These questions were from Living and Loving and were published in this issue.
Question: Is there any risk associated with having a baby after 35?
Dr Mokaya: Bodily changes in women are a natural progression. Therefore there isn’t something that suddenly happens on the day a woman turns 35 that’s going to make it more difficult for her to have children. The age of 35 has been used as a benchmark because at birth a woman will have half a million eggs. By the time she reaches puberty that drops to about 50 000, and only 350 will mature and be released during ovulation.
Falling pregnant in the late 30s and beyond depends on how receptive and responsive the body of a woman is – a 35-year old’s ovaries can be just as healthy as a 29-year olds. A woman may not ovulate as often or as easily later in life because the older she gets the less responsive her uterus becomes to implantation – so her eggs may never implant, or the woman may experience a miscarriage. Further, the eggs released later in life may not be as high quality as those released earlier and this can cause problems. Although the risk of structural abnormalities doesn’t necessarily increase with age, genetic and chromosomal abnormalities become an issue.
How can a woman ensure a healthy pregnancy after 35?
To increase the chances of falling pregnant, it is vital to stop contraceptive measures early, even up to two years before a woman start’s trying. This is particularly the case with the long-term contraceptive injection since it takes the body’s cycle time to settle into its own rhythm. The pill is not as much of a problem but it may take a bit of time, so planning ahead by around six months to a year is necessary.
Once a woman is pregnant, going for prenatal counselling is important to ensure that there is no history of abnormalities in the family, or a history of miscarriage. A woman will also need to be screened for medical problems such as diabetes, hypertension and high blood pressure, which she might already have but not know about. A woman can dramatically reduce her risk of problems by having regular antenatal check-ups with her doctor and monitoring the pregnancy under their guidance. Second and third trimester screenings are particularly important. Women must also do their best lead a healthy lifestyle, which includes a healthy dies and moderate exercise. There is no harm in taking vitamins, but it is important that they do not replace healthy food. Folic acid, however, is an absolute essential. It is crucial for a woman to watch her weight and reduce stress levels – which is major contributing factor to miscarriages. Cutting back on work hours and getting enough rest is also important.