Recently, the media reported that 40-year-old Britney Spears is pregnant. In Poland, the pregnancy of the 49-year-old Kasia Sokołowska caused a stir. To this day, in such cases, the term “geriatric pregnancy” is used inadequately. What does this mean from a medical point of view? Dr Dominika Trojnarska, a gynecologist from the Superior Medical Center, explains for MedTvoiLokona.
- The term “geriatric pregnancy” has fallen into disuse because of its negative connotation. Now more often it is talked about late motherhood or advanced maternal age
- In the past, this term was used to describe women over 35 years of age. – More and more often it is said that this “late motherhood” should apply to pregnant women over 40 – argues Dr. Trojnarska
- – I remember that for my grandmother, who became pregnant for her third time at the age of 43, it was difficult. She was ashamed because she was “too old to be pregnant” – says the doctor. Today, women are deliberately wearing tight fitting clothes, regardless of age
- More current information can be found on the Onet homepage.
Karolina Świdrak, Medonet: Is geriatric pregnancy a term that actually functions in medicine?
Dominika Trojnarska, MD, PhD, gynecologist from Superior Medical Center: The term “geriatric pregnancy” actually comes from medicine, but is abandoned because of the negative connotations of these words. Now it is more about late motherhood or advanced maternal age.
What conditions must be met to be able to speak of late motherhood?
Of course, the main criterion here is age. It concerns women who become pregnant after the age of 35. But we also have some distinctions here – German literature only talks about late motherhood in the case of primiparous women, while Anglo-Saxon publications do not take this factor into account at all. And from a medical point of view, it makes a difference whether a woman is in her first or subsequent pregnancy.
What?
Pregnancy of a woman who has given birth before is simply easier to handle. Her body is better adapted to it. I am therefore definitely inclined to the German definition. And here Meghan Markle is a perfect example, because she gave birth to her first child after 35 years of age.
But Meghan is not some isolated case at all. Late motherhood is becoming an increasingly common phenomenon. It is said that the number of pregnant women over 90 has doubled since the 35s. Generally, the average age of pregnant women increases every year. Even 30-40 years ago, women gave birth when they were 24 or 26 years old. Now this border has shifted towards 30. More and more often it is said that this “late motherhood” should apply to pregnant women over 40 years of age.
Why exactly do women get pregnant later and later?
First, we are dealing with social behavior. It’s about a career, the need to achieve a certain level of stability or find the right partner. But there is also the issue of effective contraception and methods of assisting reproduction. It all adds up to the situation when women decide to have their first child later and later.
And this may be associated with specific problems.
Yes, first with getting pregnant. But not only. Late motherhood means a greater risk of developing glucose intolerance or even gestational diabetes during pregnancy. It is a condition that occurs more often in older women. In addition, there is a greater risk of hypertension in pregnancy, and also of pre-eclampsia. Premature birth is statistically more common in slightly older women. The same applies to the low birth weight of children. In the case of late motherhood, we are more likely to deal with miscarriages and chromosomal disorders. On the other hand, when it comes to the delivery itself, caesarean section is performed more often.
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Late maternity is an indication for caesarean section?
No, but pathological conditions are actually more common then. And these are such an indication. You always have to look at the patient and thoroughly analyze the risk during pregnancy and childbirth. But if the child is correctly positioned and the woman has no comorbidities, then there are no contraindications for natural delivery.
Here it is also worth paying attention to the health of the woman before pregnancy. Did she decide to have a child at a later age because it was her conscious choice, or maybe she had struggled with infertility for years. This may indicate, for example, anomalies in the structure of the uterus, which determine the incorrect position of children and are an indication for caesarean section. And there are also women over 40 who have been trying to conceive for so long that they treat childbirth by caesarean as a form of additional protection for the health and life of the newborn. They think it’s the easier, more secure way. I am not a supporter of cesarean section on demand, but in the case of women at this age, health indications are already frequent – for example because of comorbidities they had before pregnancy.
The average age of pregnant women is changing, but so is their approach to this state. This “late motherhood” is no longer a cause for shame.
Definitely. I remember that for my grandmother, who got her third pregnancy at the age of 43, it was difficult. She was ashamed because she was “too old to be pregnant”. And today no one looks at it like that anymore, the attitude of society has changed. Until recently, loose clothes were worn to hide the belly. Now, on the contrary – women put on close-fitting clothes to emphasize their pregnancy, to be able to show it off. They find out more quickly, and then they want to show everyone how happy they are that they are expecting a baby. This is a completely different trend where pregnancy is something to be proud of, a unique state. Especially since women more and more often decide to have only one child, so they want to emphasize the uniqueness of this situation. They want to celebrate their state.
But the approach to miscarriages or stillbirths has also changed. People start to talk about them aloud as well – it is a mourning that must sometimes be shared with the world. Meghan Markle also had a miscarriage in her second pregnancy and she said it loudly. And this, in turn, winds up the whole positive circle – it gives hope to other women who have had this situation. She had a miscarriage and got pregnant again. It was bad, but it could be good.
Is there an age limit that should not be exceeded when pregnant? The moment when it is better not to have children anymore?
It’s hard to set a specific boundary. Once, during a medical deontology class, a lecturer asked us to analyze a situation when a couple adopts a child. A provocative question for discussion was: is he doing this to make himself happy or to make his adopted child happy? In my opinion, it is important to think mainly about the welfare of the child. And now, when should a woman not give birth anymore? In 2015, a 65-year-old woman in Germany, 26 weeks pregnant, gave birth to quadruplets. When her children come of age, she will be 83 years old. It is possible that even this moment he will not live.
So it’s not about a health limit?
Strictly speaking, you can do a lot. Even a uterus transplant. But you have to think ahead, think about how long we can be with the child, accompany him in life. It’s hard for me to say where this border lies. Anyone who wants to become a parent has to largely answer this question for himself.
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Also read:
- Are you planning a pregnancy? Start with research – take care of your and your baby’s health
- Pregnancy – what should you know about it? The most important questions about pregnancy symptoms, calendar and tests
- When a premature baby is born, that is, the difficult beginnings of motherhood
- Lethal defects of the fetus. What does it mean? [WE EXPLAIN]