As you get older, pregnancy poses three distinct issues. The first is whether you're able to get pregnant in the first place. A woman's fertility declines as she ages. Many factors contribute to this, but the primary one is what doctors call egg quality. When a female is born, her ovaries already contain all the eggs she will ever have in her life. As she gets older, the eggs in this dwindling supply deteriorate, as do the structures that protect them until they are ready to be used. Over time, an increasing proportion of the woman's eggs can't be fertilized at all, or are so badly damaged they die soon after fertilization. The increased incidence of other health problems -- including hormonal malfunctions, infections of the reproductive tract, and diseases such as diabetes -- also contributes to the general decline in fertility in this age group.
Even so, many women over 40 can and do get pregnant. That raises the second issue: whether your baby will be healthy. Just as egg abnormalities make it harder for an older mother to conceive, they are also responsible for the higher incidence of problems in the eggs that do make it to birth. Babies born to older mothers have an increased risk of disorders such as Down syndrome that result from genetic abnormalities in the egg. The risk of other types of birth defects rises with age as well. Older mothers are generally offered the option of testing a baby before birth for some of the more common problems.
The third issue is whether pregnancy after 40 is safe for you, the mother. Older moms have a higher risk of certain complications, such as preeclampsia (high blood pressure during pregnancy) and gestational diabetes (pregnancy-induced diabetes). Still, if you're in good health, get adequate nutrition, avoid tobacco and alcohol, and exercise regularly, you have excellent prospects for a safe pregnancy. Before you try to conceive, talk with your health care provider to determine whether you face any particular health risks, and whether there is anything you can do to improve your chances.
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