I am increasingly looking after pregnant women who are 35 years and older. This is normal today and nothing special from a medical point of view. Around one in four babies in Germany is now born to a "late" mother. And yet Maternity passport a cross at High-risk pregnancy. This applies to women over 35 with their first child and to women over 40 with another child. Regardless of how healthy and fit they are.
The life plans of older pregnant women are different: some are already settled professionally or have already made progress on the career ladder and would like to continue this soon after the birth. Others make a conscious decision in favour of family life and put their job on the back burner for the time being. The vast majority are in excellent health. If there are health issues, these are usually independent of age.
As different as the life situations of 35-plus women may be, the fact that they are labelled as "high-risk pregnant women" simply because of their age often puts a damper on their joy about the life growing inside them. It is not uncommon for insecurity to spread, worries arise and even the measures recommended by the Prenatal diagnostics can cause stress.
What does science know about "late" mothers?
Purely statistical 35plus pregnant women are slightly more likely to experience certain complications during pregnancy, such as pre-eclampsia, premature births or placental irregularities. The risk of miscarriage also appears to be slightly higher. In older pregnant women, the question of a possible chromosomal abnormality in the baby is also quickly raised.
However, these risks do not increase suddenly and abruptly from the age of 35, but rather increase slightly as the expectant mother gets older.
The most common chromosomal abnormality is Down's syndrome, known as trisomy 21. purely statistical The risk of having a baby with Down's syndrome in a 25-year-old pregnant woman is 1:1400, which in purely statistical terms means that out of 1400 mothers who are 25 years old at birth, it is estimated that one will have a baby with Down's syndrome. For a 35-year-old woman, this risk is put at 1:360 (i.e. one in 360 mothers) and for a 40-year-old woman at 1:100 (i.e. one in 100 mothers).
Down syndrome means that chromosome 21 is present three times instead of twice in each cell of the child's body. This affects the baby physically and mentally. However, nobody can predict how severe the impairment will be later on. In some children, Down syndrome is barely noticeable, while others need a lot of support.
It's not just age that counts
Of course, the actual course of a pregnancy does not depend on mathematical probabilities. Much more important than the age of the mother-to-be is the question of her health and behaviour. This should reassure every "late" mother: Until you are healthy and take careful care of yourself, the chances of an unremarkable course until birth are very good. Experience shows that most "late mums" even take very responsible care of their health and therefore also that of their baby: They consciously eat a balanced and wholesome diet, develop a good rhythm between activity and rest, keep an eye on their physical fitness and keep their hands off alcohol and cigarettes.
In addition, all expectant mothers, regardless of their age, enjoy a comprehensive screening programme. The midwife or doctor keeps a particularly close eye on those who are considered high-risk pregnant women - including those aged 35 and over. This allows any irregularities or abnormalities to be recognised as early as possible. This significantly reduces any health complications. And the possibilities of modern obstetrics also ensure the best possible safety for mother and child in the delivery room.
Prenatal diagnostics is voluntary
Pregnant women at a later age in particular are often advised to undergo additional prenatal diagnostics to see whether the baby is healthy. Various tests make this possible. Nevertheless, it should not be carried out automatically, but should be carefully considered by the woman or couple concerned. To this end, they should seek in-depth medical and, if possible, psychosocial counselling.
It is important for me to emphasise: As a pregnant woman, you also have the right not to know. This applies regardless of your age. You can have the tests offered to you - but you can also refuse them for whatever reason. And remember: Of course, every prenatal diagnostic procedure is always associated with the hope that everything will be fine with the child in the end. The fact that a different result can also emerge is often suppressed for the time being. From my point of view, however, it would be better if the women and couples affected before would deal with this possibility of a finding and, if necessary, be accompanied in the process. They can consider: If our unborn child is ill or has a disability, how would we deal with this result? What decisions would we then have to make? This is precisely why counselling is so important.
Pregnant women over 35 often feel under pressure from those around them to have certain tests carried out. If they refuse, they are unfortunately often met with a lack of understanding. Or they even have to listen to reproaches if they decide to bring their baby into the world despite the knowledge that it will be different from other children.
But you alone make the decisions about yourself and your baby. Don't hesitate to seek help and counselling - let yourself be informed and empowered. Your caring midwife is also a reliable point of contact for you. And I am also at your disposal here with my knowledge and empathy.
And don't forget:
Today, pregnancy is normal even if the woman has passed the "magic 35". And the vast majority of children born to older mothers are born "healthy as poop" after a completely unremarkable pregnancy. So enjoy the time until then as much as you can. And once your little miracle has seen the light of day and you're holding it in your arms, "age" will no longer be an issue anyway.
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