Everything you need to know about pregnancy in your late thirties

BENGALURU: Embarking on a pregnancy only in late thirties is becoming common for various reasons such as, finding a partner late, awaiting career stabilisation, etc. Many concerns may arise in one’s mind when considering delaying pregnancy. ‘Am I likely to have some difficulty in falling pregnant? Am I more likely to have a miscarriage? Will the baby be okay?’ The list goes on.

With various sources around painting a not-so-positive picture, it is but natural to feel gloomy. However, it is not true that all odds are stacked against you. Most women in their late thirties with regular cycles have about 25 per cent chances of conceiving per cycle. The most important factor seems to be hitting the bull’s eye at the time of ovulation, which is a window of about six days (five days prior to ovulation and a day after ovulation). However, getting stressed about finding when one has ovulated is not going to help. Enjoying regular sex and increasing the frequency during the fertile days would certainly help increase the chances of a conception. About 70-80 per cent women fall pregnant in their first year of trying without protection.

Should I consult a doctor before pregnancy?
Pre-conceptional counselling is extremely important for someone considering pregnancy especially so, if in late thirties. It involves the following:

■ Folic acid tablets to prevent neural tube defects (defects in the brain and spine) in the baby. Ideally, the tablets have to be taken at least one month prior to conceiving.
■ Screening for any pre-existing conditions such as hypothyroidism etc and optimise control
■ Vaccinations for certain infections such as Rubella ( German measles) etc
■ Advice regarding balanced and regular meals
■ Focus on fitness and improving core muscle strength
■ Advice about avoiding smoking (both active and passive), alcohol and drugs

Will the pregnancy be at a higher risk?
Pregnancy complications seem to be related to pre-existing conditions rather than increased age alone. There are some important aspects to consider in a pregnant woman over 35 years of age. Some evidence says that there may be a higher risk of miscarriages (general population about 1 in 4). However, this may be related to other factors such as obesity and stress.

In advanced age, certain tests will be performed at the third month in order to determine the risk of the baby having a chromosomal abnormality like Down’s syndrome. Also, screening for risks like development of hypertension in pregnancy and small babies is advised.

There is some evidence to say that women over the age of 35 are more likely to have a caesarean section but the evidence may be skewed due to other contributing issues such as obesity.

In general, the woman is encouraged to be as physically active as possible. There is no reason to avoid work or the commute if all is normal. Informing one’s boss/ manager / colleagues can be done once the pregnancy is confirmed and the scan shows a normally developing fetus. Stress of any kind is to be avoided.

The author is a senior consultant obstetrician and gynaecologist,Fortis La Femme Hospital, Richmond Road