
The age bar for childbirth is pushed further and further, a natural question arises - is there really a medical basis for age recommendations for childbirth, or are all the obstacles in our head? Obstetrician-gynecologist Nadezhda Konstantinovna Glukhova helped us to answer these questions.
What determines the possibility of late pregnancy
Each of us has our own age of the reproductive system, which is determined genetically, and also depends on the general state of health and lifestyle. This means that at 40-45 years old, two different women who both look great and both take care of their health will have completely different reproductive health status.
We are talking, first of all, about the so-called ovarian reserve - the number of eggs in the ovaries and capable of fertilization. Up to 25% of women suffer from early depletion of the ovarian reserve and, as a result, infertility and the onset of premature menopause. After the age of 30, a woman's natural ability to conceive gradually decreases, and after 43 years, most women lose the ability to conceive. However, there are women who, on the contrary, are distinguished by late menopause. For them, 40-43 years is still a period of fertility heyday, and they easily become pregnant.

How medicine can help
If you are postponing pregnancy for social reasons, the issue of housing, work has not been resolved, there is no husband, etc. - it will not be superfluous to undergo an examination and assess your ovarian reserve. This way, you will at least know how long you can maintain fertility, which means effectively planning a family and having children at a suitable time in your life. This examination will also help those who potentially dream of a second, third and so on child, but postpone the moment of conception (see also: "Cosmetic procedures during pregnancy: what is possible, what is not").
In the West (and now in our country), the practice of “delayed motherhood” has long been widespread among actively working women or women without a life partner. A woman stores her healthy eggs in a cryobank so that she can conceive and give birth at an age when her natural ability to conceive will be reduced. Delayed motherhood also solves the problem of genetic pathologies, the risk of which increases dramatically with late birth. In short, modern medicine allows you to outsmart nature a little.

What obstacles can you meet
But, unfortunately, in one thing, it is impossible to outwit nature: no matter how good we look, oxidation processes, withering processes, the development of chronic diseases associated with age-related changes in the body are still going on in the body. This is especially true for women living in large metropolitan areas experiencing constant oxidative stress.
The main risk area: osteochondrosis of the spine. Rarely does anyone approach 40 with an absolutely healthy back. The second is blood pressure problems. The third is thyroid dysfunction, metabolic disorders. Therefore, the widespread opinion that late childbirth completely rejuvenates the body and starts the processes of regeneration and renewal is fundamentally wrong.

It is also worth considering the developing organism of the baby, which will take all the resources it needs. If the mother, for some reason, does not have these resources due to age, the baby will develop with a delay. First of all, here we are talking about hormonal dysfunctions.
Late pregnancy, most likely, will mercilessly expose all those weaknesses and hidden sores that have accumulated with age and which we could not even suspect.
It is important to understand that if a woman becomes pregnant after 40 years, then the ideal situation would be a deliberate planned pregnancy. Even at the planning stage, it is advisable to undergo a classical clinical examination with an extended examination by a cardiologist, ophthalmologist, vertebrologist, endocrinologist, phlebologist, gynecologist. Back problems, blood pressure, blood sugar, hormonal levels - all this must be diagnosed before pregnancy. Hope at random is not our topic in this case.

Why it used to be different
An interesting point: before, women gave birth to 8-10 children and recovered quite quickly. It seems impossible now. The reason is that a woman's body is really designed for multiple births. After them and during the period of breastfeeding, the woman's body does not produce eggs, that is, for some time it is in the period of physiological amenorrhea, rest and rest of the ovaries. At the end of the feeding, the woman becomes pregnant again. Thus, earlier, for the entire reproductive period, a woman's body produced a foreseeable number of eggs. We now produce eggs every month, non-stop, for many years. Thus, our ovarian reserve is depleted faster and reproductive health as well.

What else is important to think about
In addition to carrying a baby and giving birth, you should think in advance about the first year of the baby's life. For the category of women 40+, this particular period can conceal the greatest difficulties and require special attention.
It is no secret that it is the first years of raising a baby that have a depressing effect on women's health, and after all, recovery processes slow down with age. Constant carrying heavy weights, sleepless nights, stress - at 20-30 years old it will not be tolerated at all the same way as at 40-45. A 40+ woman who wants to stay vigorous and blooming, and most importantly a positive mother for her children, must get enough sleep, eat a balanced diet, and take care of her back. Perhaps for the sake of this, we will have to reconsider what we are used to in the first pregnancies: we should take care of ourselves, actively use outside help (perhaps, nannies with accommodation), learn to put our health on a par with the priorities that the baby dictates.

If you do not think it through in advance, expectations from late parenting can not only fail, but also lead to chronic health problems and, as a result, to a lack of attention given to the baby. Everything should be for joy and for the benefit of your health. Therefore, if we think about late childbirth, then first of all we calculate the strength and resources.
A separate topic is childbirth after 45 years, that is, childbirth against the background of the onset of menopause. Here it is hardly possible to give general advice at all, since any such pregnancy will be individual and should take place under the close supervision of an endocrinologist.

A quick memo: what you need to know about late pregnancy and childbirth after 40
- It is not age itself that is important, but a woman's reproductive health, which can be assessed by a gynecologist. Modern technology allows you to preserve healthy and high-quality eggs for possible late pregnancy.
- With age, chronic diseases accumulate, which can adversely affect gestation. It is necessary to stabilize the state of problematic body systems before pregnancy. Pregnancy should take place under the close supervision of an endocrinologist.
- Do not neglect pregnancy screenings. Also consider doing a non-invasive test (examining embryo DNA from the mother's blood to identify the five most common genetic syndromes, including diabetes).
- For late childbirth, the most acute period is the first years of a baby's life. It is necessary to plan recovery procedures, the rhythm of the day, external assistance and honestly calculate your strength. This also applies to the later life of the child.
- During pregnancy, it is important to create conditions for full physical activity. Ideally, to leave the city for a while, to live in nature.
- Consulting a psychologist will help you to understand yourself, to understand your deepest desires. After all, sometimes the desire to have a baby after 40 is an expression of completely different desires - the same fear of aging.
- The main thing is a positive attitude plus a balanced, attentive attitude towards your health.
Expert

Nadezhda Glukhova
Photo: Getty Images
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