Dear Doctor,

I am 38 years old and hope to have children someday. However, being single makes me worry that I am running out of time. What are the dangers of having a baby at my age or even in my 40s?  Clarisse

-

Dear Clarisse,

Many women plan for a family after completing their education and settling in their career. Though this is good, especially regarding empowerment, it carries some disadvantages as well. By the time a woman is set in her career, she is in her 30s or early 40s.

The biggest risk of starting a family late in life is about motherhood. After 35 years or so, premenopausal changes start in the body due to changes in the hormonal balance. This may reduce chances of fertility.

Even if a woman conceives, there is high risk of miscarriage in early pregnancy.  Chances of chromosomal abnormalities increase with pregnancy occurring at a later age. Eggs are formed in the ovary from a very young age and with the aging of the body, eggs also age. Therefore, risk of children being born with Down syndrome, or impaired intellect or birth defects, are higher in babies born to ageing women. 

After 30, a woman risks developing chronic non communicable diseases like hypertension, diabetes, and etcetera, due to multiple factors. These conditions, if uncontrolled, increase the risk of miscarriage, intra-uterine death or stillbirth. The baby delivered may have congenital abnormalities.

Chances of a normal delivery are reduced with advancing age. It may be due to being overweight, stiffening of joints or stress, or some other chronic problem. At times, the obstetrician may decide to deliver the baby via C-section, simply to keep the mother and baby safe, by avoiding a difficult and prolonged labour. Worse scenario is, if normal labour starts but complications ensue, necessitating a C-section in emergency, where they may be ill prepared for it. C-section itself carries risks like excess bleeding, post-surgery trauma, and etcetera.

Considering these problems, a woman has to think thoroughly before deciding to have a baby later in life. A good career is important, equally important is the place of a baby in a woman’s life. Hence, both pros and cons should be weighed.                                                Dr. Rachna   Pande is a specialist in internal medicine.