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Ann Douglas, author of The Mother of All Pregnancy Books: The Ultimate Guide to Conception, Birth and Everything in Between and The Mother of All Baby Books: The Ultimate Guide to Your Baby's First Year, is here at Pregnancy & Baby! Read Ann's advice on everything from keeping romance alive amidst the structure and stress of baby-making to weathering the storms of morning sickness to preparing for the birth of your dreams.
Ann Douglas

More Mom's the Word by Ann Douglas

Not all doom and gloom
It can be more than a little disconcerting to hear yourself described as "elderly" or "of advanced maternal age" when you only recently celebrated your 40th birthday, but, in the eyes of the obstetrical profession, that's exactly what you are.

Obstetricians don't care how young you look and feel, or whether you can still fit into the same size of jeans that you wore 20 years ago: they're concerned about the age of the eggs that are nestled away in your ovaries. And, as much as you might like to ignore this fact, the clock started ticking on those eggs more than 40 years ago.

While it's not all doom-and-gloom on the reproductive front -- the majority of women giving birth in their 40s manage to end up with healthy babies in their arms -- there is sometimes a price to be paid for postponing motherhood until later in life. Here's what you need to know when you're making the mother of all decisions -- when to start your family:

Understanding fertility
Your fertility declines as you age. Unlike men, who have the ability to manufacture sperm throughout their lives, women are born with all the eggs they're ever going to have. The quality of these eggs deteriorates over time, something that can lead to fertility problems as a woman ages.

Older mothers face an increased risk of miscarriage, stillbirth or infant death. Because your eggs age along with all the other cells in your body, they are more likely to have chromosomal problems than the eggs of a younger woman, according to Ottawa, Canada obstetrician Andree Gruslin.

Older mothers are more likely to become pregnant with multiples. The risk of conceiving more than one baby increases with age, even if you're not taking fertility drugs. According to the National Center for Health Statistics, women over the age of 45 are 10 times as likely to become pregnant with multiples as women in their 20s.

Older mothers are more likely to develop certain types of pregnancy-related complications. These complications include diabetes, pre-eclampsia (high blood pressure), placenta previa, placental abruptions, preterm delivery and intrauterine growth retardation. And, according to a study reported in the January 1999 issue of Obstetrics and Gynecology, a woman who is 40 years or older when she gives birth to her first child is almost four times as likely to develop gestational diabetes as a woman in her 20s.

Older mothers may have some age-related health conditions which could make their pregnancies more difficult to manage. Such conditions include hypertension, cardiovascular disease and diabetes.

Older mothers are more likely to require cesarean deliveries. One study found that women over the age of 44 are 7.5 times as likely to require a cesarean delivery as younger women.

Still, you needn't abandon your plans to have a baby just because you're no longer a spring chicken -- at least reproductively speaking. According to obstetrician John R Sussman, co-author of The Unofficial Guide to Having A Baby, there's plenty of reason to remain hopeful about your odds of taking home a healthy baby: "For the large majority of women, having a baby in their early 40s is safe and uncomplicated."

For more on pregnancy beyond age 40:

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