I suddenly received a tip from my crush today: Goddess Gao Yuanyuan has become a mother!
As an ordinary female observer, my first reaction was naturally: Is the goddess still as beautiful even after giving birth? Is the little goddess stunningly beautiful?
But after calming down, as a professional obstetrician and gynecologist, my second reaction was: Wow! A goddess nearing 40, had a vaginal delivery followed by a C-section? How much did the baby weigh? How much weight did she gain during pregnancy? Did she have any complications during pregnancy or childbirth?
Yes, even though Yuan Yuan's ageless beauty is astonishing, as a pregnant woman, she still carries the label of "first childbirth at the advanced age of 39," which makes people worry about her.
Every older expectant mother goes through a 10-month ordeal, and even with the utmost care, problems can still arise. Today, let's talk about how older expectant mothers overcome these challenges!
Level 1
I didn't even have a chance to properly love you before I had a miscarriage .
Older women have a higher rate of miscarriage. Studies have calculated the expected risk of miscarriage for each age group: 12% for women under 30, 25% for women aged 35-39, and 51% for women aged 40-44. Most miscarriages occur between 6 and 14 weeks of pregnancy, which is the early pregnancy period.
I often get asked by young expectant mothers who have just found out they're pregnant, "Dr. Mou, the rate of miscarriage is getting higher and higher these days, and I don't dare tell my family I'm pregnant." I usually tell them, "Look, we can see the baby's heartbeat! Once a fetal heartbeat is detected, the miscarriage rate drops significantly, usually less than 10%. You can consider calling your parents to share the good news as soon as you leave the house!"
However, for older pregnant women, the chances of miscarriage are still relatively high even after a fetal heartbeat is detected. Studies have reported that the miscarriage rate for pregnant women aged 38-40 after a fetal heartbeat is detected is 19.8%, and for those aged 41-42 it is 29.9%.
So how do we cope with such a high miscarriage rate? Besides trying to conceive as early as possible, it's recommended that older mothers control their weight before pregnancy, adopt a healthy lifestyle, avoid exposure to potentially toxic substances, and take folic acid before and during pregnancy. Finally, in the face of threatened miscarriage, it's not advisable to insist on trying to save the pregnancy.
Level 2
The risk of chromosomal abnormalities and other malformations in fetuses of fallen angels
It seems to be common knowledge that advanced maternal age increases the risk of fetal chromosomal abnormalities. A major reason why countless mothers and mothers-in-law urge their daughters and daughters-in-law to have children is: "Look, if you don't have a child soon, the child will be more likely to have problems later on." This "problem" in the public's mind can be understood to some extent as fetal chromosomal abnormalities. In clinics, we frequently encounter older expectant mothers anxiously seeking advice on related issues.
Indeed, the risk of chromosomal disorders increases with maternal age. One study from amniocentesis showed that the incidence of chromosomal abnormalities (all types) was 1 in 132 at age 35, rising to 1 in 50 at age 40.
Here, Dr. Mou would like to give a big hug to all the expectant mothers I've mentioned who are even more anxious, and then say with utmost sincerity:
"Don't miss any of the necessary prenatal checkups. Although non-invasive prenatal testing (NIPT) can detect the three most common chromosomal disorders, if your doctor recommends amniocentesis, then go for it. Also, since not all birth defects are caused by chromosomal abnormalities, unfortunately, the risk of non-chromosomal abnormalities, especially heart abnormalities, increases with age in older mothers. Therefore, subsequent anomaly scans should also be performed as advised."
Finally, some people have heard that third-generation IVF can check the chromosomes of embryos. Can doing this guarantee that the baby will be normal? Dr. Mou does not recommend that healthy couples undergo third-generation IVF simply to avoid chromosomal abnormalities.
Level 3
Sweet Burden: Pregnancy-Related Medical Diseases
The most common medical complications during pregnancy are hypertension and diabetes. The incidence of both diseases increases in older women, especially in overweight women (mothers who are slightly overweight or above should start to worry...).
The incidence of gestational hypertension in the general population is 3-4%, while the incidence increases to 5-10% in women over 40 years of age. The incidence of diabetes also increases accordingly from 3% to 7-12%.
Of course, modern medicine is quite effective, and the serious risks posed by these diseases, such as the infamous placental abruption and eclampsia, can be avoided through close monitoring and intervention. However, overall, the rates of fetal growth restriction, premature birth, and cesarean section have still increased.
Unlike the previous questions, Dr. Mou's advice regarding pregnancy-related medical complications is not so weak. First, she recommends that everyone have a pre-pregnancy checkup, manage any complications promptly, and maintain good weight control before and during pregnancy, which can, to some extent, nip complications in the bud. Second, regularly follow your doctor's instructions for prenatal checkups. If any illness is discovered, don't panic; most cases of hypertension and diabetes can have good outcomes with careful management.
Level 4
Ultimate boss giving birth
Older expectant mothers often lack confidence when discussing delivery methods, asking questions like, "Am I too old to give birth?" or "I'm too old, is a C-section safer, so I don't have to suffer twice?"
Indeed, even in countries with low cesarean section rates, the rate of cesarean sections among older women is relatively high. While we don't know Gao's delivery method, many older first-time mothers do manage to deliver vaginally successfully. We advise all expectant mothers not to back down on their own; while this isn't something you can decide solely by will, there are many controllable factors.
include:
From the start of pregnancy, actively learn about vaginal delivery and build confidence in it. In terms of actions, manage your weight well. If your doctor assesses that vaginal delivery is possible, give yourself and your baby a chance and strive to achieve vaginal delivery.
Finally, I hope that every older expectant mother will have a healthy pregnancy, and even if there are some bumps along the way, she can walk through them safely and overcome all obstacles to achieve her official announcement of "mother and child/daughter safe and sound"!
This article was first published on the Obstetrics and Gynecology Channel of Medical World.
This article was written by: Mu Tian, Obstetrician and Gynecologist at Zhuozheng Medical Center.
Editor in charge: Zheng Huaju
