Although pregnancy and childbirth is a natural physiological process, it is still a huge burden on a woman's body, regardless of her age. However, it is necessary to take into account the fact that some failures and changes in work, which the body can “forgive” at 20, at 35 can turn into very serious problems. Age itself is a hindrance to birth healthy baby is not. But over time, various changes occur in the female body:

• the hormonal background changes;
• the tone and elasticity of tissues decreases;
• chronic diseases develop;
• there are changes in the reproductive system, etc.

The older a woman is, the higher the likelihood of her having chronic pathologies that can significantly complicate the course of pregnancy.

Pros and cons of late pregnancy

Late pregnancy today still causes a lot of controversy and gives rise to all kinds of myths. Carrying a baby is a lot of stress and a lot of work, and in adulthood, the risk of developing various complications increases many times. One of the most important factors in the favorable course of late pregnancy is its competent management. Therefore, it is extremely important to choose a doctor who will help a woman at this stage of life, taking into account all the individual characteristics of the body.

Late pregnancy has a number of significant benefits:

• prepared material base;
• a conscious approach to motherhood;
• later onset of menopause.

Also, the hormonal surge during pregnancy and breastfeeding has a positive effect on the appearance of a woman. The condition of hair, skin and nails improves, and psychologically a woman feels younger than her peers.

However, late pregnancy, in addition to the positive side, has many disadvantages:

• all existing chronic diseases, which greatly complicates the course of pregnancy;
• there is a high probability of developing severe toxicosis, up to the onset of preeclampsia and eclampsia;
• the risk of gestational diabetes mellitus;
• the risk of developing chromosomal abnormalities in the fetus increases.

The percentage of spontaneous abortions caesarean section, low birth weight, placental abnormalities and birth complications in older pregnant women are much higher than in younger women. Due to the natural loss of elasticity and extensibility of tissues in late pregnancy, there is a high risk of rupture of the cervix and soft tissues of the birth canal, which increases the likelihood postpartum hemorrhage... You should also know that the peak of twin births occurs just at the age of 35-40 years.

Late pregnancy: risks to the baby

Although numerous studies prove that a healthy woman over 35 years old has every chance of safely enduring and giving birth completely healthy child, it is necessary to approach pregnancy planning as carefully as possible in adulthood. Since women with excellent health by the age of 40 it becomes less and less, the risk of developing various complications remains high not only for the expectant mother herself, but also for the fetus:

• premature birth;
• underweight;
• intrauterine growth retardation;
• hypoxic damage to the central nervous system;
• genetic diseases.

However, despite such frightening information about possible complications late pregnancy, medical statistics clearly confirm that most women who decide to become a mother at the age of 35-40 and older give birth to absolutely healthy babies. The main thing is not to rely on fate, but to prepare for pregnancy in advance.

But if the pregnancy was not planned and the "two stripes" came as a surprise, the main task is to minimize the risk of complications, using the professional help of specialists. Late pregnancy is a difficult path for both the expectant mother and the baby. In order for the expectation of the baby to pass calmly and safely, a pregnant woman needs the support and help of a doctor who will monitor the development of the fetus, notice any changes in the condition of the pregnant woman and promptly eliminate them.

One of the most important diagnostic measures in late pregnancy is fetal screening studies, which allow to exclude or identify with a high degree of accuracy various deviations in the development of the baby. This is a complex of studies aimed at identifying abnormalities and congenital diseases of the fetus, including:

• 3D / 4D ultrasound;
• fetal cardiotocography (CTG);
• invasive studies (strictly according to indications) - chorionic biopsy, amniocentesis.

If you want the best obstetricians and gynecologists in Moscow to conduct pregnancy, come to the Clinic of Modern Medicine. Our clinic is equipped with advanced expert-class equipment, which allows us to carry out full-fledged prenatal screening, eliminating the possibility of a diagnostic error.

Late pregnancy management at the Clinic of Modern Medicine

The most important factor in the favorable course of late pregnancy is its competent management. You can get all the necessary consultations and undergo examinations at any antenatal clinic in Moscow. But in most cases a woman will have to face a very formal attitude, queues, lack of the necessary specialists and other "delights" of free medicine.

It is much safer for the expectant mother and child, especially when it comes to late pregnancy, to entrust its management to an experienced, competent and trustworthy doctor who will draw up a schedule for managing and monitoring pregnancy, taking into account the individual characteristics of the woman's body. Pregnancy management in the Clinic of Modern Medicine is comfort, care and full monitoring of the course of pregnancy according to an individually developed program.

The management of late pregnancy in our clinic is carried out by obstetricians-gynecologists of the highest category, who have many years of practical experience. The leading gynecologist during pregnancy is always in touch, which makes it possible, if necessary, to contact him and resolve any exciting issue. You can conclude a pregnancy management contract with the clinic at any time. However, in order to avoid even the slightest possibility of developing complications, it is better not to delay the registration with registration in late pregnancy.

Depending on the clinical situation, the pregnancy management program is drawn up with the involvement of narrow specialists - a geneticist, neuropathologist, endocrinologist, cardiologist, etc. Doctors jointly evaluate everything possible risks for the expectant mother and baby, adjust the treatment (if necessary) and constantly monitor the course of pregnancy.

Benefits of pregnancy management at the Clinic of Modern Medicine:

• the ability to independently choose a doctor;
• unlimited number of visits;
• round-the-clock communication with an obstetrician-gynecologist;
• in-depth prenatal diagnostics;
• regular monitoring of the condition of the fetus;
• availability of all narrow specialists;
• powerful modern laboratory and diagnostic facilities.

Yes, late pregnancy is not easy. But mothers in adulthood approach the birth of a baby more consciously, observe pregnancy more carefully and prepare more thoroughly for childbirth. And the accompaniment of late pregnancy by an experienced specialist is a guarantee of the birth of a healthy child!

Since the late 1970s, there has been a rapid increase in the number of women giving birth at the age of forty and even over forty. For a quarter of a century, the number of women giving birth among women aged 35-39 has increased by 90%. And the number of young mothers who are 40 and more has increased by 87%.

If fifteen years ago, 25-year-old girls were called "old-age", but today this term is used in relation to women in labor over 35 years old, and even then, quite rarely. There has been a significant shift in the age bracket of a woman capable of getting pregnant and giving birth.

Unplanned pregnancy

To begin with, the modern standard of living presupposes sexual activity and regular sex life in women who are not only "over 30", but also "over 40" and "over 50". Thus, naturally, the very possibility of getting pregnant is preserved.

At the same time, a fairly large number of pregnancies in adulthood are unexpected (and unwanted) for women. This is evidenced by at least the fact that, according to statistics, more than 70% of pregnancies in late reproductive age (after 35 years) are terminated by artificial abortions.

After all, by the age of 35-40, most women have already solved family planning issues, and their pregnancy is the result of neglect of contraception or the ineffectiveness of previous methods of contraception. So, for example, it is not uncommon for the physiological method of contraception, based on calculating the days favorable for conception, to "fail" due to the violation of the cycle as a result of natural age-related changes in the woman's body.

Many women rightly believe that their ability to conceive decreases with age and no longer pay due attention to contraception. However, the decline in the ability to conceive is by no means tantamount to infertility and the risk of accidental pregnancy in an elderly, unprotected woman is often higher than in a young woman who uses contraception.

And although at present only every tenth pregnancy is preserved among women over 40 years of age, let us not forget that 20 years ago the number of such births was significantly less, so that there is an encouraging trend - fewer and fewer women allow unwanted pregnancies, more and more women, " accidentally "becoming pregnant in adulthood, he decides to give birth - not only saving the life of the conceived child, but also, to some extent, returning his youth.

Planned pregnancy

Increasingly, women deliberately postpone the birth of children "for later" - until they achieve career success, solve the housing issue, and just before marriage, because the age of marriage has increased recently. And this is not a whim and not a whim, this is an objective tendency. After all, if physical maturity modern man reaches much earlier than his ancestors, that time of social maturity, when a person is ready to create a family and raise children, when he independently, without resorting to outside help, can provide a decent standard of living for his family and children, comes only by the age of thirty. Most likely, this is precisely the main reason that today's young parents have grown so old.

However, the number of women for whom late childbirth is not the first is also quite large. The increased percentage of divorces in modern society leads to the fact that many women between the ages of 30-40 remarry and want to have a child in a new marriage.

But even faithful spouses, by the age of 35-40, quite often have the opportunity to “have a second child” - they have strong positions at work, a stable income, a good apartment. And - what is remarkable - the desire not only to have a second child, but to have children of different sexes. Polls show that the expectations associated with the appearance of a child of a certain gender are much stronger not for those parents who are expecting their first child, but for those who want a brother for their eldest daughter or certainly a sister for an older son. This circumstance also explains the fact that a woman's third pregnancy is more likely to end in childbirth if the two older children are same-sex.

But women over 35 who decide to get pregnant are often faced with the fact that conception at their age is fraught with significant difficulties (it does not matter at all whether a woman wants to give birth to her first child, second or third child). After all, a woman's ability to get pregnant begins to decline somewhere after age 30, so it is not surprising that the older a woman is, the longer it will take for her to become pregnant. This is due to various reasons. Over the years, women have a decrease in the number of ovulations - an increasing number menstrual cycles passes without the formation of an egg, and the onset of pregnancy in such a cycle, of course, is impossible. With age, many women develop such diseases as endometriosis (a disease of the uterine mucosa associated with hormonal imbalance and preventing embryo implantation), obstruction of the tubes, in which it becomes impossible for the egg to enter the uterine cavity, etc. Various extragenital diseases (not directly related to the genital area) appear that prevent pregnancy. So, if a woman under 30 years old has a 20% chance of getting pregnant during one monthly cycle, then a woman over 40 has only 5%.

However, as we have already said, the fact that it takes more time to conceive is by no means equivalent to infertility. And yet, there should be no time to waste: if pregnancy does not occur after a year of sexual activity without contraception, you should consult a doctor to identify the reasons that prevent conception. Most women over 35 are able to conceive, carry and give birth to a healthy baby, and modern medicine I can help them in this.

Long-awaited pregnancy

Touching upon the topic of pregnancy in adulthood, one cannot but say about women for whom the opportunity to get pregnant only with the help of medicine has become the only chance to experience the happiness of motherhood. Among those who go to clinics for IVF (in vitro fertilization, ie fertilization "in vitro") - the last hope of women diagnosed with "primary infertility" - there are a lot of those who are over 30 and even over 40. The chances of giving birth to such women are two times less than among young people, but this is at least some chance in comparison with the diagnosis, which 20 years ago sounded a ruthless sentence. Today, doctors urge women not to delay the treatment of infertility and resort to the help of assisted reproductive technologies, because the younger the patient, the more chances of success.

But this is today, when there are already more than a million people in the world who were born with the help of IVF. A forty-year-old woman with primary infertility 20 years ago did not have the opportunity to resort to this procedure (the first “test tube” child was born only in 1978 and very far from Russia), 10 years ago she did not have money to perform such manipulations, and only now may try to get pregnant. Undoubtedly, the development of assisted reproductive technologies, especially in vitro fertilization, is one of the factors that led to an increase in the number of late pregnancies and “aged” young mothers.

However, she was treated for infertility for many years, an almost desperate woman, and a happy mother of two teenage boys, so waiting for a girl, and a successful "businesswoman" who finally found time to produce offspring, and a woman who no longer thought about marriage, but unexpectedly married, and a mature lady seeking to keep her young husband - all of them, having become pregnant, will face approximately the same problems. Let's leave aside the question of the prehistory of pregnancy and talk specifically about them - about the medical features of pregnancy in adulthood, about how a woman should behave, what to fear and what to prepare for in this position.

Late pregnancy problems

I warn you: we will now talk about the problems, complications and dangers, leaving aside all the undoubted charms and benefits associated with late pregnancy. The purpose of this article is not to scare a woman who is wondering whether to decide or not to take such a responsible step, but to warn what difficulties she will have to face and outline ways to overcome them.

Let us single out two topics in the discussion of this issue: what is the danger of pregnancy in adulthood for the mother and what problems may arise in the child of an “elderly” woman in labor. Naturally, you need to remember that such a division will be largely arbitrary, because a pregnant woman and a fetus are a single organism, and almost all the problems of the expectant mother are reflected in one way or another on the child.

Risk for a woman

• Miscarriage. If in women under 30 the risk of miscarriage is 10%, then in women 30-39 years old it is already 17%, and in women 40-44 years old it rises to 33%. The increasing risk of miscarriage is not only due to age-related changes of the entire female body, but also with the aging of the eggs themselves, as a result of which the conception of a fetus with gross genetic disorders occurs much more often.
• Placental problems (chronic placental insufficiency, previa, premature placental abruption).
• Exacerbation of chronic diseases. Pregnancy can exacerbate almost any of the chronic diseases, and with age, the likelihood of a woman having such diseases only increases. Of course, pregnancy with chronic kidney disease will require continuous medical supervision. More than careful medical management of pregnancy is necessary for diseases of cardio-vascular system, in particular with arterial hypertension. Arterial hypertension in itself is a fairly common complication of pregnancy, and if a woman has previously suffered from this disease, pregnancy can worsen it general state, increasing the risk of gestosis or preeclampsia (a condition characterized by an increase blood pressure, puffiness and presence of protein in urine). The most severe manifestation of preeclampsia - eclampsia (convulsions) - can seriously disrupt the functioning of the nervous system up to stroke and coma with serious impairment of brain function.
• Women over 40 are 3 times more likely to develop diabetes during pregnancy than before 30. Diabetes of pregnant women requires adherence to diet and special prescriptions (approximately 15% of women are prescribed insulin injections). In women with diabetes mellitus, the risk increases during pregnancy: preeclampsia, premature birth, placental complications, specific fetal damage - diabetic fetopathy, stillbirth.
• Multiple pregnancy (age 35-39 is the peak of twin births). Complications during childbirth (greater likelihood of weakness in labor, a greater risk of rupture of the soft birth canal due to a decrease in tissue elasticity, bleeding caused by placental problems, etc.).
• Cesarean section. In primiparous 35-40 years old, the probability of delivery by caesarean section is 40%, over 40 years old - 47% (while only 14% of women under 30 years of age give birth by caesarean section).

Risk to the child

• Premature birth.
• Light weight.
• The danger of hypoxia during childbirth.
• The risk of chromosomal abnormalities in the fetus.

Alas, with the age of parents, the risk of having a child with any chromosomal abnormalities increases dramatically. This is due to various and not fully understood reasons, including the aging of germ cells, and the time that various pathogenic factors and toxic substances are exposed to the human body, increasing with age. (By the way, an increase in the percentage of miscarriages in middle-aged women is also associated with gene mutations - embryos developing from cells with damaged chromosomes turn out to be unviable.)

The number of diseases caused by chromosomal abnormalities is quite large, but the most famous and greatest fear in parents is caused by Down syndrome - a combination mental retardation and abnormalities in physical development, due to the presence of one extra 21st chromosome. The likelihood of having a baby with Down syndrome increases with the age of the mother (see table).

However, as can be seen from the same table, even a fifty-year-old woman has a great chance (more than 90%) of giving birth to a healthy child, and in general 97% of women who have undergone prenatal examinations receive confirmation that the probability of having a full-fledged child is the same as and in younger women.

In addition, the modern development of prenatal diagnostics gives the family the opportunity to examine the fetus at a fairly early stage of pregnancy and identify (and more often exclude) possible deviations. It would be useful for a young woman to undergo such examinations, all the more so, medical and genetic counseling should not be neglected for those who, by age, entered the “risk group”. By the way, some of the doctors, in the prime of prenatal diagnostics, see one of the reasons for the increase in the number of middle-aged mothers: women have gained confidence that even after forty they will be able to give birth to a healthy child.

So what is the evidence from numerous studies? Paradoxically, they are optimistic: they say that the overwhelming majority of women who decide to give birth late are giving birth to healthy children!

You have to re-experience or discover the happiness of motherhood for the first time. You already live enough in the world and have the wisdom that twenty-year-olds do not have, you already know: nothing comes for free, without labor, sacrifice and effort; you already have enough strength and patience to overcome all difficulties. That love, those feelings that are born with this child, will change your life. Happiness maternal love, pride in your child, a second youth - all this you have to go through in the coming years, but for this now, in these 9 months, you will need attention, composure, indefatigability, iron will and self-discipline, and sometimes readiness for self-sacrifice.

Content

Recently, women who give birth to their first child after the age of 30 have ceased to be an exceptional and surprising fact. Today, their number has practically leveled off with the number of women who become mothers between the ages of 20 and 30. Of course, such an advantage in age could not fail to interest doctors and psychologists who are trying to understand the reasons and possible consequences such a phenomenon.

Is there an age for pregnancy

At the end of the last century, there were two terms in official medicine for women giving birth:

• elderly primiparous - applied to all women who became mothers after the age of 20;
• an old primiparous woman is a woman who gave birth for the first time after 30 years.

In modern obstetrics, both concepts have lost their relevance; today, childbirth is considered late if it occurs in a woman over 35 years of age.

Trying to find the reasons for such a phenomenon as late childbirth, many doctors and psychologists come to the conclusion that this fashion came to the post-Soviet space from the West. It was in the countries of Western Europe and the USA that a woman had to first become successful, realize herself in work and career, and then could drop out of public social life for several years and devote herself to raising a child. With the development of feminism and equal rights for men and women, this trend began to gain momentum, since a woman was able to earn on an equal basis with men and be independent from him.

However, in-depth research has revealed that this is not the only reason for late birth. Another important aspect is the state of health of young girls, because many of them at the age of 20-25 simply cannot get pregnant, undergo long courses of treatment and restoration of reproductive health.

If women's health, which allows a girl to become a mother, depends on hormonal levels and can be restored by taking special drugs, then the general condition of the body deteriorates with age. Problems and irregularities in the work of the gastrointestinal tract, a decrease in thyroid function, a decrease in the level of immunity, hypertension and varicose veins, dysfunction of the spine - all these problems appear in women with age and significantly affect the possibility of a healthy bearing of a child.

Considering late motherhood as an increasingly common phenomenon, it is important to take into account all its pros and cons.

Positive factors

One of the most important and significant advantages of late motherhood is that it is often a planned and expected pregnancy. A woman has reached a certain age, status and position, therefore she approaches the issue of conceiving and giving birth to a baby consciously and seriously. As a rule, adult parents understand all the responsibility that will fall on them to the newborn. In addition, they are morally, financially and physically ready for this, that is, they have allocated time, responsibilities and pay maximum attention to the baby.

It is for this reason, as noted by many scientists who have studied this issue, that children of adult parents are often more stable, calm and emotionally developed than newborns of young mothers. Adult parents do not need frequent absences for meetings with their peers, youth breakaway and the desire to use the maximum free time for themselves personally, which is so characteristic of young people in 20-25 years.

Despite the fact that the physiologically most suitable age for the birth of a child is 20-29 years old, emotionally men and women mature to be good parents much later, by about 5-8 years. An important factor is the financial situation of the family, usually spouses over the age of 30 have much less housing and financial problems than young people in their 20s. This means that the birth and upbringing of a child will take place in a more favorable atmosphere, where there is no constant search for an additional source of income.

Another important difference between adult parents and young spouses is that an older pregnant woman understands the importance of the doctor's recommendations and takes a more responsible attitude towards her health and the condition of the unborn baby. Compliance with all the rules during pregnancy is an important prerequisite for a healthy and easy delivery.

Negative aspects of late motherhood

Along with the many advantages of conceiving and having a child by a woman after the age of 35, there are a number of disadvantages of this phenomenon, which are also worth thinking about. Often, in women after 30 years of age, many chronic diseases begin to manifest and worsen, which previously could not have made themselves felt at all. And at the age of 40, it is difficult to find a woman who would not suffer at least some kind of ailment or disease. All this is reflected in the level of immunity, which affects many processes in the female body.

Concerning women's health, then after 35 years, the number of ovulations in a woman is significantly reduced, which means that the ability to conceive a child also decreases. Eggs age, and hormonal changes affect the susceptibility of the uterus. That is why the number of spontaneous miscarriages and ectopic pregnancies in women after 35 years of age increases significantly.

In addition, all these factors of aging of the female body can affect the health of the fetus, if conception does occur. Aging of the egg can provoke the development of chromosomal changes, which increases the risk of developing pathologies, including Down syndrome in a child. Statistical data confirm this likelihood, because young mothers who gave birth at the age of 20-23, for 700-800 healthy children, have one child with such a pathology. Whereas in a woman closer to 40 years of age, the ratio is one sick child to only 120-150 healthy children.

because of disabilities the female body after 35 years and reduced immunity, late pregnancy can take place with complications, which are expressed in late toxicosis, edema, fetal hypoxia, premature birth, etc. These and other features of late pregnancy often lead to the fact that a woman undergoes a cesarean section. Such a decision of doctors may also be due to muscle weakness and low elasticity of the joints of a woman after 35 years.

If, nevertheless, childbirth proceeds naturally, it can be delayed in time, end in soft tissue ruptures and perineal injuries, which is also due to age-related changes in the woman's body. Another unpleasant moment in the life of mothers who gave birth late may be lactation disorders, which will cause the child to switch to artificial feeding.

Features:

A woman after the age of 35, who is registered with an antenatal clinic, is included in the risk group and will be examined more closely than future young mothers. This is due to the desire of doctors to anticipate any possible violations or deviations from the normal course of pregnancy. Such control will necessarily include examination of the fetus for the presence of pathology, in particular for possible development Down's disease.

To determine the presence of such a violation during pregnancy, there are several methods. Firstly, in the first trimester, the villi of the future placenta are taken for analysis from a pregnant woman, the study of which can give an accurate answer. Secondly, the analysis of amniotic fluid, or as it is called in medicine, invasive perinatal diagnosis, at a later date also shows the presence or absence of Down syndrome in the child.

What is the best age for a woman to have a child? Of course, only she herself can make the final decision. However, doctors believe that it is better to acquire offspring at a young age, when the body has maximum strength and stable immunity. Psychologists add that a woman should take shape as a person capable of experiencing a deep sense of motherhood and passing on life experience to her child. The following course of events is optimal: at the age of 12-14, the girl begins to menstruate, at about 18-19 years of age - sexual activity and at about 22-24 years of age the first birth occurs. At this time, hormonal levels are optimal for bearing offspring. In general, the ideal age for conceiving a child varies from 22 to 30 years. But life circumstances do not always correspond to the ideal. What about women who are going to become mothers after 30 or even after 40 years? When deciding "to be or not to be" conception, you need to objectively assess your capabilities.

Why does this happen?

The main causes of late pregnancy can be divided into two large groups: social and medical. Unsettled life, low wages, difficult family relationships and the desire to "live for themselves" lead to the fact that some women do not want to have children aged 23 to 33 years. In addition, in our turbulent age, many strive to provide themselves with a sufficiently high level of education, to occupy a high social position, to make a successful career and to ensure the prosperity of their family, postponing the birth of a child to a later date. These and other social aspects are the reason that many women begin to think about procreation after 30 years. The same reasons can affect a woman's desire to have a second or third child at a "respectable" age.

Medical reasons for late pregnancy are certain diseases that have prevented the conception or bearing of the fetus for a long time.

Features of the course of pregnancy

After thirty, many women already have various diseases that can complicate the course of pregnancy and affect the health of the mother and the unborn child. So, for example, if a woman sometimes had headaches before pregnancy, then during the gestation of a baby it may turn out that they are associated with a periodic increase in blood pressure. Such rises can become regular. This condition can complicate the course of pregnancy, lead to the development of gestosis, which is manifested by an increase in blood pressure, changes in urine tests, and the appearance of edema.

Endocrine diseases (diseases of the thyroid, pancreas and other glands) can complicate pregnancy internal secretion), available before pregnancy. So, after 40 years, the risk of developing diabetes mellitus in pregnant women increases, and in the presence of this disease, even before pregnancy, a worsening of the condition and progression of the disease can be expected. Uncompensated, untreated thyroid diseases, excess or lack of hormones can lead to the threat of termination of pregnancy. Often, the first signs of a disease that did not manifest itself earlier are indicated precisely during pregnancy.

An important role is played by the factor that the older a woman is, the more sexual partners she could have over the past years. This means that with age, the risk of acquiring sexually transmitted diseases, including genital herpes, genital warts, and cytomegalovirus, increases. A woman may not even suspect that she has diseases, since some of them are asymptomatic. Since during pregnancy the body's immune forces are in a depressed state, which protects the baby from possible immune aggression, then during this period an exacerbation is more likely. infectious diseases... It should be noted that with an exacerbation of certain infectious diseases, including sexually transmitted diseases, it is imperative to consult a doctor and undergo a course of treatment, because the pathogen has an effect not only on the mother's body, but also on the baby's body. Some diseases, aggravated before childbirth, can determine the tactics of delivery. So, with an exacerbation of genital herpes or diseases caused by papillomavirus infection, immediately before childbirth, it becomes necessary to end the pregnancy by cesarean section.

Over the years, the structure of the internal genital organs changes. In young women, the tissues are elastic; over time, the structure of collagen and elastin fibers changes, which provide sufficient density and extensibility of the tissues. As a result, the ability of the uterus to hold and carry the fetus decreases, and the risk increases every year.

Women with chronic diseases of the heart, lungs, kidneys and other organs are at risk of premature birth.

Separately, it should be noted changes in the reproductive health of future parents.

A female fetus is born with a certain number of follicles in the ovary. During the childbearing period of a woman's life, a gradual expenditure of this reserve occurs. In each, 1 egg matures, but the existing follicles do not remain unchanged, aging processes take place in them, as well as in other tissues and organs of a person. These processes are primarily reflected in the state of the chromosomal set, which explains the fact that with age, the likelihood of having children with chromosomal pathology increases. According to statistics, (developmental anomaly on the twenty-first chromosome) is 100 times more common in the 40-year-old group than in women who gave birth at 22-24. The state of health of the father also influences the formation of the baby. In particular, if a man has been exposed to radiation, suffers from chronic alcoholism or other diseases that affect the state of tissues involved in the process of spermatogenesis, then the risk of chromosomal diseases of the fetus increases. But at the same time, many cases of the birth of healthy children in elderly parents are known.

Changes in a woman's reproductive system can also affect the course of pregnancy. The presence of miscarriages, abortions, inflammatory diseases of the uterus leads to problems of formation, attachment of the placenta, may occur (a condition in which the placenta blocks the opening leading to the cervical canal; spontaneous delivery is not possible), as a result of functional underdevelopment of the placenta, it may develop (a condition in which the child receives less nutrients and oxygen).

Features of childbirth

The risk of developing complications during childbirth also increases slightly. Physiological changes in the structure of the body and cervix can cause weakness in labor. The likelihood of rupture of the soft birth canal and the occurrence of bleeding increases.

Women often ask the question: is the first forthcoming birth after the age of 30 an indication for a caesarean section? There is no definite answer to it. If, in addition to the patient's age, all other figures (pelvic size, blood pressure indicators, test data, the number of heartbeats and breaths per minute, diopters for myopia - myopia, etc.) do not cause any doubts in the doctor, then the question of the method of delivery is decided in favor of childbirth through the natural birth canal. If, in addition to age, there are any indicators that indicate problems related to the health of the mother or baby, then, taking into account the age, a decision is made about a cesarean section. In each case, this issue is resolved individually. Since, as already mentioned, the number of diseases of both the reproductive system and organs that are not directly related to childbirth increases with age, the number of cesarean sections in women of the older age group also increases.

It should be noted that if late childbirth is not the first and the older child is already difficult to call a baby, then the mother's body does not always retain the memory of the childbirth that took place 15-20 years ago and the process of cervical dilatation can proceed according to the "laws of the first birth", that is. there is a possibility of complications in childbirth.

Required examinations

First, it should be said that, having decided on such a crucial step as having a child, you should not try to save time on preliminary examination, and, if necessary, on treatment before pregnancy. After all, the likelihood of complications of pregnancy and childbirth increases in the presence of various diseases, and the time that may be needed for recovery and treatment after premature termination of pregnancy is incomparable with the time that will be required for a thorough examination before conception.

Expectant parents need to identify the presence of sexually transmitted infections, cure chronic inflammatory processes genitals, visit a dentist, carry out the necessary correction in the presence of diseases of all organs and systems, take a course of vitamin therapy. After all, pregnancy and childbirth require the woman's body to maximize the mobilization of all forces and reserves.

With the current level of development of prenatal diagnostics and obstetrics, almost every family has the opportunity in the early stages of pregnancy to undergo an examination in a medical genetic consultation to exclude fetal pathology and give birth to a healthy baby. In order not to miss the birth of a child with a gross genetic pathology, all parents over thirty years old are offered to undergo various studies in a medical genetic consultation. For example, at 16-20 weeks of pregnancy, a blood test is taken from a vein to determine the likelihood of a fetal genetic pathology. This method belongs to non-invasive (non-operative) diagnostic methods. congenital defects and developmental anomalies. If, according to the results of these tests, doubts arise or the pregnant woman is more than 40 years old, then the range of tests expands. As additional studies, invasive methods are used: in the first trimester, this is a chorionic biopsy (a piece of tissue is taken for analysis, from which the placenta is then formed). In the second trimester, chordocentesis is performed (fetal blood sampling through the umbilical cord vessels). If these studies are carried out and their results are satisfactory, then there is no need to worry about possible genetic defects in the child.

Despite all the possible difficulties during pregnancy and childbirth, women who decide to give birth to a baby at a middle age have a number of advantages, the main of which is a conscious approach to motherhood, the desire to do everything possible so that the baby is born healthy.

Igor Baranov
Leading Researcher, Department of Pregnancy Management
with a high infectious risk of the Scientific Center of Obstetrics,
Gynecology and Perinatology, Russian Academy of Medical Sciences, Doctor of Medical Sciences

Discussion

Da uzh, breda mnogo v stat "e. Pochemu-to v evrope ni odin ginekolog ne nagovorit zhenshine takogo. Evropeyskie zhenshiny v bol" shinstve rozhajut pervyh detey posle 30. Tut nikto ne udivitsja 30. Tut nikto ne udivitsja, esli u zamy detective Ne slushayte nikogo! Zavodite detey togda, kogda poschitaete nuzhnym! deti dolzhny byt "zhelannymi- eto samoe glavnoe.

i live in Belgium. I can not say that it is forbidden to give birth to old-born here. This is the age of up to 44 years. But my sister's gynecologist, she is 35, when she was pregnant with her second child, all the time warned that she was old-born. So, in Europe, of course, less often than we have. but also remind of age.

It is necessary to be checked up to 30 years, no one is insured. And with good health, children with problems are sometimes born. So if not yourself, then the fetus should always be examined in any way, there is nothing to rely on.

Elena. Nikto ne govorit, chto posle 30 rozhat "nevozmozhno. Ya zhila vo Francii i seichas zhivu v USA i deistvitel" no v etih stranah chasto rozhayut posle 30. Esli vy zdorovy i vse prekrasno, to ochen "horosho, prekrasno .No v Evrope iv USA te kto rozhayut do 30 SOCIAL "NO schitayutsya ranorodyashimi, as FIZIOLOGICHESKOI tochki zreniya ginekologi ochen" dage raduyutsya, esli zhenshina beremeneet ran "she. Tak chto Anna prava. Nu razhlno by nt" vnimate sya

That's right, you have to be very careful, check a hundred times. And about Europe and the United States, then Julia, you are wrong. They also consider it late childbirth. And our pediatricians, gynecologists are better than them, maybe rougher, I agree, but better as specialists. In Europe, they won't tell you anything or scare you, because they don't care about your problems, give birth when you want, it's your business - this is such an approach. 03/17/2004 12:46:38

What is the best age for pregnancy?

The main purpose of a woman is motherhood, but not all representatives of the fair sex think so. Some are as concerned as possible with a career or personal well-being, believing that a child can become a hindrance. Others want to have children, but their personal life does not work out or their material condition does not allow them to think about procreation.

Many fear that the years go by, and they may not have time to give birth to a healthy baby. What best age for pregnancy and is there any reason for concern?

• Medical reasons for the best age for pregnancy
• Social aspect
• Pregnancy after 35 years
• Later paternity

If earlier it was believed that giving birth is the lot of young people, now in a gynecological consultation one can meet both a young girl and a pregnant lady well over 30. The opinion of gynecologists and sociologists differs in terms of the most optimal age for childbirth. They reasonably argue their views.

Medical justification for the best time to get pregnant

According to most gynecologists and obstetricians, according to medical indicators, the best age for pregnancy is from 19 to 26 years. By the age of 19, the girl had already turned into a woman, the body was in its prime. The formation of internal genital organs has occurred, the ovaries maintain hormonal balance. The muscles of the vagina are firm and elastic. The pelvic bones are quite mobile, and this will have a good effect during childbirth.

In addition, in young women, the abdominal muscles are usually well trained, so such women in labor are more effective at following the obstetrician's commands during pushing. At a young age, the expectant mother has not yet accumulated chronic diseases. Childbirth, as a rule, goes well, there are fewer perineal ruptures, there is practically no bleeding. It is easier for young women in childbirth to recover their physical shape, postpartum complications are less likely.

Swedish scientists from the Karolinska Institute conducted thorough research and named the favorable age for pregnancy - up to 30 years. They do not recommend postponing the first pregnancy for a long time, because every year the chances of a successful conception are significantly reduced and childbirth may be premature. Scientists studied a group of primiparous women aged 30-34 years and found that age has the main influence on problems during pregnancy, and only a minor one - bad habits, overweight. The risk of complications is 20% higher compared to 25-30 year olds.

Reproductive activity begins to fade after 25 years. Gynecologists say that late childbirth is harmful to the health of not only the mother, but also the baby. Scientists at the British University of Newcastle conducted research and found that children with genetic disorders, congenital diseases, in particular, Down syndrome, are born to elderly parents.

Social aspect

According to psychologists, planning the first pregnancy by the age of 30–35 is considered normal. This is what women do in Europe, where the average age for first-time birth is about 32. In London, primiparas under 30 are not considered a risk group. Social factors of late pregnancy often depend on ambition and material well-being. An ambitious woman cannot decide on pregnancy until she achieves certain success in her career and feels that she is firmly on her feet.

When she is mentally and physically ready to become a mother, the child will not be a heavy burden, but a welcome gift of fate. According to Forbes magazine polls, among two thousand women surveyed with higher education, the overwhelming majority - 76%, are sure that the most suitable age for the birth of the first child is in the range of 25–34 years. At the same time, almost half believe that it is necessary to give birth no earlier than 29 years old, because until these years it is impossible to have time to get an education, build a career and provide a material base for the future child.

Early pregnancy - good?

It happens that girls become pregnant at the age of 13-16. At this age, children usually appear unplanned. The young mother herself is almost a child herself, she has not matured physically, and her partner does not have the material components to support his wife and baby. All these factors affect the nervous system of a woman in labor, stress can negatively affect a fragile young body. On the medical side, it is still developing, the genitals are not fully formed.

The hormonal background of young girls is unstable, there may be a lack of the necessary hormones - and estrogen, which affect the formation of the placenta. Gynecologists warn that pregnancy in childhood although possible, it is not desirable. During childbirth, there may be bleeding and various complications. Psychologists are also strongly against early pregnancy, because a young mother, due to everyday difficulties, cannot devote enough time to the child and is not morally ready for his birth.

Pregnancy at a young age

The most suitable age for pregnancy, recommended by doctors, is from 19 to 26 years, when, from a physiological point of view:

• the bones of the pelvis are mobile;
• the birth canal is elastic,
• the body does not yet suffer from age-related diseases;
• the risk of miscarriage is lower than at a later age;
• the likelihood of developing pathologies in an infant is less.

You can have time to give birth to a second baby before the age of 30. In the second pregnancy, the age difference between the children should be approximately three years. During this time, the body will fully recover, and the first child will grow up, so it will be easier for a young mother to take care of the newborn.

Pregnancy after 35 years

Earlier, thirty-year-old women who first decided to become a mother were referred to by gynecologists as “age primiparous”. Now 35-year-olds are not considered very rare. Although modern medicine works wonders, first pregnancy at a later age is a rather risky step. It is even more difficult to get pregnant, because the number of cycles without ovulation increases, the uterus becomes less susceptible to the development of a fertilized egg. It may even come.

Health problems can appear both during gestation and during childbirth. The probability of manifestation of placental insufficiency is high. , weak generic activity, profuse bleeding, ruptures of the soft birth canal.

Possible complications:

• prematurity;
• toxicosis in the second half of the term;
• postmaturity;
• premature discharge of water;
• insufficient labor activity;
• fetal hypoxia.

The desire to have a child does not stop some even at a later age. The older the age, the less likely it is to conceive. In 64% of women 40–45 years old, infertility is manifested. The risk of miscarriage, compared to 30-year-olds, increases by about 3 times. During gestation, pathologies such as placental abruption and chronic diseases may worsen.

This is a dangerous, critical age for pregnancy, so you need to undergo a more thorough medical examination. Each organism is individual, pregnancy can proceed in different ways. It is not the actual age that is important, but the biological one, which is determined by the psychological and physical condition. Doctors note that menopause occurs later in those who have given birth after forty, they are less at risk of genital oncology and live longer.

Later paternity

The possibility of conception and the physical condition of the unborn child is influenced by the age of not only the mother, but also the father. In men over 45 years of age, the probability of successful conception is reduced by 3 times. Active spermatozoa do not decrease with age, but their quality deteriorates. Semen is affected by negative factors - bad habits, ecology, taking dangerous medications. It has been established that elderly fathers often have children with developmental defects, including Down's syndrome.

Both early and late motherhood and fatherhood have their positive and negative sides... And yet, according to sociological research, many respondents believe that the optimal age for pregnancy is up to 30 years, when young parents have already taken place as individuals, have a strong material base, and are full of physical strength to raise their child.