Pregnant woman reflecting by the ocean. Photo by Pixabay
Photo by Pixabay

What I Learned as a Geriatric Pregnant Lady

Advanced Maternal Age: a.k.a. birthin’ babies at a ripe old age

Last year, I gave birth at the age of 40. Next year, I’ll do it again at the age of 42. Here are some lessons I’ve learned along the way.

Lesson 1: 40 is not, in fact, the new 30.

Okay, look, 40 is 40. And that’s beautiful. For many women, 40 can be both scary and liberating. It’s an arbitrary threshold, but 40 can be considered the year you can officially say “screw it” to a lot of the rigamarole that young women have to put up with. It’s mainly an attitude, not a physical turning point.

But… middle age is also a physical turning point, not just a state of mind. And pregnancy in middle age is different than pregnancy in young adulthood.

“Advanced Maternal Age”

After age 35, pregnancies are called Advanced Maternal Age and they are associated with greater chances of complications.

Birth defects: Certain birth defects are a higher risk for older women because their eggs are older — because you’re born with all the eggs you will ever have — and the genetic material can be damaged. Remember, if you’re 40, so is the egg that you’re using to make your baby.

Also more common are premature births, miscarriages, or fertility challenges that make it harder to get pregnant in the first place. Right now, I’m 41 and my genetic screening results lists some pretty high risk rates of serious conditions.

For example, my eggs currently have a 1 in 38 chance of producing a baby born with Down Syndrome. If you have a baby at age 25 by comparison, your chance of having a baby with Down Syndrome is 1 in 1,340.

Overall in the US, about 1 in 700 babies are born with Down Syndrome and there are multiple ways during pregnancy to screen for it and other genetic conditions. Some of the chromosomal abnormalities the blood tests screen for are so severe that the baby will die at birth or within the first year of life. So the risks are very real.

Testing is a good idea, regardless of your religious beliefs, so you know ahead of time what to plan for and expect.

Other pregnancy complications: For older moms, pregnancy complications like diabetes, high blood pressure, and preeclampsia are more common. And older women are more likely to require a c-section because of these conditions.

Older women are also more likely to carry twins, which can compound all of these other risk factors.

Lesson 2: Advanced Maternal Age is increasingly common.

All these risks aside, American women are having babies later in life.

At the age of 39, I went to one old gynecologist for a consultation. I told him I was thinking of trying to become pregnant and asked for testing on my uterus and fallopian tubes to see if I was in good enough shape to see it through.

This elderly doctor pulled out what looked like a yellow page from a Reader’s Digest and told me that a study from decades ago on Amish women had shown the chances of successful pregnancies plummeted after the age of 39, and that I shouldn’t hold my breath.

Well, I wasn’t about to be outdone by Amish ladies!

The number of US births is on a historic decline.

Women in the US — and other wealthy industrialized countries — are having babies later in life than they used to, for different reasons. Overall, the US fertility rate is at an all-time low.

Part of it is the economy (stupid), which makes it harder for a young couple to establish themselves with a home and stable income. Part of it is the desire on the part of women to earn higher education degrees and establish careers before they start a family.

Some of it might just be a generational shift that regards young adulthood as most of one’s 20s. In the past, many girls would be married with children by the age of 20. Today, those young women are more likely to be in school. One great side effect is that US teen pregnancy is at all-time low.

Fertility issues are also more common today than in the past, for complex reasons and with tragic results. Some couples struggle for years to start a family and must receive expensive fertility treatments or implantation procedures before they can have a child.

Lesson 3: You will live in the clinic.

As a lady blessed with a geriatric pregnancy, you will be scrutinized and tested half to death.

Diabetes testing: Gestational diabetes is more common in older moms, even if you aren’t overweight.

To test for gestational diabetes, you’re usually sent to the hospital lab. There is an initial one-hour test, and a three-hour test that follows if you fail the first one.

You sometimes need to fast beforehand and avoid drinking anything the day of the test. The test involves providing a blood sample, then drinking a gross little bottle of liquid that tastes like Tang.

If you’re old enough to know what Tang is, you probably need this test.

Then you wait an hour and return to the lab for another blood draw. If you’re doing the three-hour test, you have to repeat this waiting and blood sample routine two more times.

These tests are a pain, but they are important. Undetected diabetes causes major problems during pregnancy. You have to watch your diet and follow the medical instructions on managing your condition for your own sake and for your baby’s.

And if you end up having gestational diabetes, it will usually go away as soon as you give birth.

Monitoring and ultrasounds out the wazoo: I’ll just tell you, if you are an older mother-to-be, you’re going to be probed and monitored on a weekly basis as you get closer to your due date.

In my own experience, thankfully buttressed by decent health insurance, I was required to report to a perinatal center every week to have baby’s movements and heartrate measured over a half-hour period.

Then I’d get a brief ultrasound that measured baby’s growth, watched for movements, and recorded his heartbeat.

Why? Because just the status of Advanced Maternal Age puts a pregnancy in a higher risk category. And high risk pregnancies are carefully monitored. If a baby isn’t moving very much, if there are problems with the heart, if the baby is positioned breech — clinicians need to know and take action.

Lesson 4: Cankles. OMG, the Cankles, y’all.

I had two children in my 20s, both healthy pregnancies and uncomplicated deliveries. My older kids are now large surly teens who help me with their itty bitty brother.

But even with my prior experience with pregnancy, I wasn’t prepared for some of the changes that being an older woman brought into the mix.

Lifestyle changes

Pregnancy at any age is a haul. You spend nine months, ideally, taking extra good care of yourself.

You watch your diet and nutrition, track your weight gain, try to get enough sleep, exercise — you know, all the stuff that healthy people are supposed to do all the time.

For many of us, unfortunately, these are kind of big lifestyle changes. I’m a generally healthy person with generally healthy habits, but it’s not a conscious part of what lifestyle people call their lifestyle. Health and fitness aren’t my lifestyle, you know?

But pregnancy requires a conscious approach to these things. Because they are important both for your own health and for the new little person you are building inside of you.

Some surprising new pregnancy issues as a 40-something:

Cankles — the swelling in my feet, ankles, and lower legs from water weight was unbelievable. By the end of my pregnancy, I could barely get a pair of sandals on my poor feet. Just sitting in a chair for any length of time turned painful. Riding in a car made a mess out of me.

Carpal tunnel? — This one was a complete surprise in my last pregnancy, and boy, is carpal tunnel syndrome ever painful. Pain and tingling in your hands can be caused by water weight gain. Arthritis is also aggravated by pregnancy weight.

Pelvic joint pain — I did my best to take a walk every day, but dear lord, the pain in the hips gets excruciating. This isn’t caused by lack of exercise or stretching. It’s partly hormonal: your body is getting ready to deliver a baby and hormones help loosen up the ligaments in your hips. This pain is also caused by pressure on nerves that run under your uterus and legs. This condition is called sciatica and it can be a real bitch. Ain’t no party like a nerve pain party.

But here’s the good news. Most of those issues went away with childbirth. Within a week of giving birth, I had lost nearly 40 pounds, most of it the baby, placenta, and just a huge amount of water!

Besides all that, I got a daggone baby out of it!

And let me tell you, my ankles felt amazing.

A compassionate and opinionated human being. | Fiction author and visual artist in Central Appalachia. | Give my newsletter a try: https://bit.ly/2sZGM6n

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