When you’re twenty, forty sounds REALLY old. I’m fully aware that any twenty-somethings reading this are probably thinking that by forty they will be very different people; much more steady, sensible and worldly-wise, and that they will, like, totally have their shit together. When you’re forty however, you realise that no-one ever really has their shit together, and as for being more stable and wise; in some ways you are, but in many respects you just learn to manage the capricious and immature side of yourself, rather than grow out of it. You compartmentalise it, as if it were an over-excited chimp that you keep in a room on the other side of the house (if you’ve got your shit together enough to have bought a house that is….I haven’t.)
I never really thought about how old I’d be when I had children, but I suppose I didn’t really think I’d be as old as forty. Throughout my twenties, having children was a far-off concept, and I just vaguely thought that “in ten years time I’d think about it”. It wasn’t on my radar at all; I’d been brought up by a single mum who was a career woman; I’d seen her go from 1980’s benefits mum to training for seven years to be come a chiropractor and subsequently opening her own clinic, so my idea of womanhood was working, not mothering. My grandmother was the same; she came to the UK in the 1940’s and worked every day of her life —pretty much— until she died in her eighties. Getting married and having children was never really put on the plate as ‘the thing you do’, and if anything, seeing my mum struggle with two children on her own, coupled with her mental health issues, never made family life look particularly appealing.
My trajectory was doing my “A” levels, followed by University, and then throwing myself into life in all it’s wild, colourful, scary and exciting dimensions. I travelled, lived abroad, learnt languages, worked in TV, partied and studied, and when girlfriends discussed marrying rich men and ‘settling down’, it never quite hit home as something that was for me. I had a few serious relationships with guys who were ready to settle down, but I ran away as far as I could whenever things got serious. Not physically necessarily, but mentally; pushing them away because I was scared off by the thought of commitment. I took a long time to ‘mature’ in that sense, and it wasn’t until I was about thirty-seven that I started to change my mind about the whole “in ten years I’ll think about it” thing. Which is good, seeing that I didn’t really have ten years by that stage. Thankfully, I met my partner Rob, and thankfully he was also pushing the big four-“o”, so he also wanted to have children straight away, before he lost too much more of his hair.
Our first child Odhrán was born two days before I was thirty-nine. Because I’ve never experienced pregnancy as a younger woman, I didn’t know how the treatment I received throughout that pregnancy differed from that given to any other woman. I was assigned to a specialist maternity unit, but that was more to do with my family history of mental ill-health than my age, so the more frequent visits to the midwife were less to do with me being thirty-eight and more to do with me being likely to lose the plot. I managed to get through the pregnancy unscathed, and then went on to get pregnant again when Odhrán was sixteen months old.
This time, it seems my most recent birthday means I have crossed the line over to “Geriatric Motherhood’, and I have definitely noticed that my age is now a factor, if not with my own health, then with the supervision of the medics. Thirty-five maybe be the age at which you’re considered to be having a “geriatric pregnancy”, but forty is the milestone that, if crossed, flags up a whole host of other things on which the health professionals looking after you will be keep an eye.
So what can you expect if you’re forty and pregnant? Well, again, I was assigned back to the same specialist unit as with my first pregnancy, but this time I’ve noticed a few added extras. Here is a run-down:
More frequent midwife (antenatal) appointments:
I see my midwife every three weeks for urine checks, blood pressure, fetal heartbeat checks and bump measurements. In these appointments she asks me how I am generally, mentally, and whether there is anything that concerns me. On one appointment, she picked up on my vaginal thrush symptoms, and also sent me for tests which showed that I had Group B Strep (a common bacteria that two in five people have living in their body, which is normally harmless but does need some management during birth to ensure the baby doesn’t get ill, so it’s important that the delivery team are aware). My midwife will also flag up any concerns she has with fetal growth, for example if your bump is measuring big or small you’ll be sent for extra scans at the hospital.
How does this differ from a younger woman’s experience? For younger pregnant women, visits to the midwife would be much less frequent. According to the NHS, for first pregnancies, you can expect to have up to ten antenatal appointments throughout the whole pregnancy, and that includes all your hospital scans. For women having their second baby, you’ll have only around seven antenatal appointments throughout the whole pregnancy. In my case, if you add up all the midwife appointments, scans and seeing the consultant, I will total about sixteen or seventeen planned antenatal appointments (and this isn’t even my first baby!).
Despite being fit, active and with no health conditions (thank God) being over forty means that I’ve been told that I have to take a daily 150mg dose of Aspirin in order to prevent blood clots, hypertension and possible preeclapmpsia. I don’t have any other warning signs for developing any of these conditions, so although it can be taken from as early as twelve weeks, I was only prescribed it from twenty-seven weeks. As there is no evidence that it does any harm, I decided to heed the midwife’s advice and take it as a precaution, even though developing these conditions is not one of my concerns.
Another thing I’ve been told just recently is, that in addition to all the extra antenatal appointments I am having because of my age, I will also be given a consultant appointment at around thirty weeks. This is to discuss our birth plan and to advise me that they recommend an induction. Which brings me on to the next point:
Induction plan at forty weeks:
Being aged forty or above means that a consultant will advise that I am induced on my due date (forty weeks), as according to the NHS, losing your baby as a stillbirth once ‘overdue’ carries about twice the risk of a younger mother (which is about the same risk as that to a thirty year old woman at forty-two weeks pregnant; one in five hundred).
Glucose Tolerance Test (GTT):
The NHS say that developing gestational diabetes is approximately four times more likely in mothers over forty when compared to women in their twenties or early thirties (about one in twenty-five compared to one in one hundred). My midwife tests my urine for sugar at every antenatal checkup and I also had a GTT test to check that my body was able to metabolise sugars in the normal way. It is: yay!
That’s about it…for now! It’s important to note that despite older mothers seeming more likely to experience problems in pregnancy and childbirth, what is unclear is whether the increased chance of complications applies to all pregnant women over forty, just first time mothers
over forty, pregnant women over forty who have a large number of other children or pregnant women over forty who have additional underlying health problems. If you’re fit, active and healthy like I am lucky enough to be, then conception, pregnancy and childbirth are all highly likely to go as smoothly as if you were in your early thirties. So don’t let any of this worry you! Pregnancies over forty are also on the increase, with loads of women now waiting until they’re in the right relationship or for other conditions to be right before embarking on motherhood. So if you are one of them, you are in good company!
If anything, I count myself extremely lucky to be living in the UK, where I have access to all these extra check and measures, as I’m a firm believer that there’s no harm in being extra vigilant, and of putting your mind at rest. I feel very fortunate that both me and my baby girl are in such great hands and that our health is being monitored every step of the way, “geriatric” or not! Bring on the zimmerframe!
Freya is one half of The Amateur Parents, alongside Rob, her partner. Head over to Instagram and to see all the latest posts from @the_amateur_mama