Even though many women look young, feel healthy and are having children after age 40, don’t be surprised when you go into your obstetrician’s office and have some of your youthful feelings deflated by being referred to as an “older” pregnancy. You may feel young and energetic, but in the eyes of your OB/GYN, you are elderly, according to pregnancy and baby author Ann Douglas, writing for the Pregnancy and Baby website. Don’t be discouraged, though, because even though older women are more likely to have complications, most women over 40 will have a safe and uncomplicated delivery, according to the March of Dimes.

Fertility Issues

When women reach age 40, it becomes even more difficult to get pregnant because they ovulate (release an egg) less frequently. About half of all women 40 years and older have fertility problems; many of these problems can be successfully treated, according to the March of Dimes. The irony is that while it is more difficult to get pregnant, when women older than 45 do, they are more likely to have twins or multiples. Women who are older than 45 are 10 times more likely to have a multiple birth as women in their 20s, even without taking fertility drugs. Of course, fertility drugs increase the chances of multiple births, too.

Old Eggs

You may look and feel as good as you did when you were 25, but that doesn’t change the fact that your eggs are over 40. Over time, the quality of a woman’s eggs deteriorates, says Douglas. Older eggs are more likely to have chromosomal problems, which puts older moms at an increased risk for miscarriage, stillbirth and chromosomal birth defects.

Down Syndrome

The most common chromosomal birth defect is Down syndrome, where children have varying degrees of mental retardation and birth defects. A 25-year-old has a one-in-1,250 chance of delivering a baby with Down syndrome. A woman who is 40 has a one-in-100 chance, a woman who is 45 has a one-in-30 chance, and a woman who is 49 has a one-in-10 chance. Women can have a screening test or an amniocentesis to tell if the baby has Down syndrome.

Other Complications

Miscarriages are more common as woman age. Women in their 20s have a 10 percent chance of having a miscarriage. Women age 40 to 44 have a 35 percent chance of miscarriage, and women older than 45 have a 50 percent chance. Stillbirth, the death of the fetus after 20 weeks, is two to three times as likely to happen to women over age 40. Women older than 40, are also more likely to have other pregnancy-related complications, such as gestational diabetes, high blood pressure, placenta previa (which causes severe bleeding during delivery) and preterm delivery. Older women are also more likely to need a Caesarean section than are younger women.

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