Natalie Portman, Anne Hathaway, Ciara: Is 40 the New 30 for Pregnancy?
Excerpt: This year, three famous women announced pregnancies in their 40s. Here's an honest look at fertility after 40, the risks we watch more closely and what a healthy 40-plus pregnancy plan looks like.
In this article
First, about that word "geriatric"
The honest truth about fertility after 40
What we watch more closely
What a 40-plus pregnancy plan looks like
And the good news
Frequently asked questions
Check any celebrity news site this year and you'll see a pattern. In April, Natalie Portman announced at 44 that she was expecting her third child. In June, Anne Hathaway, now in her 40s, shared that she was pregnant with her third. And in September, Ciara, 40, announced she's expecting baby number five.
So is 40 the new 30? Medically speaking, not quite. But pregnancy in your 40s is more common, and more successful, than ever. I've been caring for Monroe moms since 1982, and here's what I tell my patients.
First, about that word "geriatric"
If you're pregnant at 35 or older, you may see the old term "geriatric pregnancy" in your chart. Please ignore it. Today we say "advanced maternal age," which is only slightly less insulting. It simply means we watch a few things more closely.
The honest truth about fertility after 40
The hardest part is often getting pregnant, not staying pregnant. Egg quantity and quality decline with age, and that decline speeds up in the late 30s.
By 40, the chance of conceiving in any given month is much lower than at 30.
Miscarriage rates rise significantly through the 40s.
Many pregnancies after the mid-40s involve fertility treatment or donor eggs.
Celebrities don't always share how they conceived, and they don't owe anyone that information. But it's worth knowing that a magazine cover doesn't tell the whole story.
If you're over 35 and have been trying for six months without success, see a doctor. Over 40, many experts suggest getting evaluated right away.
What we watch more closely
According to March of Dimes, pregnancy later in life carries higher odds of:
Chromosomal conditions such as Down syndrome
Gestational diabetes
High blood pressure and preeclampsia
Placenta problems
Cesarean delivery
Stillbirth, which is why we often recommend extra monitoring near the end of pregnancy
Higher odds are not a guarantee of anything. The large majority of women in their 40s have healthy pregnancies and healthy babies.
What a 40-plus pregnancy plan looks like
Start prenatal vitamins with folic acid before conception, if you can
Get a preconception visit to check blood pressure, blood sugar and medications
Discuss genetic screening early, including a simple blood test that screens for chromosomal conditions
Ask about low-dose aspirin, which can lower preeclampsia risk for some women
Plan for extra monitoring in the third trimester
Talk about delivery timing, since many doctors recommend delivering around 39 weeks after age 40
Our pregnancy care team builds that plan with you, from the preconception visit through delivery.
And the good news
Women in their 40s often bring something younger moms don't: stability, patience, finances and a very clear sense of what they want. Many of my patients over 40 tell me this was exactly the right time for them.
You can absolutely have a healthy pregnancy in your 40s. You just deserve a plan built for it.
Thinking about pregnancy after 35 or 40? Book a preconception visit at Monroe OBGYN or call (734) 242-2022.
Frequently asked questions
What's the chance of getting pregnant naturally at 40? It's lower than in your 20s and 30s, and it drops further each year. Many women do conceive naturally in their early 40s, but it can take longer. If you're 40 or older, don't wait to get a fertility evaluation.
Is a pregnancy after 40 automatically high-risk? It's watched more closely, but that doesn't mean something will go wrong. Most women in their 40s have healthy pregnancies. The extra monitoring is there to catch problems early.
When should I start prenatal vitamins? Ideally at least a month before you start trying. Folic acid helps prevent certain birth defects that develop very early, often before you know you're pregnant.
Can I have a vaginal birth after 40? Yes. Cesarean rates are higher after 40, but many women deliver vaginally. We'll talk through your options as your pregnancy goes on. If you've had a C-section before, read Kim Kardashian's Placenta Accreta.
References
March of Dimes. Pregnancy After Age 35.
About the author: Dr. Soudabeh Ahadi, MD, is a board-certified OB-GYN and the founder of Monroe OBGYN, where she has cared for women and families since 1982. She provides prenatal care, genetic screening, preconception counseling and infertility evaluation.
This post is for general education and isn't medical advice. Talk to your own doctor about your situation.
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