A Guide to Having a Healthy Pregnancy in Your Forties (2023)

There is no one perfect time to get pregnant. Many people, though, have often been told that having a baby after you are 35 increases many risks. This might have led you to believe that there are not many people who have babies after this point. However, the truth of the matter is that many people are having babies in their 40s.

If you're pregnant at 41, 43, or older, you may understandably worry about how your age may impact your pregnancy. Luckily, while the risks of complications are lower in your 20s and 30s, you can have a healthy pregnancy in your 40s, particularly if you are otherwise in good health and get regular prenatal care. Learn more about having a healthy pregnancy in your 40s.

How Many People Have Babies in Their 40s?

You might be surprised to learn that not only do women have babies in their 40s, but the rate of people having babies in this decade of life has been on the rise since 1985. In 2018, women between the age of 40 and 45 gave birth at the rate of 11.8 babies for every 1,000 women.

Overall the U.S. birth rate is declining, but this age category is bucking the trend. This means that you are very likely to find other parents your age in your childbirth class, prenatal groups, and parenting circles.

Getting Pregnant in Your 40s

One of the biggest barriers to pregnancy in your 40s is your fertility. Certainly, there are women who have no issues getting pregnant well into their 40s. Though statistically speaking, you are less likely to get pregnant and more likely to need the aid of fertility treatments the older you are when you are trying to conceive.

Your chance of getting pregnant in one year without fertility help in your late 30s is about 60%. This equates to a 13.2% chance of pregnancy in any one cycle for women ages 38 to 39years compared with 20% in each cycle at age 30 to 31. This pregnancy per cycle rate drops to 6.6% for those up to 44years.Rates of pregnancy decline significantly with each year, particularly steeply for those who have never had a child.

Fertility Treatment

Fertility treatment means different things for different people. It can mean anything from conceiving while taking oral medications and having regular intercourse to using donor eggs and trying to conceive with in vitro fertilization (IVF).

About one-third of women over 35 will get help from a fertility specialist, and that number increases with age—half of the women trying to conceive in their early 40s will do so. It is also important to note that the age of your partner does impact the health of your pregnancy.

One thing of particular interest will be the supply and quality of your eggs. The number of eggs and the health of said eggs diminishes the older you get. There are tests your doctor can do that can estimate how well your eggs are holding up, and this would be a part of your fertility testing.

In general, after the age of 35, if you have not conceived after 6 months of well-timed intercourse with no birth control, you should seek the help of a fertility specialist.

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Staying Pregnant in Your 40s

Every pregnancy carries the risk of miscarriage, and thatrisk does go up with age. Part of that risk in your 40s is that you are more likely to have a chronic condition at this point in your life than previously.

A chronic condition like diabetes, high blood pressure, or thyroid disease can complicate your pregnancy and potentially increase the risks of miscarriage and pregnancy loss, including stillbirth. This is one of the reasons that preconception care is very important.

By meeting with your practitioner prior to pregnancy, you can minimize these risks by getting a chronic condition under control. You may also have a medication review to see which medications you're taking would be compatible with pregnancy. You may find newer medications to switch to and take time to ensure they work for you before attempting a pregnancy.

Physical Changes During Pregnancy

Pregnancy certainly changes your body. Women who have children both earlier and later in life are quick to note that pregnancy in their 40s was often more physically challenging than it was in their 20s or 30s.

One of the biggest risks to your comfort with a midlife pregnancy will be your overall fitness level. Someone who has been very active and has few daily aches and pains, in general, is more likely to have a fairly normal course with pregnancy-related physical symptoms.

If you are already experiencing the aches and pains commonly associated with midlife, you may find that some of the physical symptoms of a changing pregnant body to be more pronounced.

The good news is that if you are already exercising, there is usually no reason to stop. Prenatal exercise classes can help you have a safe and easy pregnancy. Your doctor or midwife can advise you on what alterations you need to make to your scheduled workouts.

Keep in mind that moving is one way to alleviate the stress and strain of pregnancy on your body. Even if you are new to exercise, you can still reap the benefits. Swimming, walking, and yogaare three things that many practitioners recommend to women who have not been exercising much prior to pregnancy or for women who are having some setbacks in the workout schedules.

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Recommended Weight Gain in Pregnancy

Emotional Changes During Pregnancy

Pregnancy alters your emotion via hormones. The mood swings that can accompany pregnancy are well known. This should not be much different due to age. Though, as a more mature woman, you probably have something your younger counterparts do not—the ability to cope with these changes more effectively.

Financial and relationship concerns can lead to emotional irritability during pregnancy. While age is certainly not a cure-all for these woes, with age comes a certain amount of stability. This might mean that some of the stress many young people feel about finding a house or a stable job is something that you may not be dealing with at this stage of the game.

Why You Have Mood Swings During Pregnancy

Financial Stability in Your 40s

One of the main reasons women say that they have delayed having children into their 40s is to ensure that they are financially stable. This may mean different things to different people.

Perhaps you had a job that required a lot of travel when you were younger. Maybe you wanted to reach a certain level in your company before you felt like you could have a baby. There might also be a certain level of financial status you wanted to be able to achieve first—a home, a college fund, a certain amount in your retirement account. There are many reasons you may have intentionally delayed childbearing.

Finding other women who are close to your age and are having babies can provide a big benefit. While you may be one of the older mothers in playgroup, you won't be alone. Make friends with other older mothers in addition to other mothers. This will help you have someone to share your unique issues with.

Pregnancy Risks After 40

Pregnancy in your 40s is potentially more complicated. The healthier you are at the beginning, the less likely you are to experience complications. But even healthy women can have complications in pregnancy.

Women pregnant over 40 are more likely to experience:

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  • Cesarean birth
  • Low birth weight
  • Pregnancy complications, including high blood pressure, gestational diabetes, and preeclampsia
  • Premature labor and preterm birth

Women in their 40s also have a higher chance of having multiples, such as twins or triplets. While it may be easy to chalk this up to fertility treatments, there is also a natural increase in the rates of multiple pregnancies, even without using fertility medications or treatments. This is something to keep in mind as you plan for pregnancy.

Talking to your doctor about your medical history and staying on top of your prenatal checkups can minimize some of these risks by allowing them to spot or manage potential complications before they become serious.

Heart Palpitations in Pregnancy

Screening for Down Syndrome

Genetic tests are recommended for pregnant women of all ages. However, in your 40s, genetic screening becomes even more prominent. This is because maternal age is one of the key risk factors for Down syndrome.

A 25-year-old woman has a 1 in 1,2000 chance of having a baby with Down syndrome; by age 40, the risk has increased to 1 in 100, according to the National Down Syndrome Society. That number jumps to 1 in 10 by age 49.

Genetic screenings will be offered during your prenatal care appointments. The test results are given in a way that would tell you about the likelihood of your baby being born with a genetic problem in comparison to your age.

For example, your screening results might say that your risk of having a child with Down syndrome is 1 in 200. This would be considered a "negative" result because your actual risk was better than your statistical risk (1 in 100 for a woman at 40).

If your test said you had a 1 in 80 chance of having a baby with Down syndrome, this is considered a "positive" result. This means that your risk of giving birth to a baby with Down syndrome is higher than your statistical risk.

Genetic screening does not say with certainty that your baby has a genetic problem, it merely calculates the risks compared to your age group.

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Genetic screening is great because it does not pose any risk to the mother or the baby. It can also help you decide if genetic testing is more appropriate for your family.

Genetic testing provides you with an accurate picture of your baby's genetics and a diagnosis. The trade-off is that there is a potential risk to your baby from amniocentesis or chorionic villus sampling (CVS).

Labor and Birth in Your 40s

With getting pregnant and staying pregnant out of the way, it's time to think about having the baby. The news is similar—labor has a higher risk of being more complicated and resulting in more complications for you. One good bit of news is that if this is not your first baby, the risk of preterm labor and birth is less than a mother having her first baby over 40.

What makes labor and birth more complicated in your 40s is largely your health. A woman who has a chronic condition is more likely to experience complications than a woman who does not. Though chronic conditions are only a piece of the puzzle.

There is some belief that a soon-to-be mother's age and mental state increase the risk of complications during labor, including induction of labor and cesarean section. Specifically, in addition to pregnancy-related complications, you are more likely to be induced because of concern over the continuing pregnancy.

Research also shows that the overall need for cesarean section increases with increasing maternal age. Research shows that the overall rate for a woman is about 32%. This number jumps to 48% for women over 40. This is not to say that you will absolutely be induced or have a cesarean section, but simply that it is more likely.

This is something that you will want to talk to your doctor or midwife about. Finding a practitioner who is experienced in birth with older mothers might be helpful. Your attitude also matters. Using positive pregnancy affirmations can be helpful in reminding yourselfabout your goals for this pregnancy.

Postpartum Health

The main thing most people are concerned about is the health of the baby. While a baby resulting from pregnancy in your 40s is more likely to have some complications, the good news is that with good care, watchful eyes, and modern technology, the vast majority of these babies are born healthy.

Again, it is important to keep in mind that an increased risk of a complication is not the same thing as having that complication guaranteed.

A Word From Verywell

While there are certainly some challenges to overcome in your 40s when it comes to getting pregnant and having a baby, you are not alone. The number of women who are having babies at this age is increasing. With proper prenatal care, the chances of you having a healthy baby are still great. Take that to heart and enjoy your pregnancy as much as you can.

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Is it healthy to have a baby in your 40s? ›

Due to advances in technology surrounding fertility, pregnancy, and delivery, it's possible to safely have a baby at age 40. However, any pregnancy after age 40 is considered high risk.

Can you have a healthy child at 43? ›

Pregnancy in Your 40s

If you get pregnant after 35 years old, experts call this an “advanced maternal age” pregnancy. But it's still possible to get pregnant and deliver a healthy baby in your 40s. Childbirth at older ages has become more common too. Since the 1990s, birth rates in people aged 40-44 have gone up.

How likely is Down syndrome at age 42? ›

Maternal age

A 25-year-old has a one in 1,200 chance of having a baby with Down syndrome. By 35 years of age, the risk increases to one in 350—and it becomes one in 100 by the age of 40. The chances of Down syndrome further increase to one in 30 by age 45, according to the National Down Syndrome Society.

Can a 45 year old woman have a healthy pregnancy? ›

Pregnancy after age 45 years is infrequent and the mother and baby should be considered as a high risk. There is a greater incidence of spontaneous abortion, gestational trophoblastic disease and chromosomal abnormalities in the fetus.

What are the chances of Down syndrome at 40? ›

Risks for chromosome abnormalities by maternal age

The chance of having a child affected by Down syndrome increases from about 1 in 1,250 for a woman who conceives at age 25, to about 1 in 100 for a woman who conceives at age 40.

What are the signs of good fertility? ›

Here are eight signs it may be easy for you to get pregnant, according to experts.
  • You Have A Very Regular Cycle. ...
  • You Feel Well In General. ...
  • You've Never Had A Pelvic Infection. ...
  • You Have Other Signs Of Regular Ovulation. ...
  • You Don't Smoke Cigarettes. ...
  • Your Periods Aren't Extremely Heavy. ...
  • Your Periods Aren't Extremely Painful.
Jan 4, 2019

How can I prevent a miscarriage after 40? ›

How Can I Prevent a Miscarriage?
  1. Be sure to take at least 400 mcg of folic acid every day, beginning at least one to two months before conception, if possible.
  2. Exercise regularly.
  3. Eat healthy, well-balanced meals.
  4. Manage stress.
  5. Keep your weight within normal limits.
  6. Don't smoke and stay away from secondhand smoke.

What is the healthiest age to have a baby? ›

Experts say the best time to get pregnant is between your late 20s and early 30s. This age range is associated with the best outcomes for both you and your baby. One study pinpointed the ideal age to give birth to a first child as 30.5.

Does folic acid prevent Down syndrome? ›

An adequate intake of folic acid during pregnancy, believed to protect against neural tube defects (NTDs) in babies, may also help prevent Down's syndrome, researchers report in The Lancet​ this week.

Does father's age affect Down syndrome? ›

Fisch and his colleagues found that the rate of Down syndrome steadily increased with advancing paternal age for the maternal age group of 35 to 39 years. The greatest increase, however, was seen in the maternal age group of 40 years and older with increasing paternal age.

Which gender is more likely to have Down syndrome? ›

Because the likelihood that an egg will contain an extra copy of chromosome 21 increases significantly as a woman ages, older women are much more likely than younger women to give birth to an infant with Down syndrome.

Is it too risky to have a baby at 45? ›

Beyond age 45, there are even more health risks. A recent study that looked at almost 37 million deliveries between 2006 and 2015 showed that women aged 45-54 years have the highest rates of preeclampsia, gestational diabetes, postpartum hemorrhage, and hysterectomy—as well as c-section deliveries.

Can I have a healthy baby at 42? ›

Most people over 40 have healthy pregnancies and healthy babies. But there are some things you need to think about. You'll want to be sure to get good antenatal care.

Can I use my own eggs at 46? ›

While IVF and PGS technology can dramatically increase a woman's chances of getting pregnant later in life, there will come a time when a woman's eggs are simply no longer viable. Although of course there are exceptions, using own eggs for IVF by women over the age of 45 is unlikely to be successful.

What age is Down syndrome a risk in pregnancy? ›

Women who are 35 years or older when they become pregnant are more likely to have a pregnancy affected by Down syndrome than women who become pregnant at a younger age.3-5However, the majority of babies with Down syndrome are born to mothers less than 35 years old, because there are many more births among younger women ...

At what age does Down syndrome increase? ›

The risk increases with the mother's age (1 in 1250 for a 25 year old mother to 1 in 1000 at age 31, 1 in 400 at age 35, and about 1 in 100 at age 40). However, 80% of babies with Down syndrome are born to women under age 35 years.

How common are birth defects after 40? ›


The odds of a mother over 40 giving birth to a child with chromosomal abnormalities also significantlyincreases. At age 35, the risk of having a baby with chromosomal abnormalities is 1/192, but by age 40, the risk climbs to 1/66 (almost 2%).

What are the 4 main causes of birth defects? ›

Smoking, drinking alcohol, or taking certain drugs during pregnancy. Having certain medical conditions, such as being obese or having uncontrolled diabetes before and during pregnancy. Taking certain medications, such as isotretinoin (a drug used to treat severe acne). Having someone in your family with a birth defect.

What is the root cause of Down syndrome? ›

About 95 percent of the time, Down syndrome is caused by trisomy 21 — the person has three copies of chromosome 21, instead of the usual two copies, in all cells. This is caused by abnormal cell division during the development of the sperm cell or the egg cell.

What vitamin prevents birth defects? ›

Folic acid is very important because it can help prevent some major birth defects of the baby's brain (anencephaly) and spine (spina bifida). The neural tube forms the early brain and spine.

What age is fertility best? ›

A woman's peak reproductive years are between the late teens and late 20s. By age 30, fertility (the ability to get pregnant) starts to decline. This decline happens faster once you reach your mid-30s. By 45, fertility has declined so much that getting pregnant naturally is unlikely.

Can you tell if you will have fertility issues? ›

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, women with infertility may have irregular or absent menstrual periods. In some cases, men with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function.

Do regular periods mean good fertility? ›

There's a very good chance if you are experiencing a regular monthly period, you are fertile. While it is true that women have a finite number of eggs, lack of conception is predominately due to other causes.

What is the miscarriage rate at age 43? ›

Miscarriage issues

To wit, between the ages of 40-44, 34% of pregnancies end in miscarriage. After 45, this number jumps to 53%. These numbers shouldn't discourage you, however, especially if you read them in reverse: 66% of pregnancies between the ages of 40 and 44 don't end up with a miscarriage.

What fruit is not good for pregnancy? ›

Fruits to Avoid During Pregnancy Diet
  • Papaya – It tops the list for obvious reasons. ...
  • Pineapple – These are also not recommended to the pregnant women as they contain certain enzymes that alters the texture of cervix which could induce premature contractions. ...
  • Grapes –

How can I make my uterus strong to prevent miscarriage? ›

However, there are ways to lower your risk of miscarriage, including:
  1. not smoking during pregnancy.
  2. not drinking alcohol or using illegal drugs during pregnancy.
  3. eating a healthy, balanced diet with at least 5 portions of fruit and vegetables a day.

How much money should you have saved before you have a baby? ›

Richardson believes that in 2022, hopeful parents should have at least six months of living costs saved up to “take the pressure off the increased costs and decreased income.” Richardson recommends reorganising your budgets as soon as you decide that you want children.

Can stress cause Down syndrome? ›

Down syndrome, which arises from a chromosome defect, is likely to have a direct link with the increase in stress levels seen in couples during the time of conception, say Surekha Ramachandran, founder of Down Syndrome Federation of India, who has been studying about the same ever since her daughter was diagnosed with ...

Do Prenatals prevent Down syndrome? ›

Results: A significant protective effect was seen with large doses of folic acid ( approximately 6 mg/d) and iron (150-300 mg/d of ferrous sulfate) during the first gestational month against Down's syndrome (adjusted odds ratio 0.4, 95% confidence interval 0.2 to 0.7 for both).

Does dads age affect baby? ›

As the father grows older, the number of mutations in the father's genome increases, leading to an increase in the incidence of congenital malformations in offspring [11, 65]. Older paternal age may be harmful to the offspring's health in terms of genetic mutations, telomere length, and epigenetics [66].

Which parent carries Down syndrome? ›

In the majority of cases, the extra copy of chromosome 21 comes from the mother in the egg. In a small percentage (less than 5%) of cases, the extra copy of chromosome 21 comes from the father through the sperm. In the remaining cases, the error occurs after fertilization, as the embryo grows.

Is Down syndrome from egg or sperm? ›

Most cases of Down syndrome are not inherited. When the condition is caused by trisomy 21, the chromosomal abnormality occurs as a random event during the formation of reproductive cells in a parent. The abnormality usually occurs in egg cells, but it occasionally occurs in sperm cells.

What are the risks of having a baby at 43? ›

In women 40 years or over , the risk of pregnancy complications, such as high blood pressure, preeclampsia, and gestational diabetes, increases. The rate of birth abnormalities or genetic conditions in the baby also increases.

What happens if Down syndrome test is positive? ›

A positive screening test result means that your baby's chance of having Down syndrome is higher than average. Your test results may include a number that describes how high the risk is. But a high risk doesn't mean your baby will have Down syndrome.

What causes Down syndrome during pregnancy? ›

Down syndrome can be caused by one of three types of abnormal cell division involving chromosome 21. The three genetic variations include: Trisomy 21– More than 90% of Down syndrome cases are caused by trisomy 21. An extra chromosome (chromosome 21) originates in the development of either the sperm or the egg.

How to tell if you have Down syndrome during pregnancy ultrasound? ›

An ultrasound can detect fluid at the back of a fetus's neck, which sometimes indicates Down syndrome. The ultrasound test is called measurement of nuchal translucency. During the first trimester, this combined method results in more effective or comparable detection rates than methods used during the second trimester.

Is it wise to have a baby at 44? ›

If you're pregnant at 41, 43, or older, you may understandably worry about how your age may impact your pregnancy. Luckily, while the risks of complications are lower in your 20s and 30s, you can have a healthy pregnancy in your 40s, particularly if you are otherwise in good health and get regular prenatal care.

Who has had a baby at 44? ›

Other such celebrities include Janet Jackson, who became pregnant with her first child at 49 and Gwen Stefani, who gave birth to her third child at age 44. Getting pregnant later makes getting off to a healthy start even more important.

What are the pros and cons of having a baby at the age of 40? ›

Pros and Cons of Having a Baby in Your 40s
  • Con: There Is A Higher Risk Of Miscarriage. ...
  • Pro: You'll Be More Financially Secure. ...
  • Con: It Can Cause A Strain On Your Heart. ...
  • Pro: You'll Get To Make Lots Of New Friends. ...
  • Con: You Will Have To Make Some Sacrifices. ...
  • Pro: It Will Give You A New Lease On Life.

Are my eggs still good at 40? ›

After this age, egg quality slowly deteriorates until around age 37, and then deteriorates more rapidly until about age 42. After roughly age 42, fertility for most women basically falls off a cliff. While some women in their mid-40s will achieve a pregnancy, many more will be disappointed.

Is having a baby in your 40s too old? ›

Due to advances in technology surrounding fertility, pregnancy, and delivery, it's possible to safely have a baby at age 40. However, any pregnancy after age 40 is considered high risk.

What is the chance of twins by age? ›

7.3 percent in women younger than 35. 6.9 percent in women age 35 to 37. 6.8 percent in women age 38 to 40. 5.1 percent in women age 41 to 42.

What age do you run out of eggs? ›

Over the course of a lifetime your ovaries will release about 500 eggs in their mature form. When the supply of eggs runs out, your ovaries cease to make estrogen, and you will go through the menopause. For most women this happens around the age of 50: the average age in the developed world is 51.4 years1.

What are the symptoms of poor egg quality? ›

There aren't many obvious symptoms of low egg reserve, so our fertility experts ask you about:
  • Absent or late periods.
  • Shorter-than-average menstrual cycles.
  • Irregular periods with a heavy or light flow.
  • History of miscarriage.

Who is the oldest woman to give birth naturally without IVF? ›

In both cases the children were conceived through IVF with donor eggs. The oldest verified mother to conceive naturally (listed currently as of 26 January 2017 in the Guinness Records) is Dawn Brooke (Guernsey); she conceived a son at the age of 59 years in 1997.

What age is it too late to have a baby? ›

A woman's peak reproductive years are between the late teens and late 20s. By age 30, fertility (the ability to get pregnant) starts to decline. This decline happens faster once you reach your mid-30s. By 45, fertility has declined so much that getting pregnant naturally is unlikely.

What happens if you have a baby in your 40s? ›

Once again, the older an egg, the more likely it is to have chromosomal issues, which can increase your child's risk for certain birth defects. For women who get pregnant at 25, the risk for Down syndrome, the most common chromosomal condition, is about one in 1,250; at age 40, that risk jumps to about one in 100.

What are the disadvantages of having a baby later in life? ›

Babies born to older mothers have a higher risk of certain chromosomal conditions, such as Down syndrome. The risk of pregnancy loss is higher. The risk of miscarriage and stillbirth increases with age. This may be because of preexisting medical conditions or because of chromosomal conditions in the baby.

How many eggs does a woman have at 40? ›

How many eggs does a woman have at 40? By the time a woman reaches 40, she'll be down to about 18,000 (3% of her pre-birth egg supply).

What age are men most fertile? ›

Age and Male Fertility

Peak male fertility is around 25-29 years old. Sperm quality begins to decline at 30. At 45, men begin to experience a significant decrease in semen volume. Older men can also take longer to conceive a child.

What age is the perfect age to have a baby? ›

Your fertility naturally declines as you get older, which could make it harder for you to conceive. And starting a family later in life could pose greater risks for pregnancy complications. Experts say the best time to get pregnant is between your late 20s and early 30s.

How do I prepare for having a baby at 40? ›

Eat a balanced, nutritious diet, lose weight if you are overweight, and take a prenatal vitamin that has at least 400 micrograms of folic acid. You should have a full medical exam before you become pregnant. Tell your doctor that you are planning to become pregnant and ask about potential health risks.

How can I improve my egg quality after 40? ›

Ways to Improve Egg Quality after 40
  1. The Fertility Diet. A diet high in fat and low in carbohydrates helps to improve overall fertility and egg quality. ...
  2. Quality Sleep. Quality sleep is related to egg quality and fertility directly. ...
  3. Avoid Smoking. ...
  4. Avoid Caffeine and Alcohol. ...
  5. Manage Stress. ...
  6. Light Exercise/ Yoga. ...
  7. Supplements.
Dec 20, 2021

What are the positives of having a baby? ›

Pros of Having Children
  • Excitement.
  • Satisfaction.
  • Joy/fun.
  • Self-esteem.
  • Meeting a long-term goal.
  • Challenge.
  • Love and growing through giving.

Are there any benefits to having children? ›

'The results shows that people who have children are happier and have greater satisfaction and emotional well-being than those without children,' says Tom Yang, the study's lead researcher.

What are the right reasons to have a baby? ›

33 reasons to have a baby
  • Because no other word sounds as tender as "Mommy"
  • Because children say, "I love you" a thousand times.
  • Because I can be proud to be a mother.
  • Because spending time with a child is more exciting than a disco.
  • Because no one can force me to say no to a baby.


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