

About pregnancy at the age of 39, it cannot be unequivocally stated that it is late. And at 40, a woman may well bear a child. However, after 45, it is better not to plan the birth of children.

By this age, the reproductive system of many women begins to malfunction. Fertility problems are common. Often married couples report unsuccessful attempts at conception, although they continue to lead an active sex life.

What dangers and difficulties can lie in wait for a woman who decides to become a mother at 39-40 years old? These can be problems of a medical, psychological or social nature.

Medical aspect

Although many women do well after forty and look great, this does not cure their health problems.

Pregnancy at 39 years old, according to doctors, can lead to the following complications:

• Anemia.
• Pathology of the musculoskeletal system.
• Divergence of the rectus abdominis muscles.
• Hemorrhoids.
• Calcium deficiency.
• Chromosomal pathology in the fetus.

Anemia

The risk of anemia in women often increases with age. The development of this disease is directly related to the duration and volume of blood loss.

If a patient has had heavy periods since adolescence, it is very likely that she is losing more iron than she can get in a month. Thus, the level of this trace element decreases steadily throughout life.

This usually happens rather slowly and at the age of 25–30 years, there may be no obvious anemia. However, by the age of 40–45, doctors often make such a diagnosis.

During gestation, iron is consumed in a larger volume, since the lion's share of it is sent to meet the needs of the growing fetus. The presence of even a slight iron deficiency, which is often found after 35 years, almost always causes anemia without correction during pregnancy.

This disease can manifest itself with the following symptoms:

• Fatigue.
• Frequent colds.
• Low pressure.
• Dizziness, sometimes fainting.
• The temperature rises to 37.7–37.5 °.
• Sometimes cracks in the corners of the lips, stomatitis.
• A change in taste preferences (a woman may have a desire to eat chalk, clay and other unappetizing things).

With severe anemia of the mother, the child also suffers. At the same time, he develops oxygen starvation - chronic hypoxia. The consequence of it may be a delay in the intrauterine development of the fetus.

Pathology of the musculoskeletal system

By the age of 39–40, most women have degenerative changes in the spine of varying severity. This disease is called osteochondrosis. There may also be joint lesions, especially large ones - arthrosis.

Changes in body weight, displacement of the center of gravity can aggravate the damage to the musculoskeletal system and worsen the course of the disease. Often, a pregnant woman complains of pain in the back and legs, a feeling of numbness in the limbs, burning, paresthesia.

When carrying a baby, the hormone relaxin is actively produced in the body. It increases the extensibility of the ligamentous apparatus of the joints and enhances their mobility. It can also adversely affect the condition of the musculoskeletal system.

Sometimes there is a specific complication of pregnancy - symphysopathy, hypermobility of the pubic articulation. The consequence of this is pain in the pubic area, difficulty with some movements, climbing stairs, walking.

As the mother ages, the likelihood of such complications increases.

Discrepancy of the rectus abdominis muscles

The divergence of the rectus abdominis muscles is often associated not with the woman's age, but with the number of previous pregnancies and childbirth. Although the condition of the abdominal muscles also plays a significant role. Usually, the younger the expectant mother, the less often she has problems with the muscles of the anterior abdominal wall.

This feature has little effect on the course of pregnancy, although the abdomen may not acquire a rounded, but somewhat pointed shape along the midline.

After giving birth, a woman complains of a bulging belly, which cannot be brought back to normal by exercise. If she tries to rise from a supine position, a bulge will be clearly visible along the midline. When palpating this zone, the fingers do not feel muscle tension and resistance, they freely plunge inside.

The divergence of the rectus muscles (diastasis) of the abdomen can transform into a hernia - the umbilical or white line of the abdomen.

Hemorrhoids

Hemorrhoids often develop towards the end of pregnancy. Maybe it will worsen for the first time after childbirth. The main pathological mechanisms of its appearance are considered:

• Stagnation of blood in the area of \u200b\u200bthe hemorrhoidal plexus.
• Excess weight.
• Sedentary lifestyle.
• Constipation.
• Improper behavior during the pushing phase.

As a rule, with age, the likelihood of developing this unpleasant disease increases. The number of previous births also affects it.

Hemorrhoids also occur at a young age, but much less often, since the main imprint on the health of this zone is imposed by the lifestyle.

Calcium deficiency

At a young age, calcium deficiency is a rare pathology. Most often it is caused by an unbalanced diet and endocrine diseases. The older the woman, the higher the likelihood of her calcium deficiency, especially if she had previously had to bear and give birth to children.

As a rule, before the appearance of specific symptoms, few people check the level of this trace element and do not make up for its deficiency.

Over the course of nine months of pregnancy, calcium is consumed at a doubled rate, because without it, the full development of the fetus is impossible. With a lack of a trace element, the child's musculoskeletal system will suffer first. However, others - cardiovascular, endocrine, nervous - are also involved in the pathological process.

Symptoms of a lack of this trace element:

• Poor condition of hair and nails.
• Multiple caries, tooth decay.
• Bone pain.
• Fractures.

Chromosomal abnormalities of the fetus

Chromosomal abnormalities are complications of pregnancy that are directly related to the mother's age. This is especially true in relation to some trisomies - Down syndrome, Patau, Edwards.

Up to 35 years of age, the risk of chromosomal mismatch in 21 pairs (Down syndrome) is 1: 700 and further increases every year. At 39 years of age the risk approaches 1: 214, and by 45 it becomes extremely high - 1:19.

This increase in chromosomal breakdowns is associated with the constancy of the eggs in the woman's body. Throughout her life, they are not renewed or divided.

All unfavorable factors affecting the reproductive system can affect the chromosome set of a cell, and these changes remain for life.

Diagnostics

In modern obstetrics, it is customary to examine pregnant women for this kind of pathology. For this, expectant mothers are offered to undergo biochemical and ultrasound screening in the first and second trimesters.

However, if the woman is over 35 years old, it is better for her to have an invasive procedure called amniocentesis. In this case, it becomes possible to determine the karyotype of the fetus, and chromosomal abnormalities are excluded or confirmed with a 99% guarantee.

If the result of the analysis is disappointing, the woman has the right to terminate the pregnancy for medical reasons. That is why it is not worth delaying the research.

But invasive testing carries with it an increased risk of miscarriage and other complications (such as infection).

In recent years, another diagnostic method has been of practical interest to doctors - determination of the karyotype of the fetus by analyzing the mother's blood. For this, the blood is centrifuged to isolate the fetal cell culture.

The technique has not yet received widespread acceptance due to the high cost and risk of error, however, active developments in this direction are underway.

Psychological features

When planning a late pregnancy, one should not forget about the psychological characteristics. On the one hand, women aged 39–40 are more conscious and balanced about their desires. They plan to conceive in advance, undergo a comprehensive examination, and carefully take care of their health.

Often, the birth of a baby after 40 years gives the mother strength, rejuvenates her. Many women, they say, are experiencing a second youth.

On the other hand, the opposite situation may arise. Pregnancy is not always planned and desired at this age. Given the woman's age, conception is often the result of contraception failure. In this case, the expectant mother may experience a feeling of confusion and depression, uncertainty about the future.

If a late pregnancy is the first, then, most likely, the child is long-awaited and very desirable. At the same time, the mother may have hyper anxiety and overprotection, a lack of criticism towards herself and the baby, which ultimately harms their relationship.

But in most cases, mature women turn out to be more responsible and caring mothers than young girls.

Social status

However, our society is not always tolerant of late pregnancy. Some people may openly express their bewilderment about the birth of a baby at such a mature age that it can ruin the mood of even the most unflappable woman.

At the age of 39–40, many have a peak in their careers, they reach certain heights in the professional field. As a rule, the financial condition of such parents is quite stable. Even without the support of her husband, a woman is able to feed herself and her child.

Of course, the decree can negatively affect the career, but the employer usually waits for valuable employees as long as necessary.

If the expectant mother has not taken place in a certain profession before this time, it may be difficult for her to find a job after forty years.

Pregnancy at the age of 39-40 opens up new opportunities for a woman. You should not give it up because of unfounded fears and advice from strangers. However, at the same time, you must be very careful about your health and not ignore the doctor's recommendations.

The birth of a child is the next step, a new life that is full of happiness, joy and pleasant worries. But what if you didn’t have time, couldn’t, didn’t meet the same person, didn’t allow health or financial condition to give birth to the first, second or fifth desired baby earlier? What if you are threatened with pregnancy at 38? The opinion of doctors is ambiguous. Let's weigh the pros and cons.

Pregnancy and age

Physiologically, pregnancy becomes possible in girls from the beginning of the first menstruation - at the age of 11-13 years. Fortunately, today this is rather a terrible exception than the rule - the days of early marriage and the lack of methods of contraception are gone.

Long before the final cessation of menstruation in women, fertility drops sharply. And with the onset of menopause, usually after 55 years, the ability to conceive is reduced to zero.

Early labor

By the age of eighteen or twenty, the reproductive system of a girl is completely ready for bearing and giving birth to a child. But the lack of psychological readiness to become a mother keeps most expectant mothers from taking such a serious step. More than 80 percent of all young pregnancies are accidental and unplanned. Often such a mistake leads girls to an abortion, which inevitably affects the future reproductive function of the body. Those who decided to leave a child at the age of 18-20 often have complications of pregnancy associated with the instability of the hormonal background, anatomically narrow pelvis, and immaturity of the muscular layer of the uterus.

Correct, according to doctors, age for pregnancy and childbirth

The ideal age for the birth of the first child is 20-30 years. It is during this period that a large proportion of all planned pregnancies and childbirth falls. The woman's body has not yet had time to acquire serious chronic diseases and is completely ready for procreation. Psychologically, young mothers and fathers are determined to have children, age crises have already passed, and there is still a lot of strength for night ups and moral overloads.

Late pregnancy

After 30-35 years, women usually give birth to their second or third child. But thanks to the achievements of medicine, it is increasingly possible at this age to become a primiparous mother. After all, not everyone manages to get pregnant the first time before 30 years. Career, financial instability, lack of a reliable partner and living space, problems in gynecology, chronic miscarriage, tubal ligation, difficulties with conception - all these are common problems due to which the first pregnancy occurs at 38 years old.

The opinion of doctors about conception at this age is uncertain. On the one hand, it is great that medicine today actively uses in vitro fertilization (IVF), has a huge arsenal of tools to stimulate pregnancy, maintain it, the possibility of thorough intrauterine diagnosis of pathologies, timely and safe delivery, resuscitation and treatment of newborns. But we must not forget that with age, the risks of genetic disorders and malformations in a child increase, a woman's body is more difficult to tolerate pregnancy, childbirth is less natural and often traumatic. In addition, after 30 years, it is more difficult to physically cope with a newborn baby.

First pregnancy at 38 years old

The opinion of doctors is controversial. Many argue that carrying a child at this age can negatively affect the mother's health, cause pathologies in the fetus and complicate the process of childbirth. But practice shows that careful preparation for conception, serious monitoring of pregnancy and timely correction of possible complications help to bear and give birth to healthy and strong babies at any age.

The planned first pregnancy at 38 years old is primarily the preparation of the body. Often it takes a lot of time to get tested and correct violations, which is not left at all. By the age of 40, fertility is decreasing and there are often problems with conception.

after 35

The first pregnancy at 38 years old is a great success. The chances of getting pregnant naturally drop by the age of 40. After all, the ability to conceive (fertility) is already significantly lower than that of a twenty-year-old girl. According to statistics, on condition of regular sexual intercourse (at least three times a week), 70 percent of women become pregnant during the year.

How to help the body?

• Take vitamin complexes for pregnant women.
• Get enough sleep and rest at any free moment.
• Drink plenty of clean water.
• Don't be nervous, get rid of stress.
• Eat healthy and wholesome food, oven-cooked or steamed, and don't overeat.
• Include legumes, nuts, dairy products in your diet, eat more fruits and vegetables.
• Get rid of bad habits (smoking, alcohol, coffee drinks - all this badly affects sperm motility and can prevent the onset of ovulation).
• Lose weight, if necessary, or gain weight. Lack of weight or excess weight has a negative effect on the possibility of conception and the course of pregnancy.

Rebirth at 38

If at the family council it was decided that one child is not enough for you, you are expected at 38 years old. The opinion of doctors is that the second and subsequent pregnancies after 30 are much better than the first. The woman knows what awaits her, and the body has already gone through all the stages during the bearing of the previous child. Therefore, neither the second nor at the age of 38 should frighten future parents. The opinion of doctors should be taken into account only in case of serious health problems and high risks of complications for the mother and child.

Complications and risks

After thirty-five years, doctors warn of the possibility of the following complications:

• Genetic disorders (chromosomal pathology). The chances of abnormalities in the chromosome set of the fetus increase. These errors can be eliminated with a high probability by passing a high-quality screening examination at the 11-12th week of pregnancy.
• Miscarriage. This happens in women of any age. But due to the lack of hormones in elderly women, such cases are much more common. This can be prevented if the doctor sees the problem in time and prescribes the appropriate medications ("Utrozhestan", "Duphaston").
• Incorrect placement of the placenta during pregnancy can lead to complications during labor or detachment during pregnancy. This condition requires special monitoring and may be an indication for a caesarean section.
• Diabetes and gestosis. Due to being overweight and unstable blood pressure, gestational diabetes mellitus can develop. This complication sometimes forces doctors to resort to an emergency caesarean section in order to exclude chronic fetal hypoxia, nephropathy and stillbirth.
• Premature birth and underweight of the newborn. Very often, mothers' children after 35 are born prematurely and, accordingly, have a small weight - about 2.5 kilograms. With proper care, these babies have a good prognosis for their future life.

Of course, when pregnancy occurs at 38 years old, the risks cannot be ruled out. You can only reduce their likelihood with careful preparation and observation by good specialists.

Pros of late pregnancy

What good is it if there is a late pregnancy, childbirth? 38 years is a respectable age, which has its advantages. So what are the benefits of late pregnancy?

• Stability. Most likely, your family has already reached that minimum of material wealth, which allows you to breathe calmly and not think that there is nothing to eat tomorrow. This means that you will not be worried about your career and early going to work, but only your own child.
• Confidence in your spouse. Usually, at this age, all the passions of the young have already subsided and you and your husband are in a calm and good relationship that is so necessary for the pregnant woman and her child.
• Rejuvenation of the body. Everyone knows that motherhood paints a woman, and the production of female hormones and collagen helps smooth out wrinkles, makes the look bright and glowing from the inside.
• Mindfulness. Only now, when you are in no hurry and are on the verge of understanding the meaning of life, you can give yourself completely to your baby and enjoy every day with him.

This is how all women should look positively at pregnancy at 38 years old. Each will find its pros and cons. But still, if you have already decided on this step, try to think about the good and not be afraid of anything.

There are several rules that will help prevent complications when a pregnancy is planned at 38 years old. The opinions of doctors and their advice are as follows:

• Pass all the necessary tests: urinalysis, blood tests and other standard tests during medical examination. Check the status of chronic diseases and examine the genitals.
• Treat all possible diseases before pregnancy.
• During planning, start drinking special vitamins containing an increased dose of folic acid. This vitamin reduces the risks of neural tube pathology.
• Get tested for sex hormones. Such a study allows you to know in advance or from the first weeks of pregnancy about the need to adjust the hormonal background.
• Check sperm quality. It's not just a woman who needs to prepare for pregnancy. The quality of the paternal material can greatly affect the pathologies of fetal development. The daily routine, rejection of bad habits, good nutrition and an active lifestyle will improve the quality of the seed.
• Adjust your diet, monitor your weight and get rid of bad habits. A healthy lifestyle can improve the condition of the body and facilitate
• Do not use medicines and dietary supplements without consulting a doctor. For example, an excess of vitamins D and A increases the child's risk of developing abnormalities.

Pregnancy according to indications

Sometimes it happens that doctors strongly recommend a woman over 30 to become a mother in the near future. List of main indications:

• polycystic ovary disease;
• uterine fibroids;
• hyperandrogenism;
• fibrocystic breast disease;
• endometriosis;
• vegetative dystonia.

Doctors give such recommendations not in vain. There are a number of studies proving the healing effects of pregnancy and childbirth on cysts and fibroids. Breastfeeding often leads to resorption of mastopathy. But even if pregnancy cannot improve health, the sooner it occurs, the less likely a woman is to remain childless due to chronic diseases.

Late labor

If the first pregnancy has come and passed safely at 38 years old, the opinion of the doctors will be as follows: there is another important and difficult stage ahead - childbirth.

You need to carefully prepare for this important day. Courses teaching breathing techniques and pain relief, literature, fitness for pregnant women - all this will help the expectant mother feel more confident and control the process.

When pregnancy passes at 38 years old, the opinion of doctors often sounds like this: a woman herself will not be able to give birth. Then the diagnosis "weak labor" is made and it is recommended to carry out a cesarean section. If the doctor recommends this method of delivery, do not panic or refuse the operation. This is most likely the safest way for your baby to be born.

Pregnancy at 38 years old: reviews

Many mothers say that childbirth and pregnancy at 38 years old (the opinion of doctors here is very different from the feelings of women) left only the best impressions about themselves. Often at this age, the awareness of their position and the willingness to become a mother makes a woman absolutely happy and peaceful, life again takes on meaning and is filled with joy.

Since the late 1970s, there has been a rapid increase in the number of women giving birth at the age of forty and even over forty. For a quarter of a century, the number of women giving birth among women 35-39 years old has increased by 90%. And the number of young mothers who are 40 and more has increased by 87%.

If fifteen years ago, 25-year-old girls were called "old", today this term is used in relation to women in labor over 35, and even then, quite rarely. There has been a significant shift in the age bracket of a woman capable of getting pregnant and giving birth.

Unplanned pregnancy

To begin with, the modern standard of living presupposes sexual activity and regular sex life in women who are not only "over 30", but also "over 40" and "over 50". Thus, naturally, the very possibility of getting pregnant is preserved.

At the same time, a fairly large number of pregnancies in adulthood are unexpected (and unwanted) for women. This is evidenced by at least the fact that, according to statistics, more than 70% of pregnancies in late reproductive age (after 35 years) are terminated by artificial abortions.

After all, by the age of 35-40, most women have already solved family planning issues, and their pregnancy is the result of neglect of contraception or the ineffectiveness of previous methods of contraception. So, for example, it is not uncommon for the physiological method of contraception, based on calculating the days favorable for conception, to "fail" due to the violation of the cycle as a result of natural age-related changes in the woman's body.

Many women rightly believe that their ability to conceive decreases with age and no longer pay due attention to contraception. However, a drop in the ability to conceive is by no means tantamount to infertility and the risk of accidental pregnancy in an elderly unprotected woman is often higher than in a young woman who uses contraception.

And although at present only every tenth pregnancy is preserved among women over 40 years old, let's not forget that 20 years ago the number of such births was significantly less, so there is an encouraging trend - fewer and fewer women allow unwanted pregnancies, more and more women, " accidentally "becoming pregnant in adulthood, he decides to give birth - not only saving the life of the conceived child, but also, to some extent, returning his youth.

Planned pregnancy

Increasingly, women deliberately postpone the birth of children "for later" - until they achieve career success, solve the housing issue, and even just before marriage, because the marriageable age has increased recently. And this is not a whim and not a whim, it is an objective tendency. After all, if a modern person reaches physical maturity much earlier than his ancestors, then the time of social maturity, when a person is ready to create a family and raise children, when he independently, without resorting to outside help, can provide a decent standard of living for the family and children, comes only by the age of thirty. Most likely, this is precisely the main reason that today's young parents have grown so old.

However, the number of women for whom late childbirth is not the first is also quite large. The increased percentage of divorces in modern society leads to the fact that many women between the ages of 30-40 remarry and want to have a child in a new marriage.

But even faithful spouses, by the age of 35-40, quite often have the opportunity to “have a second child” - they have strong positions at work, a stable income, a good apartment. And - what is remarkable - the desire not only to have a second child, but to have children of different sexes. Polls show that the expectations associated with the appearance of a child of a certain gender are much stronger not among those parents who are expecting their first child, but among those who want a brother for their eldest daughter or certainly a sister for an already grown son. This circumstance also explains the fact that a woman's third pregnancy is more likely to end in childbirth if the two older children are same-sex.

But women over 35 who decide to get pregnant are often faced with the fact that conception at their age is fraught with significant difficulties (it does not matter at all whether a woman wants to give birth to her first child, second or third child). After all, a woman's ability to become pregnant begins to decline somewhere after age 30, so it is not surprising that the older a woman is, the longer it will take her to get pregnant. This is due to various reasons. Over the years, the number of ovulations in women decreases - an increasing number of menstrual cycles pass without the formation of an egg, and the onset of pregnancy in such a cycle, of course, is impossible. Many women develop with age such diseases as endometriosis (a disease of the uterine mucosa associated with hormonal imbalance and preventing embryo implantation), obstruction of the tubes, in which it becomes impossible for the egg to enter the uterine cavity, etc. Various extragenital diseases (not directly related to the genital area) appear, which prevent pregnancy. So, if a woman under 30 years old has a 20% chance of getting pregnant during one monthly cycle, then a woman over 40 has only 5%.

However, as we have already said, the fact that it takes more time to conceive is by no means equivalent to infertility. And yet, there is no time to waste: if pregnancy does not occur after a year of sexual activity without contraception, you should consult a doctor to identify the reasons that prevent conception. Most women over 35 are able to get pregnant, bear and give birth to a healthy baby, and modern medicine can help them with this.

Long-awaited pregnancy

Touching upon the topic of pregnancy in adulthood, one cannot but say about women for whom the opportunity to get pregnant only with the help of medicine has become the only chance to experience the happiness of motherhood. Among those who come to clinics for IVF (in vitro fertilization, ie fertilization "in vitro") - the last hope of women diagnosed with "primary infertility" - there are a lot of those who are over 30 and even over 40. Chances of giving birth to such women are two times less than among young people, but this is at least some chance in comparison with the diagnosis, which 20 years ago sounded a ruthless sentence. Today, doctors urge women not to delay the treatment of infertility and resort to the help of assisted reproductive technologies, because the younger the patient, the more chances of success.

But this is today, when there are already more than a million people in the world who were born with the help of IVF. A forty-year-old woman with primary infertility 20 years ago did not have the opportunity to resort to this procedure (the first “test tube” child was born only in 1978 and very far from Russia), 10 years ago she did not have money to perform such manipulations, and only now may try to get pregnant. Undoubtedly, the development of assisted reproductive technologies, especially in vitro fertilization, is one of the factors that led to an increase in the number of late pregnancies and “aged” young mothers.

However, she was treated for infertility for many years, an almost desperate woman, and a happy mother of two teenage boys, so waiting for a girl, and a successful "businesswoman" who finally found time to produce offspring, and a woman who no longer thought about marriage, but unexpectedly married, and a mature lady seeking to keep her young husband - all of them, having become pregnant, will face approximately the same problems. Let's leave aside the question of the prehistory of pregnancy and talk specifically about them - about the medical features of pregnancy in adulthood, about how a woman should behave, what to fear and what to prepare for in this position.

Late pregnancy problems

I warn you: we will now talk about the problems, complications and dangers, leaving aside all the undoubted charms and benefits associated with late pregnancy. The purpose of this article is not to scare a woman who is wondering whether to decide or not to take such a responsible step, but to warn what difficulties she will have to face and outline ways to overcome them.

Let us single out two topics in the discussion of this issue: what is the danger of pregnancy in adulthood for the mother and what problems may arise in the child of an “elderly” woman in labor. Naturally, you need to remember that such a division will be largely arbitrary, because a pregnant woman and a fetus are a single organism, and almost all the problems of the expectant mother are reflected in one way or another on the child.

Risk for a woman

• Miscarriage. If in women under 30 the risk of miscarriage is 10%, then in women 30-39 years old it is already 17%, and in women 40-44 years old it rises to 33%. The increasing risk of miscarriage is associated not only with age-related changes in the entire female body, but also with the aging of the eggs themselves, as a result of which the conception of a fetus with gross genetic disorders occurs much more often.
• Placental problems (chronic placental insufficiency, presentation, premature placental abruption).
• Exacerbation of chronic diseases. Pregnancy can exacerbate almost any of the chronic diseases, and with age, the likelihood of a woman having such diseases only increases. Of course, pregnancy with chronic kidney disease will require continuous medical supervision. More than careful medical management of pregnancy is necessary for diseases of the cardiovascular system, in particular with arterial hypertension. Arterial hypertension itself is a fairly common complication of pregnancy, and if a woman has previously suffered from this disease, pregnancy can worsen her general condition, increasing the risk of preeclampsia or preeclampsia (a condition characterized by increased blood pressure, swelling and the presence of protein in the urine). The most severe manifestation of preeclampsia - eclampsia (convulsions) - can seriously disrupt the functioning of the nervous system up to stroke and coma with serious impairment of brain function.
• Women over 40 are 3 times more likely to develop diabetes during pregnancy than before 30. Diabetes during pregnancy requires adherence to diet and special prescriptions (approximately 15% of women are given insulin injections). In women with diabetes mellitus, the risk of pre-eclampsia, premature birth, placental complications, specific fetal damage - diabetic fetopathy, stillbirth increases during pregnancy.
• Multiple pregnancy (age 35-39 - the peak of twin births). Complications during childbirth (a greater likelihood of weakness in labor, a greater risk of rupture of the soft birth canal due to a decrease in tissue elasticity, bleeding caused by placental problems, etc.).
• Cesarean section. In primiparous 35-40 years old, the probability of delivery by caesarean section is 40%, over 40 years old - 47% (while only 14% of women under 30 years of age give birth by caesarean section).

Risk to the child

• Premature birth.
• Light weight.
• The danger of hypoxia during childbirth.
• The risk of chromosomal abnormalities in the fetus.

Alas, with the age of the parents, the risk of having a child with any chromosomal abnormalities increases dramatically. This is due to various and not fully understood reasons, including the aging of germ cells, and the time that various pathogenic factors and toxic substances are exposed to the human body, increasing with age. (By the way, an increase in the percentage of miscarriages in middle-aged women is also associated with gene mutations - embryos developing from cells with damaged chromosomes turn out to be unviable.)

Mother's age	Down syndrome risk in a child
25	1 in 1,250
30	1 in 952
35	1 in 378
40	1 in 106
45	1 in 30
49	1 of 11

The number of diseases caused by chromosomal abnormalities is quite large, but the most famous and greatest fear in parents is Down syndrome - a combination of mental retardation and deviations in physical development, due to the presence of one extra 21st chromosome. The likelihood of having a baby with Down syndrome increases in proportion to the mother's age (see table).

However, as can be seen from the same table, even a fifty-year-old woman has a great chance (more than 90%) of giving birth to a healthy child, and in general 97% of women who have undergone prenatal examinations receive confirmation that the probability of having a full-fledged child is the same as and in younger women.

In addition, the modern development of prenatal diagnostics gives the family the opportunity to examine the fetus at a fairly early stage of pregnancy and identify (and more often exclude) possible deviations. It would be useful for a young woman to undergo such examinations, all the more so, medical and genetic counseling should not be neglected for those who, by age, are included in the “risk group”. By the way, some of the doctors, in the prime of prenatal diagnostics, see one of the reasons for the increase in the number of middle-aged mothers: women have gained confidence that even after forty they will be able to give birth to a healthy child.

So what is the evidence from numerous studies? Paradoxically, they are optimistic: they say that the overwhelming majority of women who decide to give birth late are giving birth to healthy children!

You have to re-experience or discover the happiness of motherhood for the first time. You already live enough in the world and have the wisdom that twenty-year-olds do not have, you already know: nothing comes for free, without labor, sacrifice and effort; you already have enough strength and patience to overcome all difficulties. That love, those feelings that are born with this child, will change your life. The happiness of maternal love, pride in your child, a second youth - all this you have to go through in the coming years, but for this now, in these 9 months, you will need attention, concentration, tirelessness, iron will and self-discipline, and sometimes readiness to self-sacrifice.

Perhaps many ladies wondered if it was possible to get pregnant at the end of 40 years. Studies have shown that by 41, only a good half of all women retain their natural ability to conceive, and by 45, only one in ten manages to become pregnant. Therefore, of course, it has the essence to start trying to get pregnant as early as possible and not wait too long, at a time when it will not be possible to do without the help of qualified experts. Despite the fact that at the moment it is generally accepted to be considered infertility inability to become pregnant within twelve months, for women of this age group, perhaps, it is not necessary to wait longer than six months before starting to look for other methods of solving this problem. So, at the end of 40, it is possible to become pregnant, but only on one condition: you need to try to get pregnant with the classical method.

Some women who are in their 40s have not been able to get pregnant just because they have not been able to figure out the right time.
To be honest, there are thousands of circumstances due to which a lady gives birth later than in most cases the doctors advise. In the west, this can already be called a strongly pronounced trend: ladies have their first child closer to forty simply because they want to first solve all the other troubles: take an education, make a career, achieve a good financial situation, acquire a home of their own, check the correctness of their choice and the strength of the alliance ...

Moreover, there is a fully scientific explanation for this. The fact is that the older a lady becomes, the less her chances of getting pregnant become. Therefore, the older you get, the fewer days you have to get pregnant. And at the end of 35-40 years, you may have only one or two days for the whole year, in which it will be possible to conceive. But getting pregnant with the classic method can be tricky. This is due to the fact that you are now in the sunset of your reproductive phase of life. Your supply of oocyte follicles dries up and your body's estrogen production decreases.

The limited supply of oocytes is believed to be the main reason for the decline in fertility with age. In addition, the remaining eggs age and with each passing year become less capable of fertilization, while the uterus becomes less and less adapted to pregnancy. It is quite true that the older you get, the less your chances of getting pregnant and bearing a fetus. Starting at about 37 years old, fertility slowly decreases from year to year and, according to statistics, begins to fall at a catastrophic rate at the end of 41 years.

As you get older, the chances of miscarriage and the possibility of birth defects also increase, as the uterus slowly becomes less talented in holding the embryo, while the percentage of chromosomal abnormalities and the formation of defective embryos increases from a few cases to two out of ten by 40 years and up to four to five out of ten by age 45.

But all this information of gloomy statistics does not mean at all that it is you who do not have the opportunity to get pregnant and give birth to a healthy child, if you are already over forty. The statistics are fascinating, but they summarize the data for the entire population as a whole. She does not need to be obligated to treat you personally. Now ladies give birth to children after a long time after the end of the onset of childbearing age, and through the newest scientific methods that amaze the imagination, in addition, after a long time after the onset of menopause.

If you finally decided to have a baby, don't be confused by these numbers. Of course, some women in the same chronological age are biologically significantly younger than others, and their ovaries function much longer than the average level. In addition, if you do get pregnant, do not pay attention to how hard it is for other ladies to achieve this goal, since you are 100% pregnant.
So at what time do you have the opportunity to conceive a child?

The most possible time for conceiving a child is 12-14 days before the onset of menstruation. But the fact is that this is not a completely correct time, tk. different factors can influence it. For example, it can be influenced by stress levels, illness, and many other factors and external stimuli.

If menstruation has become irregular, or they begin more than once every thirty days as before (for most women at the end of 35-40 years this is exactly what happens), then it becomes much more difficult to find out at a time when you can successfully conceive a child ... Based on this, the older you get, the more closely you need to monitor your period.

Secondly, a healthy child is born not only from the fact that the egg is fertilized by the sperm. There are a large number of factors, the observance of which leads to the birth of a healthy child. For example, the older a person becomes, the more correctly you need to know the period at the time when a new egg appears. In order for the sperm, like the egg, to be just emerging, you need to avoid intercourse a few days before ovulation, because scientifically proven that sperm can remain in the body for up to three days.

The most suitable time for conceiving a child is the day of ovulation. On this day, you need, as often as possible, to have sexual intercourse, because just on a given day, the newly emerging egg is possibly fertilized only by the released sperm.

Third, a man also needs to maintain healthy sperm. You need to abstain from sex for 3-4 days before conceiving a child. But never longer.

So, using all of these simple, but at the same time effective ways listed above, you can also get pregnant at the end of 35-40 years. These methods are completely natural, natural, do not cause any harm, moreover, they are very effective. If you begin to use these methods correctly, it will save you from in vitro fertilization (in the common people - a test tube baby), and from other surgical interventions, thanks to which you can become pregnant.

- one of the most important and joyful events in a woman's life. But, like all the most important, this event entails not only joy, hopes and aspirations, but also a lot of worries and fears. And with age, these experiences become more and more. Unfortunately, not all worries of expectant mothers who have crossed the 30-35-year mark are unfounded.

The age period from 20 to 30 years is considered the most favorable for the birth of the first child. For subsequent labor, the best interval is 3 years. During this time, the woman's body has time to recover, that is, to go through a period of rehabilitation after childbirth.

In obstetric practice, there is a specific term "age primiparous", which refers to women who give birth for the first time at the age of 30 and older. However, more and more women around the world are postponing motherhood for the fourth decade of their lives. The reasons may be different, but for most women it is a desire to achieve a certain social and professional status, to make a career, before completely devoting themselves to the family. Following the model of other countries, where women are just beginning to give birth at thirty-five, and sometimes at forty, our number of women who gave birth to their first child between the ages of 30 and 40 has tripled over the past twenty years. Today every 12th child is born by a woman over 35 years old. For a quarter of a century, the number of women giving birth among women 35-39 years old has increased by 90%, the number of mothers who are 40 years old and more has increased by 87%. Even such well-known conservatives as doctors, for the sake of mature mothers, softened their wording: before they were called "old-born", now "age". More and more often there are opinions that women who give birth for the first time over the age of 35 should be considered "age". Everything would be fine, but such a late pregnancy, alas, is fraught with many medical troubles.

Not too late?

The most important problem for women who are not too young is infertility. So, if a woman under 30 years old has a 20% chance of getting pregnant during one monthly cycle, then a woman over 40 has only 5%. About 30% of women over 35 are generally infertile. Why? This is primarily due to age-related changes in the tissues of the uterus and ovaries, which entail a decrease in their functional characteristics. After all, it's not a secret for anyone that we grow up to a maximum of 25 years, and then the natural aging of the human body occurs. It is expressed not only outwardly, in our small wrinkles on the face and body. Age-related changes in the body primarily concern the circulatory system and at the same time are manifested, first of all, in insufficiently functioning organs.

In particular, in young women who have not given birth for many years, the internal genital organs are in a state of functional failure and therefore undergo premature aging. Starting from the age of 28-30, changes in small arteries appear in the fallopian tubes of women; in addition, with age, scars and adhesions form around the fallopian tubes and inside them. The frequency of such changes is especially high in women suffering from inflammatory diseases of the uterus, tubes, ovaries. This leads to obstruction of the tubes, in which the ingress of the egg into the uterine cavity becomes impossible. It is possible to combat these changes with the help of modern microsurgery. In addition, over the years, an increasing number of menstrual cycles pass without the formation of an egg, and the onset of pregnancy in such a cycle, of course, is impossible. During this period, the quality of the eggs decreases markedly and the number of defective eggs increases. Reducing the likelihood of pregnancy, due to the death of eggs, smoking, chemotherapy, radiation therapy.

An additional factor that reduces a woman's reproductive ability with age is also a decrease in "uterine fertility" - the ability to conceive, caused by a decrease in blood flow to the uterus and ovaries, a decrease in the susceptibility of the uterus to hormones and some chronic diseases (fibroids - a benign tumor of the uterus, chronic inflammatory processes, endometriosis, proliferation of the endometrium, the inner layer of the uterus, in places that are not typical for this). These diseases not only interfere with the implantation of the embryo, but also cause problems with bearing the onset of pregnancy.

What about your health?

Another cause for concern is the exacerbation of all chronic diseases that were inherited by a woman or were acquired in her entire past life.Women with cardiovascular diseases (arterial hypertension - increased blood pressure, heart defects), chronic diseases are especially wary of obstetricians. lungs (pneumonia or bronchitis, bronchial asthma, etc.) and kidneys (chronic pyelonephritis), with endocrine diseases (diabetes mellitus, diseases of the thyroid gland, adrenal glands, etc.). After all, if a woman had some kind of chronic disease, which did not seem to give her much trouble, during pregnancy it will certainly remind of itself. And first of all, alas, it is necessary to find out whether, in principle, pregnancy is contraindicated in this pathology.
Such contraindications can be a severe form of diabetes mellitus, severe heart defects, cancer, severe kidney pathology.
But often the desire of a woman to have a child is much stronger than the awareness of the risks to which she exposes herself during pregnancy. Chronic illnesses should be treated 2–3 months before the expected pregnancy, if necessary. Since fetal organs are formed in the first 12 weeks of pregnancy, treatment of chronic diseases with the onset of pregnancy will not bring much benefit to the unborn child. It is better to be observed during pregnancy for women with chronic pathology in special centers.

Women over 40 are 3 times more likely to develop diabetes during pregnancy than before 30. In women with diabetes mellitus, the risk of gestosis, stillbirth and specific fetal damage during pregnancy increases. Diabetes of pregnant women requires adherence to a diet and the fulfillment of special appointments of an endocrinologist.

Complications of pregnancy

The first thing that needs to be said is, of course, an increase in the likelihood of miscarriage. If in women under 30 the risk of miscarriage is 10%, then in women 30-39 years old it is already 17%, and in women 40-44 years old it rises to 33%. The risk of miscarriage is associated not only with age-related changes in the entire female body, but also with genetic disorders, as well as hormonal characteristics. Problems such as chronic placental insufficiency, previa, premature placental abruption are also possible. They are one of the reasons for intrauterine fetal hypoxia, the birth of a low birth weight child, and also the background against which premature and complicated labor develops.

Are we giving birth ourselves?

Childbirth in women after 30 also has its own characteristics, among which there is a greater likelihood of weakness in labor, a greater risk of rupture of the soft birth canal due to a decrease in tissue elasticity, bleeding.

Due to the weak labor activity, childbirth may end with a cesarean section. Doctors consider this method to be more gentle both for the health of the child and for the health of the mother herself. However, the belief that no one naturally gives birth in their 40s is a myth. If we are talking only about the age factor, childbirth passes through the natural birth canal. The decision about a planned caesarean section usually follows from a combination of factors. For example, a woman had infertility for a long time, and fears for the life of a long-awaited baby are very strong. This is a strong case for a caesarean section.

Labor is difficult and lengthy for those women whose muscle and joint elasticity decreases with age. For "late" mothers, an active lifestyle is especially relevant: more movement, swimming, special gymnastics, especially exercises for training the muscles of the perineum.