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Pregnancy After 45: A High-Risk Dilemma

As more older women attempt to beat the biological clock and conceive, they are at greater risk for developing birth-related complications. For women over 45, there is less than a 1 percent chance of getting pregnant using their own eggs. Successful pregnancy for women over 45 is nearly always the result of in-vitro fertilization (IVF) and the use of an egg donor.

Researchers at Tel Aviv University reviewed birth records from 2000 to 2008, specifically looking at the records of 177 women who gave birth at the age of 45 and beyond. The majority of the women had IVF and received donor eggs, and 80 percent of the babies were delivered via cesarean section (C-section).

Despite their celebrity, Kelly Presley (age 47), Celine Dion (age 42), and Mariah Carey (age 40), are older pregnant women who are at risk. The premature birth of Celine Dion’s twin sons did not surprise me at all. Women over 35, and especially those over 45 with underlying medical problems, should be treated prior to becoming pregnant. I cannot emphasize this enough.

I will never forget the face of a 45-year-old pregnant hospital worker who expired during birth. She was not my patient, but I would frequently see her delivering mail in the hospital. She unfortunately expired from underlying hypertension (high blood pressure) that was not properly treated, and for some reason her death affected me personally.

The risks of pregnancy-related deaths are sharply elevated for women 45 and older. Women who have heart disease should see their internists or cardiologists for a pre-pregnancy consultation prior to becoming pregnant. The heart system undergoes a tremendous amount of change during pregnancy that includes an increase in the circulating volume of blood both in the body and in the heart, as well as an increase in its heart rate.

Older pregnant women have the highest mortality rate. Older Caucasian women typically die from hemorrhage, an enlarged heart from pregnancy (cardiomyopathy), or a blood clot. Older pregnant African American women usually die from hypertensive disorders of pregnancy, stroke, infection, or other medical conditions.

If you are a pregnant woman who is 45 and older, please seek the medical expertise from a maternal-fetal specialist, preferably one that’s affiliated with a teaching hospital. Your best defense is a good offense. Despite potential complications, with the guiding hands of obstetrical experts, your pregnancy should be fine.

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*This blog post was originally published at Dr. Linda Burke-Galloway*

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2 Responses to “Pregnancy After 45: A High-Risk Dilemma”

  1. Jax says:

    As i sit here writing this i am about to turn 47, have been divorced for 5 years, in a relationship with another man for the past 4- now engaged, and have two wonderful kids from my first marriage.
    I also found out i am pregnant. Something an OB/GYN told me was unlikely to happen in my 40s given my past difficulties.

    It is a pregnancy i will be terminating for many reasons-ranging from health, high risk previous pregnancy, to finances.
    It was an unintended pregnancy after years of believing that i couldn’t get pregnant. My last pregnancy was 12 years ago and ended in a pretty horrific miscarriage.

    My first, and only biological child, i had at 26 years of age and my second was adopted when he was two (i was 38).
    For years i tried to get pregnant with my second child to no avail.
    Then at 35 i got pregnant as i was ready to face adoption.
    I miscarried almost 12 weeks into my pregnancy. Actually the fetus died roughly 10 weeks in and my body wouldn’t naturally miscarry.

    I was rushed to the ER for uncontrolled bleeding and had to be given general anesthesia so that they could perform a D&C to remove the dead fetus.

    Two years after my miscarriage we brought home our beautiful son (2 years old) which we adopted from an orphanage. An adoption which most likely not had happened if i had given birth to my second child due to finances and the fact that we only wanted two kids. So, basically, i am glad things turned out the way they did.

    Now that being said i made a choice a long time ago to not have kids beyond a certain age, namely 45.

    Morally, emotionally, physically, financially etc i don’t believe having kids beyond 45 is a good idea. I never have.
    I have seen mothers who had kids in their late 40′s and 50′s struggle and its difficult to watch.

    1st–Some of the kids had differing disabilities. While this could happen at any age the chances are far greater in mothers who have given birth beyond the age of 45.

    2nd–In many cases the moms were either “too tired”, too sick, too burned out etc to keep up with the baby, toddler, pre-schooler, young child.

    3rd–The age in which MOST men and women begin to experience various age-related illnesses, conditions, disabilities is in late 40s and beyond.
    So the likelyhood of developing a condition which will prevent you from successfully parenting a baby or young child is far greater in late 40s and beyond than it is in your 20′s and 30s.

    4th–The financial stresses can be enormous. Good luck retiring at 65 if your child is barely 12 years old.
    Children need financial support, and alot of it, even entering into their college years.
    In todays economy–at least 40% of young adults between 18-27 are still living with their parents due to the inability to find work with decent enough wages to support themselves.

    5th–I couldn’t imagine being 65-70 years old and too ill and too broke to be able to help out my young adult child (18-25 year old)-could you?
    Most employers won’t hire a 70 year old no matter how *vibrant* they are. Health insurance costs for this age group is just too great.

    6th–You will most likely never see your child get married and have children of their own or even be able to be a source of emotional, physical and economic support for them during this period in their lives.
    Nowadays most young adults, for economic reasons, won’t marry until they are almost 30 or beyond.

    My parents are in their late 60s with a slew of ailments as early as early 60s.
    Ironically, they took good care of themselves and were physically active and it wasn’t until late 50s that diagnosis of heart disease, diabetes, anxiety disorder etc came into play.

    If my mother had had a child in her late 40s or 50s I would be taking care of that child today (since my sister and brother are not in a position to do it) and my parents would deeply regret not being able to parent that child. Not to mention that child would most likely be saddened by not having had parents, in the typical sense, like other kids.
    If that child had been an only–he/she would most likely be in foster care since my parents siblings are either dead or too old and sick to take care of a child.

    The mentality that you are “very healthy and active” does not negate the fact that most disabling chronic conditions happen after the age of 45.

    My brother had his last child at 40. Now he’s a 49 year old mess. He has had numerous heart scans and diagnosed with a heart condition. After 18 years of a successful career he has been laid off for two years and unable to find work with a wage that will allow him to support his three kids (this despite two masters degrees).
    Before this my brother was a “vibrant” and “physically active” individual having served two tours in the military in his 20′s-30′s.
    His wife decided that parenting isn’t for her since at the age of 48, and with back issues, she finds it too difficult taking care of 3 little ones so she enrolled in school as an excuse to not have to parent. Since my brother lives pretty far from any of us, and since his wife doesn’t want to move closer to family, he has
    no help from family, he’s own his own when it comes to raising his kids.

    Keep in mind that neither myself or my siblings ever expected to have any kids of physical or financial issues in our 40′s.
    We are all responsible, physically active and healthy professionals people.

    My point is that STUFF HAPPENS. Even though you could argue that stuff happens at any age it is far likelier that it will happen in 40′s and beyond.

    Before you start considering having more children in your 40′s and 50s my advice is to please please reconsider.

    If this is your first child then i pray that you have the financial, mental and emotional resources to effectively parent that child. Otherwise you will most likely be bringing a world of hurt to yourselves and your children.

    One more thing–to compare yourself to women who had kids in their 40s back in the “good old days” of the 1940′s and 1950s etc is a big mistake.
    Back then these women had the resources of extended families and the divorce and unemployment rate of their husbands was alot lower than it is today.
    Back then a woman’s “career” was to raise children.
    Back then the cost of living was far lower in so far that only one spouse needed to work outside of the home.
    My grandmother had her last child at 46(unexpected pregnancy). She had a complicated childbirth and almost died. She was also bedridden for a while.
    But what she also had was a huge family support who pitched in to take care of the other kids. She had grown kids who pitched in to take care of the baby and a husband who was gainfully employed in his own business and financially successful.
    So even if his business had tanked they would have had enough money to take care of their kids. Not to mention there were plenty of jobs available for the grown kids and they were gainfully employe

  2. Prissy says:

    All well and good for mothers with underlying health issues. But what about mothers over 45 who have none at all? From the studies I have read, their outcome is as good as a woman in her 30’s.

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