According to the Royal College of Obstetricians and Gynaecologists, the ideal age to have a baby is between 20 and 35. And women who put off having children until their mid to late 30s, or even older, are ‘defying nature’. The RCOG fears too many women still do not understand that their fertility declines after 35. The chances of conceiving naturally are slim at 40 and virtually nil after 45.
“Our statement has been prompted by concern among obstetricians and gynaecologists because we are seeing more and more older women who are confronting the heartbreak of infertility and miscarriage”, says Melanie Davies of the RCOG. “Every week in my clinic I see women who say ‘if only I had known this, I could have planned for this. I wouldn’t have postponed my plans for pregnancy’.”
In the UK, the age at which women first become mothers is continuing to rise. In the mid 1980s about 8 per cent of women who got pregnant were over 40 whereas now the figure has more than doubled to 19 per cent. But as women get older the number and quality of their eggs declines, warns the RCOG, which represents the UK’s 5,148 specialists in childbirth and women’s health. This is linked with ‘worsening reproductive outcomes’. As well as the increased risk of infertility, pregnant women over 35 face a higher risk of complications during pregnancy and birth, and they are more likely to have a baby with a congenital abnormality such as Down’s syndrome.
Simply being older and pregnant carries a much higher risk of miscarriage, too. A woman over 40 is between two and three times more likely to lose a baby. And older women should not rely on IVF to help them out if they find they’re having difficulty conceiving naturally. IVF is far less successful as women get older. The live birth rate for women under 35 undergoing IVF is 31 per cent but plummets to just 5 per cent for women over 42 (most NHS fertility clinics refuse to treat women over the age of 42 with IVF unless it’s using donor eggs).
But it’s not all doom and gloom for older mums. Each year, thousands of women over 35 have a trouble-free pregnancy and give birth to a healthy child. In fact, the birth rate among older women seems to be increasing rather than decreasing.In 2008, there was a 5 per cent increase in fertility among women aged 40 and over in England and Wales compared with the previous year – higher than the rise seen in younger women. For this age group the fertility rate rose from 12.0 live births per 1,000 women in 2007 to 12.6 live births per 1,000 in 2008. Over the past decade, the number of live births to mothers aged 40 and over has nearly doubled from 13,555 in 1998 to 26,419 in 2008, according to the Office for National Statistics.
To maximise the chances of conceiving and having a healthy baby, the RCOG recommends that older women get into the best possible shape before they try to get pregnant. That means losing excess weight, eating a balanced diet, taking regular exercise, drinking only in moderation and quitting smoking. It is also a good idea, says the report, to make sure any medical conditions that a woman has are treated and are under control (for example diabetes or high blood pressure) and that they make sure to take daily supplements of folic acid while trying to conceive and for the first 12 weeks of pregnancy
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