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At 40 it’s not too late

At 40 it's not too late

Nowadays, childbirth after 35 years is considered late, and an increase in their number is a trend of recent decades. Is it good or bad to give birth after 30?

On the one hand, pregnancy and childbirth is a natural process programmed by nature, on the other hand, it places increased demands on the woman’s body.

All its organs and systems increase their work by 20–45%. For example, a future mother’s heart pumps 1.5–2 million liters of blood in 40 weeks of pregnancy. The body is able to cope with such loads, but in a situation where the first birth of a woman falls on the age of over 35 years, all sorts of problems arise more often.

For example, violations in the work of the placenta (placental insufficiency), due to which the baby suffers from a lack of oxygen (hypoxia); disruptions in the development of labor, when contractions become weak, ineffective; post-pregnancy; injuries (tears) of the mild birth canal of the expectant mother due to a decrease in tissue elasticity; preterm labor; inflammatory complications after them due to age-related decline in immunity and chronic problems, including gynecological (fibroids, inflammation of the appendages) and infectious (chlamydia, mycoplasmosis).

In 30–35% of cases for expectant mothers over 35, the first birth ends with a cesarean section. This is partly due to the fact that with the appearance of problems, such as weak contractions, surgery will be a safer solution than the use of stimulant drugs and in general any medical methods of treatment that can aggravate the chronic diseases of a woman.

That is why women over 35 should plan their first pregnancy: it is recommended to undergo an examination in advance in order to identify possible risks. Then it is important not to make a mistake in choosing a female consultation for her reference.

It is desirable that local doctors have had this experience and did not consider late pregnancy, and then giving birth, as a problem.

What to consider when choosing a maternity hospital? It is better if its level is high (as, for example, in perinatal centers and clinics): you will be guaranteed the attention of specialists of various specialties who can help in case of exacerbation of chronic problems (cardiologists, urologists, etc.). Preferably, there is a round-the-clock possibility of ultrasound diagnostics, boxes equipped with “mother” cardiac monitors (measuring the pulse, the pressure of the expectant mother) and, finally, pediatric resuscitation.

It is very important that the doctor leading the birth be experienced enough to correctly assess the situation and with the appearance of problems during the birth do not delay the decision to send a woman to the operation.

But do not think that the first pregnancy for women over 35 is a complete test. There are many chances that it will proceed quite normally, without complications.

And pregnancy hormones, especially estrogens, rejuvenate the body, tone up muscle tissue, give them elasticity, strengthen the bone system, reduce cholesterol and the risk of onset of hypertension.

Of course, it is known that there are problems that mature future mothers face more often than others: for example, the hormonal readiness of the body actually becomes lower with age, which is why labor is more difficult; it becomes harder to push, because the elasticity of muscles and ligaments is not so high; hypertension, problems with the joints and the spine appear more frequently against the background of pregnancy. Yet, these and many other “signs of age” for doctors are not a reason to immediately send a woman to a planned cesarean section, even if we are talking about first birth, despite the fact that in practice in this situation the “operational” decision is made more often than when It is about the second birth, albeit the following with a long break.

There are good reasons for referral to the operation: too narrow a pelvis of the expectant mother, a large baby, weak contractions. If there are no such problems and the mother is configured for natural childbirth – everything is possible.

Of the entire list of possible (but not at all mandatory) problems that they may encounter, it is more difficult to solve those that do not arise at all during childbirth. Easier not to let them. For this reason, such expectant mothers need more attention from specialists.

It is desirable that obstetrician-gynecologists, who have already had such experience, and a great one, are engaged in the management of late pregnancy. For example, cabinets that specialize in monitoring women from the “risk group” are currently working in many reproductive centers. There is an opportunity to conduct more in-depth studies (for example, blood coagulation), which are not provided for by the standard program of antenatal clinics.

Expectant mothers also need to be more attentive to themselves: follow the prescribed scheme of examinations and pass tests on time.

During pregnancy, expectant mothers over 35 should visit the doctor more often: in the first half – at least 2 times a month, and after the 30th week – 1 time in 7 days. No need to be surprised at the extended list of mandatory consultations and examinations: a visit to a geneticist, hormonal tests, blood coagulation tests.

All these measures will help prevent problems that, as is known from medical experience, can appear in patients with age.

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