What happens if I’m pregnant over the age of 40?

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What happens if I’m pregnant over the age of 40? 

What are the risks if you’re pregnant over 40?

Will I get extra care if I am pregnant over 40?

What can I do to make sure I have a healthy pregnancy over 40?

Are there any advantages to being older and pregnant?

What happens if I’m pregnant over the age of 40?

Rates of people getting pregnant in their 40s are at a record high. Nearly 1 birth in 50 is to someone over the age of 40. Most people over 40 who get pregnant have healthy pregnancies and babies. However it can take longer to get pregnant and some people have complications.

If you’re older than 35, you’re more likely to conceive more than 1 baby. This may be through getting pregnant naturally or using assisted conception such as IVF. Carrying more than 1 baby can make pregnancy more complex, even more so if you’re older.

Being older sometimes means that your body has to work harder than it would have done when you were younger.  

What are the risks if you’re pregnant over 40?

You’re more at risk of problems in pregnancy from the age of 35. The risks increase further as you get older. But try to remember there’s a good chance your pregnancy will be healthy.

Your age may affect how well the placenta can develop. This could make other complications more likely, such as:

• having a baby with a low birth weight  
• low-lying placenta or placenta praevia
• pre-eclampsia
• placental abruption.

You’re more likely to have health conditions in pregnancy such as high blood pressure and diabetes. You’re also more likely to have birth complications.  

Sadly, miscarriage and ectopic pregnancy are more common when you’re older. Miscarriage is common in all pregnancies but the rate rises with age, with 1 in 2 pregnancies in people over 45 ending in miscarriage.  

This sounds scary, but try not to worry too much. Even though some complications are more common as you get older, this doesn't mean they will happen to you.

Your midwife and GP are trained to care for pregnant people in their 40s, but you may also be referred to a consultant. In some hospitals and maternity units, if you’re over 40 you will be under consultant-led care. This depends on your hospital’s policy.  

Gestational diabetes  

People in their 40s are more likely to get gestational diabetes than those in their 20s or 30s. If you’re thought to be at risk you’ll be offered a test for this during pregnancy.  

Having a very big baby 

If you’re over 40 you’re also more likely to have a very big baby (over 4.5kg or 10lb, referred to as macrosomia). Having a very big baby is often also linked to gestational diabetes. Your midwife may arrange an extra scan to check the size of your baby if they think it’s needed.  

Needing to have a caesarean 

People over 40 are the most likely age group to have a caesarean birth. It is almost twice as likely that you will need a caesarean than if you were under 40. This may be because the muscles of the womb are not as strong as we get older.

If you have added complications, such as a large baby, your healthcare team may discuss the option of a planned caesarean with you.

Many women and birthing people over 40 have straightforward vaginal deliveries.

Having a stillbirth

If you’re over 35 you’re more likely to have a stillbirth compared to someone under 35. Be assured that the risk is still low though. 

It’s important to monitor your baby’s movements. Contact your midwife or maternity unit right away if you think their movements have slowed down, stopped or changed. All pregnant people over 40 are offered an induction around their due date, as the risk of stillbirth goes up after 40 weeks.

Chromosomal abnormalities

Being older means you have a higher chance of having a baby with a chromosomal abnormality, such as Down’s syndrome and Patau’s syndrome. All pregnant people are offered screening tests for chromosomal abnormalities.

Will I get extra care if I am pregnant over 40?

If you are over 40, a specialist pregnancy and birth doctor called an obstetrician will be involved in your care, along with your midwife and GP.

Because you are at a higher risk of complications, you may be offered more tests to check that you and your baby are healthy. For example, your blood pressure may be checked more often because of the higher risk of pre-eclampsia.

Your midwife will explain more about what your care plan will look like at your booking appointment. You’ll also have the chance to ask any questions or talk about any concerns you might have. Make sure you attend all your antenatal care appointments so that your healthcare team can spot any problems early and treat them.

It's possible to experience perimenopausal symptoms while pregnant. If you need support with this speak to your health care provider. You can read our blog about managing pregnancy and menopausal symptoms here.

What can I do to make sure I have a healthy pregnancy over 40?

The best thing you can do if you are pregnant at any age is to stay as healthy as you can. Try to:

• not smoke
• eat a healthy balanced diet
• lose weight before pregnancy if you are overweight or obese
• manage your weight gain if you are overweight or obese in pregnancy
• avoid certain infections, including rubella
• avoid certain foods
• cut out alcohol and stop using illegal drugs
• stay active
• limit your caffeine intake before and during pregnancy.

"I had my second child when I was 41. It was a lovely experience, and I didn't have any issues that may affect older women. I don't regret for one moment having a child in my 40s. I felt so much more confident by then." 
Helena, mum of two 
 

Are there any advantages to being older and pregnant?

It’s possible that you are eating better and being more active than you did when you were younger. Older women and birthing people are also less likely to be smokers.  

The confidence you may have got from having more life experience may make it easier to enjoy pregnancy and having children. It’s also more likely that you are emotionally and financially stable and ready for children.  

Try not to worry too much about your age. Just focus on having as healthy a pregnancy as you can and bonding with your baby. If you have any worries or concerns, it might be helpful to talk to your GP or midwife.