Getting pregnant - what age is best?
Every so often the media gets hold of a headline that offers another stick with which to beat us. Three years ago it was the idea that women should stop waiting for the perfect man and get on with getting pregnant before it was too late (ref 1). Last month, the same newspaper was confidently informing us, without a hint of a blush, that older mothers actually had healthier babies (ref 2). So what's the truth behind the headlines?
Pregnancy is pretty much always exciting and scary, often in equal measure. But having a baby when you're younger or older than the average can bring special challenges.
When you're young, you have levels of energy you can only dream of by the time you reach 40. But you may not have the social support you need to cope with the huge changes being a mother will make to your life. And there is no doubt that it is an upheaval - my 17-year-old son's favourite singer, Jonathan Coulton, sums it up in the words of one of his songs: 'You ruined everything - in the nicest way'. Young mums are more likely to go into labour prematurely and to have a low birthweight baby, which can be associated with medical problems. It's not yet clear if this relates to other factors, such as teenage mums being more likely to smoke, or whether teenage mothers just may not always be physically mature enough to give their baby all the nutrients they need. They're also more likely to develop pre-eclampsia - a condition connected to high blood pressure, which can cause serious health complications for mother and baby. And without the support they need, they're less likely to breast-feed, with all the benefits that brings their baby.
Many women who get pregnant in their late 30s or early 40s have completely normal pregnancies and healthy babies. Many more mature mums are more than ready for the total upheaval (of the best sort) that the birth of a new baby brings. Women in their late 30s are likely to have more life experience and a bigger support network of friends who have gone through pregnancy and bringing up kids themselves. Statistics tell us they're more likely to have planned their pregnancy, giving themselves the chance to stop drinking alcohol and start taking folic acid before they get pregnant. But these women are more likely to have problems with pregnancy, in addition to finding it harder to get pregnant in the first place and having a higher rate of miscarriage. They're more likely to have health problems like high blood pressure or diabetes, either dating from before they get pregnant or developing during pregnancy. Like young mums, they are also at higher risk of pre-eclampsia. They are also more likely to have problems in labour, to need a Caesarean section or to have a stillbirth. And there's no getting round the fact that the risk of having a baby with a genetic condition like Down's syndrome rises steadily with age.
Whichever end of the age spectrum you're at, you can hugely improve your chances of a healthy pregnancy and a healthy baby by looking after your own health. Taking folic acid (and possibly vitamin D) supplements; stopping smoking; avoiding alcohol; keeping to a healthy weight; taking regular exercise and a healthy balanced diet; and getting regular check-ups will all help.
If you're not pregnant by 35, should you beat yourself up? No. Getting to that magical day when you come home with a healthy, fluffy bundle in your arms may be tougher than if you were 25, but the evidence tells us you're going to be a great mum.
- Consensus views arising from the 56th Study Group: Reproductive Ageing. In: Bewley S, Ledger W, Nikolaou, editors. Reproductive Ageing. London: Royal College of Obstetricians and Gynaecologists Press; 2009. p.353-6.
- Sutcliffe AG, Barnes J, Belsky J, et al. The health and development of children born to older mothers in the United Kingdom: observational study using longitudinal cohort data . BMJ. Published online August 21 2012