Risks and Benefits of Being Pregnant at 40

Is it safe to get pregnant at 40? Having a baby after 40 increases health risks for both you and your baby. Pregnant people older than 40 are likelier to have gestational diabetes, preeclampsia (high blood pressure during pregnancy), and miscarriage. A baby is also at risk for high birth weight, genetic abnormalities, and premature delivery.

Is a 40-year-old a high-risk pregnancy? Yes, 40 is considered to be a high-risk pregnancy age. Research has shown that prenatal care can mitigate some of these risks. 

It can be challenging to get pregnant at 40. You are born with a limited egg supply, which dwindles significantly after 35. The chances of getting pregnant at 40 is 44%. Read on to learn about having a baby in your 40s, including the likelihood and risks.

What Are the Chances of Getting Pregnant in Your 40s?

Research has found that the chances of getting pregnant decrease to 44% at age 40, compared to 85% at age 30. There are other fertility options to start or extend your family if you have trouble conceiving naturally or you have age-related infertility.

These include: 

• Fertility medications that can help induce ovulation (e.g., clomiphene)
• In vitro fertilization (IVF) using frozen embryos or donor eggs (eggs from another person)
• Intrauterine insemination (IUI), or artificial insemination
• Surrogacy, or gestational carriers

Keep in mind that the success rates of methods like IVF decline as you age. People aged 41–42 have a 12% chance of achieving a live birth with IVF. Those aged 43–44 have a 5% chance. Using a donor egg from a younger donor can substantially increase the chances of a successful IVF cycle to 51%.

Why Does Fertility Decrease?

You have a limited supply of eggs at birth, meaning you are born with all the eggs you'll ever have. This egg supply dwindles considerably after 35. Fertility declines to a point where it's unlikely you'll get pregnant naturally after 45.

The quality of these eggs also decreases with age. Eggs are more susceptible to DNA damage and genetic mutations if you are older.

What Are the Risks of Pregnancy at 40?

Is a 40-year-old a high-risk pregnancy? Yes, pregnant people older than 40 have a higher risk of complications from pregnancy and childbirth. These complications include gestational diabetes, preeclampsia, and miscarriage.

Getting pregnant and staying pregnant after 40 can be difficult. The American College of Obstetricians and Gynecologists (ACOG) advises seeing a healthcare provider before trying to get pregnant to assess fertility and health risks.

C-Section

Pregnant people older than 40 are more likely to need a C-section, or cesarean section, than others. A healthcare provider makes an incision in the abdomen to deliver the baby. C-section is a major surgery that often comes with a slower recovery time than vaginal delivery. Although rare, C-sections can increase your risk of blood loss, blood clots, and infection.

Additional risk factors influence your risk of childbirth complications in your 40s. People older than 40 are less likely to get pregnant naturally, so many use IVF to get pregnant. IVF can result in multiple births. The risk of C-sections increases substantially in people over 43 who use IVF and carry twins.

The number of children you have previously birthed may also affect your risk. Older parents who have already given birth may be likelier to need a C-section than younger parents with children. People who have their first child after 40 are more likely to have a C-section than older parents who have already given birth.

Genetic Abnormalities

Your eggs become more prone to chromosomal abnormalities as you age. Children born to parents older than 40, for example, have an increased risk of Down syndrome (trisomy 21).

Down syndrome is the most common genetic disorder associated with older parents. The chances of having a child with Down syndrome is 1 in 1,480 in your 20s. That risk increases to 1 in 85 at 40 and to 1 in 35 after 45.

Gestational Diabetes and Preeclampsia

Pregnancy after 40 increases your risk of complications like gestational diabetes and preeclampsia. Gestational diabetes causes high blood sugar during pregnancy. A study published in 2016 found that 8.5% of pregnant people older than 40 develop gestational diabetes, which is more than double the risk for people younger than 35.

People with gestational diabetes are more likely to deliver a baby with a high birth weight via cesarean section and have high blood pressure. Gestational diabetes and high blood pressure also increase your preeclampsia risk. Preeclampsia is a high blood pressure disorder that can lead to life-threatening complications for the parent and baby.

Miscarriage

Some evidence suggests that your risk of miscarriage is about 53% in your 40s, compared to 10% in your 20s. Miscarriage is early pregnancy loss that occurs before the 20th week of pregnancy. You may have cramps and spotting.

Miscarriage is very common, and many people miscarry before they know they are pregnant. Pregnancy loss can be traumatic and result in emotional, mental, and physical side effects.

Premature Birth

Pregnant people older than 40 are more likely to give birth prematurely than others. Modern medicine has helped premature babies survive and go on to live healthy lives.

Newborns born prematurely have an increased risk of health concerns, such as:

• Breathing and feeding problems
• Cerebral palsy (CP), which is a group of balance and movement disorders
• Developmental delays
• Hearing issues
• Vision problems

Research has shown that older parents also have a 17.4% chance of having a baby with fetal growth restriction and a 15.4% chance of high birth weight (i.e., more than 9 pounds). Fetal growth restriction increases the risk of respiratory and vision problems and vulnerability to infections.

A higher-than-normal birth weight can lead to complicated births that result in injury or trauma to the parent and baby. Large babies are also more likely to be delivered via a C-section. 

What Are the Benefits?

It may feel overwhelming to sift through the risks of pregnancy in your 40s, but there are several advantages. Having a baby at 40, for example, may come with increased career and financial stability.

Other benefits of pregnancy after 40 for you and your children include:

• Improved cognitive function in older women 
• Increased longevity
• Less likely for children to have social difficulties
• More financially stable to raise a family
• More likely for children to succeed in education

Research has shown that the chances of getting pregnant at 42 naturally may increase if you eat a nutrient-rich diet, including high-fiber foods. A high intake of added sugars, refined carbs, and trans fats, in contrast, can decrease fertility.

Preparing for a Baby in Your 40s

Keep in mind that being at a high-risk age does not mean you cannot have a healthy baby. Everyone's pregnancy is unique, and having a baby after 40 does not mean you'll automatically encounter health problems. 

It may be challenging to get pregnant naturally at 40. Egg donors, reproductive technology like IVF, and surrogacy can help make pregnancy and childbirth possible for older parents. Reach out to a healthcare provider before trying to get pregnant. The sooner you begin receiving care and preparing for pregnancy after 40, the better your outcomes of having a healthy pregnancy are.

Cryopreservation and Genetic Testing

Cryopreservation, or freezing, of eggs in your 20s or 30s can help increase your chances of getting pregnant at 40. A healthcare provider will instruct you to inject yourself with hormone medicines at home for several days. These medicines induce superovulation, which helps the ovaries release multiple eggs per menstrual cycle.

The healthcare provider will then surgically extract the eggs. You may also opt for genetic testing of the eggs or embryos (fertilized eggs) before freezing them. Genetic testing analyzes the DNA to check for genetic abnormalities.

This process is expensive: One cycle may cost as much as $17,000 without health insurance. You'll likely need to pay an annual fee of $300–$500 fee to store the eggs.

Prenatal Care 

Prenatal care can mitigate many of the risks of having a baby after 40. Research has shown that older parents who receive proper prenatal care do not have significantly different pregnancy outcomes compared to those under 40. A study published in 2016 found about 17% of older pregnant people have C-sections. About one in 1,000 of those people delivered prematurely.

Prenatal care for older parents may include:

• Adopting a healthy lifestyle before and during pregnancy, including eating a nutrient-rich diet and staying physically active
• Attending regular prenatal checkups
• Giving birth in a perinatal center, which specializes in high-risk pregnancies
• Treating any underlying health conditions

Preparing for a Healthy Pregnancy

There are several lifestyle habits you can adopt before getting pregnant to lower your risk of complications. Here's how to prepare for a healthy pregnancy:

• Do not drink alcohol or smoke, and limit caffeine: These substances can make it hard to get pregnant. Drinking alcohol and smoking also increase miscarriage risk.
• Eat a nutrient-rich diet: Consume plenty of fruits, grains, low-fat or nonfat dairy, and vegetables.
• Reduce stress: Make time to relax and ensure you get plenty of sleep per night.
• Stay physically active: Aim for 30 minutes of moderate-intensity aerobic exercise five days per week. This includes brisk walking, jogging, and swimming.
• Take supplements: Folic acid helps protect against birth defects. Talk to a healthcare provider or pharmacist before starting any supplements.
• Visit an OB-GYN: This healthcare provider specializes in reproductive health and pregnancy. They can review your health history and discuss ways to support fertility.

A Quick Review

You are born with all the eggs you will ever have, so fertility declines with age. The chances of getting pregnant at 40 decreases from 85% at age 30 to 44% at age 40. There are several risks of having a baby at 40, including genetic abnormalities in children, gestational diabetes, and preeclampsia.

You can mitigate these risks by working with an OB-GYN. Some people opt to freeze their eggs in their 20s or 30s, which increases the likelihood of pregnancy at 40. Eating a nutrient-rich diet, getting plenty of sleep, and staying physically active can support fertility and a healthy pregnancy.