Extracted from Babycare Before Birth by Zita West (DK) £12.99

Years ago, when I was doing midwifery, anyone over 26 was considered to be an older mother. Now, it's more like 37 and many of my clients are in their late 30s or early 40s. In the UK in the past 10 years, the number of women over 40 having babies has doubled, and is now more than 2 per cent.

Mature motherhood
Many women delay motherhood through choice, while others have problems conceiving or have one or more miscarriages so have delay forced upon them. Older women may have fewer financial worries and be in more stable relationships, but their anxiety levels are likely to be higher during pregnancy and labour, especially if they've had IVF. This may, of course, reflect the fact that the older you are, the more you know.

The advantages
Women today are fitter and healthier; there are highly technical procedures to help them conceive; and their lifestyles are much improved since their grandmothers were having babies. So don't listen to too many gloomy statistics about older mothers and the possible complications in pregnancy.

There is plenty of evidence to show that a healthy woman in her 40s can have a healthy baby.

One advantage of being older is that you will feel more confident about making choices, such as whether to have tests or not. You will also be more ready to have a child because you already have a sense of fulfilment. And research shows older mothers are calmer and more likely to make time to enjoy their children. They are also more likely to breastfeed and their children seem to perform better at school.

Lifestyle adjustments
If you are older, you'll feel even more tired during pregnancy than your younger counterparts, and you'll need longer to adjust to the changes going on in your body. It's important during the first trimester to rest frequently.

You're more likely to be working in a profession, and you will have to consciously build time into your routine for rest. You may well have to go to bed early most nights. You may also have to give up work earlier than usual, at about 34 weeks. Nutritionally, it's vitally important that you pay attention to balancing bloodsugar levels.

The risk of complications
Women over 35 are at greater risk of miscarrying, of developing high blood pressure or pregnancy-induced diabetes and developing some late pregnancy problems. In many cases, however, modern obstetrics can monitor and treat these problems, and, as an older mother-to-be, you're more likely to be under consultant care.

As older women are well aware, the risk of Down's syndrome increases from 1 in 400 at aged 35 to 1 in 109 at 40 and 1 in 32 beyond 45. Other rare chromosomal abnormalities such as Patau's syndrome and Edwards syndrome are also more likely with increasing age.

Increased monitoring
Mothers over 35 are likely to have more antenatal tests and scans than younger women, but monitoring can be reassuring.

Where there are no tangible medical complications, the risks of childbirth are no greater for older women.

Multiple births
It seems older mothers are more likely to have a low birthweight baby (less than 2.5kg/5lb 8oz), but much of this risk is a result of multiple births. In 2000, 55 per cent of low birthweight babies of mothers over 45 were born in multiple deliveries. In cases of just one baby being born, women over 45 were substantially less likely to have a low-birthweight baby than younger women.

The incidence of multiple birth increases with age, more so for non-identical twins. According to research carried out at the National Institute of Child Health and Human Development, twins and triplets born to older women are as healthy as those born to younger mothers.

Health beyond birth
According to a study in the British Medical Journal, there is an increased risk of the first babies of older mothers developing diabetes. The mother's age at delivery seems to be strongly related to risk of type 1 (insulin-dependent) diabetes and a 45-year-old mother is more than three times more likely to have a child who develops diabetes than a 20 year old. This just serves to emphasize the importance of maintaining a good blood-sugar balance throughout your pregnancy, not only from the point of view of sustaining you, but also ensuring your baby's health in the future.

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