Worldwide, more women are choosing to become mothers later in life. In fact, according to the Organization for Economic Cooperation and Development, in most European countries, the average age of a first-time mother was 28 in 2018. In 1970, it was 24. In the U.S., the average age was 27 in 2018, up from age 21 in 1970. The Society of Obstetricians and Gynecologists of Canada tells us that more than half of the Canadian births in 2018 were to mothers over the age of 30.
With so many women becoming mothers later in life, today there are more resources available and a greater understanding of the risks than ever before. We’ve put together a list of eight valuable tips to help you enjoy a healthy pregnancy later in life.
- See your doctor early. Particularly if this isn’t your first rodeo, you might be tempted to wait and see your doctor a few months into the pregnancy. However, when you’re over age 35, you should see your doctor at the first sign of pregnancy. If you’re taking any prescription medications at all, ask to speak with the doctor’s medical assistant when you make the appointment to make sure what you are taking is safe for the baby.
For mothers at an advanced maternal age, it’s important to determine the exact age of the fetus. Research has found that older mothers often have a higher risk of complications when they deliver after 40 weeks of gestation. The best way to determine the precise day on which conception was achieved is to get to the doctor as soon as possible.
Additionally, see the right kind of doctor. Make sure your obstetrician has an endorsement for high-risk management or is a maternal-fetal medicine specialist (MFM). These obstetricians are trained to work with high-risk pregnancies and those who have become pregnant later in life.
- Get plenty of sleep. While all expectant mothers should get plenty of sleep, those of advanced maternal age must make adequate sleep even more of a priority. A 40-year-old body takes a bit longer to generate and repair tissue than a 24-year-old body. Tissue regeneration and production are done primarily while you sleep. Your baby’s development and your body’s ability to provide nutrition for the baby depends heavily on allowing yourself to get plenty of decent rest.
Try natural sleep remedies like pure organic cherry juice before bed, deep breathing exercises, or a pre-bedtime bath with Epsom salt. Also, get some morning sunlight on your face right when you wake up. It helps set your body’s internal clock so that you’re tired at night. Aim for at least eight hours of sleep each night and nine if possible.
- Exercise wisely. Jen Barns, a family nurse practitioner in Indianapolis, recommends regular exercise for all expectant mothers. Barnes says, “If you weren’t very active before you became pregnant, you can still exercise when you’re pregnant. Take a daily brisk walk while wearing good supportive shoes.” The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women get 30 minutes or more of moderate exercise most days of the week.
Swimming, jogging, aerobic dance classes, and Pilates are other excellent forms of low impact exercise for pregnant women of advanced age. However, particularly in the area of exercise, listen to your body. Don’t plan to exceed any previous personal speed records or weightlifting achievements during your pregnancy. It’s not the time to start training for your first marathon either.
As for high-intensity exercises, be clear with your doctor about your plans and always get clearance. Barnes says, “For most activities if you had consistently been doing it before your pregnancy, you can do it while you’re pregnant.” If you’re a long-time runner, a cyclist or a hip-hop dancer, you can likely continue throughout your pregnancy under the guidance of your physician.
- Consider your options when testing for gestational diabetes. Gestational diabetes is of particular concern for older expectant mothers. However, there are options to the glucose tolerance test (GTT) (also called the oral glucose challenge test or OGCT) that you may want to consider.
You can request that your doctor administer a hemoglobin A1c test (HbA1c) instead. It’s a simple blood draw. If you get it early on in your pregnancy and once again about halfway through, it should provide more accurate results than the GTT. Research shows that the HbA1c is 98 percent accurate at identifying gestational diabetes. The GTT is only about 76 percent accurate. The HbA1c is also not as uncomfortable for you or the baby.
If you’d rather not have the HbA1c, you might consider asking your doctor to allow you to bring in your own sugar-sweetened beverage to drink, rather than the standard Glucola they will provide for you during the GTT. Glucose contains some pretty nasty ingredients, including a flame retardant, artificial dyes, and BHA. Some alternatives to Glucola include sugar-sweetened natural lemonade or a natural sports drink without the added icky ingredients. I’ve also read about people bringing in naturally colored, sugar-sweetened jelly beans to eat instead. As long as you are taking in the same amount of actual sugar during the test, you’ll get an accurate result.
- Eat the best foods. Your baby needs a variety of fruits, vegetables, complex carbohydrates, protein, and fat to develop healthily. Your body needs all of those things too. Choose the most nutritionally dense foods available and don’t worry about calorie restriction or gaining too much weight unless your doctor advises you otherwise. Extreme weight gain in pregnancy is almost always caused by eating junk food like ice cream, cookies, potato chips, and other low-quality foods. When you’re eating plenty of whole foods and limiting refined sugar and junk food, you’ll gain an appropriate amount of weight and be able to easily get back to your pre-pregnancy weight soon after the baby comes.
Heidi Murkoff, the author of What to Expect: Eating Well When You’re Expecting, recommends the “Pregnancy Daily Dozen.” Here’s Murkoff’s list of the twelve things you should consume every day during your pregnancy:
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- Calories: Around 300 extra per day
- Protein: 3 daily servings
- Calcium: 4 daily servings
- Vitamin C (from produce): 3 daily servings
- Vitamin A (from produce): 3 to 4 daily servings
- Other fruits and vegetables: 1 to 2 daily servings
- Whole grains and legumes: 6 daily servings
- Iron-rich foods: some each day
- Fats and high-fat foods: some each day
- Omega 3 fatty acids: some daily
- Water: 10 glasses daily
- Supplement: take prenatal vitamin daily
- Take your vitamins. It’s especially important that older expectant mothers take their prenatal vitamins. If you can’t stomach the first thing in the morning, take them before bed. If they cause you to become nauseous, swallow them, then chew on ginger candy, drink ginger tea or chew on a bit of ginger root. Do whatever it takes to keep those prenatal vitamins down. If one brand of prenatal supplements isn’t working for you, try another brand.
Researchers have found that folic acid, a B vitamin, can be helpful in preventing birth defects like spina bifida and Down syndrome. Certain birth defects are more common for older expectant mothers. Take those prenatal vitamins every day!
- Choose which tests you want and which you don’t want. It’s pretty common for doctors to push extra tests onto a woman who is experiencing pregnancy later in life. But you don’t have to consent to extra testing that you don’t want.
Tests like amniocentesis and chorionic villus sampling (CVS) are invasive tests where a needle is inserted into the stomach and either amniotic fluid alone or fluid and tissue are extracted for genetic testing. These tests can help determine if your unborn child has Down syndrome.
If you know that you wouldn’t abort your child if he or she was born with Down syndrome, there may not be a need for invasive tests. These tests come with risks including the death of the child.
Ultrasound tests and maternal blood tests are excellent alternatives to other more controversial tests. Ultrasound technology has come such a long way over the years. It is not invasive and carries very little risk to the mother or child.
- Drink like a fish. Barnes doesn’t like to suggest a particular amount of water that a pregnant woman should drink each day because it can vary from woman to woman. However, she says, “Have a glass of water about every hour when you’re pregnant.”
Always choose water first when you’re thirsty. Once you’ve consumed a glass of clean water, you can have other beverages to suit your taste buds. Obviously, you’ll want to avoid sugar-sweetened drinks and caffeinated beverages. Herbal tea and naturally decaffeinated coffee are good choices when you want some variety.
You can definitely experience a healthy pregnancy at any age. Because of the special risks associated with pregnancy at an advanced maternal age, there are a few more precautions you must take. However, these tips can help you enjoy a healthy pregnancy later in life.
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