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Pregnancy after the Age Of 35

These days most women delay to become a mother and getting pregnant by the age of 30 and beyond. The chances of conceiving and delivering a healthy baby are reduced after the age of 30. But thanks to the advances made in the field of medical science, most healthy women above the age of 35 today can have healthy pregnancies

If you are above 35 years of age and want to get pregnant and deliver a healthy baby, there are a number of things that need to be handled properly. Women above the age of 35 who get pregnant have an increased chance of suffering from:

  • High blood pressure and diabetes – Pregnant women over the age of 35 years have greater chances of developing high blood pressure and diabetes during pregnancy. This condition can have a very adverse effect on the mother and the child. Also the chances of placental and bleeding problems are higher in such pregnancies.
  • Multiple pregnancies – Older women have a higher chance of delivering twins or triplets.
  • Miscarriage – Women above the age of 35 years, face a greater risk of miscarriage than their younger counterparts. The reasons for this can be assigned to chromosomal abnormalities, which are very apparent in women older than 35 years
  • Fertility problems– After 30 years of age it may take you longer to conceive. This happens because by this age you may begin to ovulate less frequently or are more affected by endometriosis. So after the age of 35, if you are not able to conceive within six months of trying, then it is recommended to see a doctor or a fertility specialist.
  • Placenta previa – In this condition, the placenta is in a wrong position and covers the cervix.
  • Cesarean section – Older women who deliver for the first time have very hard labor and fetal distress. They have higher chances of delivering through caesarean section
  • Genetic disorders – Pregnancy in older women always brings with it a risk of giving birth to a child with certain genetic disorders like Down syndrome.
  • Still birthDelivering a baby that has died before birth is very common in women over the age of 35.

To avoid all these complications during pregnancy, it is advisable that you take proper prenatal care and take on the services of a good health care provider. Even after learning about the risks and difficulties of such pregnancies, you can be reassured that you will have a healthy pregnancy and will give birth to a healthy baby, provided you follow all the guidelines set by your health care provider. Having children after the optimum years of child bearing age of 20 years through 34 years requires certain precautions and guidelines to be followed. Good health before conception and during conception will reduce your risk of complications.

Pregnancy risks in older women can be minimized if you maintain certain healthy habits mentioned below:

  • Intake of alcohol, cigarettes or illegal drugs should be stopped.
  • Only the right amount of weight should be gained.
  • Exercise moderately under guidance from your health care provider
  • Eat healthy and well balance food and include a large variety of food to your diet.
  • Any intake of medications should first be checked with your health care provider.
  • Don’t overdo your caffeine consumption
  • Folic acid is a must in your diet- this can be included even belfore you become pregnant. This vitamin helps to prevent birth defects of the brain and spinal cord in the fetus.

In case of pregnancy after the age of 35 years it is always recommended that you go in for prenatal screening tests. One of these tests is amniocentesis, where a needle in inserted through the women’s abdomen and a small amount of amniotic fluid is removed and then tests are carried out for any specific genetic disorder. This way you can be reassured about the baby’s health.

Pregnancy after the age of 35 entails a great risk for the baby like Down syndrome – a condition where mental retardation is accompanied by physical defects in a new born baby, preeclampsia – a condition where a woman’s blood pressure goes up sharply during the third trimester of pregnancy causing premature birth or low birth weight.  Some older women who conceive also have a tendency to develop ‘gestational diabetes’ where in during pregnancy you develop high blood sugar levels. As a result you give birth to large babies making normal delivery very difficult.

Teenage Pregnancy

Teenage pregnancy is when a woman under the age of 19 has sexual intercourse and becomes pregnant. The problem of teenage pregnancy is related to cultural, religious, moral, and social issues. Most of us have a firm belief that children should not get pregnant until after marriage. Pregnant teenagers always find a lack of support from their family and friends. Teen pregnancy has been a cause of concern throughout the world. The number of teenage pregnancies in the western industrialized world is alarming.

A teenager, after having unprotected sex, can immediately take an emergency contraceptive pill (ECP) which is available at most walk in clinic or from a doctor. This pill helps in several ways. Firstly it helps by stopping body from releasing an egg. If the egg has already been released then ECP prevents the egg from getting fertilized. If egg is already fertilized then it stops the egg from setting in the uterus. The ECP can be taken within 120 hours of having unprotected sex.  ECP cannot help if the pregnancy has already taken place. ECP is safe and does not cause miscarriage or abortions in case it is taken by pregnant women.

Once a teenager is pregnant then she has the option of keeping the baby or terminating the pregnancy by having an abortion. The decision to become a parent in teenage years can be very hard and taxing. Child care is a full time job and requires a lot of love and care to be given to the newborn child after his/her birth. It is a tough decision to become a single parent. Before a teenage mother decide to keep her baby and become a single unmarried parent, she needs to answer a few questions –

  • Where will you get the finance to support yourself and the baby?
  • Is the time right for you to be a parent?
  • How will you continue your studies and look after a baby?
  • Are your friends and family ready to support you?

The other way out is to go in for adoption which can be an open adoption or a closed adoption. In an open adoption you choose the parents who will look after your baby and can even keep in touch with them. In a closed adoption everything is kept private and nobody knows who are the real parents or the adopted parents.

The other choice is abortion which means ‘termination of pregnancy’. This can be usually carried out before the 12th week of pregnancy. It is safe to have an early abortion and should always be handled at a licensed clinic.  There are times when you cannot make a decision yourself, so you must find somebody to talk to. Your parents could be an ideal choice provided you are comfortable talking to them. Otherwise you could talk to a teacher, doctor, a sex counselor or a friend.

Teenage pregnancies pose a number of problems for both teenagers and their parents. One mistake by the teenagers may lead them to pay very heavily for it all their lives. They are most unlikely to finish high school or college and most of them end up depending on welfare homes. The newborns of teenage mothers have a lower birth weight.  Even if they go to school, they do very poorly and are at a greater risk of abuse and neglect. Their children also do not get the right opportunities in life and may suffer the same fate as their mother. But not all teenage mothers do end up with the same fate. There are many of them who have succeeded in life through hard work, courage, dedication, and a strong support from near and dear ones.

It is advisable to prevent an unwanted pregnancy at any stage of life rather than go through the trauma of abortion or giving birth. It is the duty of parents of teenage children to keep a check and have an open relationship and communication with their children.  Children should know that it is better to be safe than sorry. Educating teenager about sex is one good option but along with teaching the use of contraceptives, they should also be taught to say ‘no’ to sex and wait for the right time and choice.

The hardest part about getting pregnant is when teenagers have to break the news to their parents. They should talk to their parents and tell them that they need their parents support and help. Their parents may not take the news very well initially. But once they have settled down, teenagers can disclose their future decision regarding the pregnancy. The parents can help and let their pregnant daughter decide what decision should be taken.

Understanding and Coping With Miscarriages

A miscarriage is a pregnancy which gets terminated in the first six months. It can be very frustrating, full of guilt, and a sad experience for most women. Normally miscarriages happen in the first trimester, the first three months of pregnancy. A miscarriage can make “a mother to be” to go through severe emotions. You may keep on wondering as to what went wrong and where you made a mistake. You must understand that it does not happen due to anyone’s fault.

Miscarriages do not occur due to some minor problems like exercising or a minor fall. This is because the fetus is very securely kept in the amniotic fluid sac and is also protected by the mother’s bones and muscles around the sac. Around 3 in every 10 pregnancies end up in miscarriages and out of these 50 percent of women miscarry even before they realize that they are pregnant. One to three miscarriages do not spoil your chance of carrying your pregnancy to full term, but a large history of miscarriages may need to be referred to for future checkups.

After a miscarriage, you just need to coordinate with your doctor to learn the specific cause of miscarriage so that things can be closely monitored for future pregnancies. There could be a number of reasons for miscarriages like stress, physical violence, hormonal problems, infections, and maternal health problem. A mother’s lifestyle also may increase her risk of a first-trimester miscarriage. Second-trimester miscarriage often is caused by various problems related to uterus and cervix that may often lead to the birth of premature babies, if miscarriage does not take place. Some pregnancies which end in the first three months may happen due to some defect in the fetus.  Some of the known causes of repeat miscarriages are chromosomal problems, uterine abnormalities, hormonal causes, and immune system problems.

Miscarriage is a spontaneous abortion, which give many warning signals such as abnormal bleeding or spotting from vagina. Such symptoms need to be handled carefully. A vaginal bleeding suggests a risk to the pregnancy. It may or may not lead to a miscarriage but you must take all possible care and contact your doctor and act as per your doctor’s instructions. The more developed the pregnancy is, the more painful a miscarriage becomes. In an early miscarriage, there is little bleeding and some aching pain, which is very similar to a period where as a later miscarriage is very painful.  Such pain can be compared to a labor pain along with bleeding. In case you start bleeding, you need to contact your gynecologist immediately and get proper antenatal care. There are times when after lying down for some time the bleeding may stop and then the pregnancy will carry on as usual. But if the bleeding and the pain persist, then nothing can be done to stop the miscarriage. After the baby has been miscarried, you need to get dilatation and curettage (D & C) done to clean the womb. Under anesthesia, the cervix is widened and the lining of the womb is scraped or sucked away. Then the cervix is narrowed down again.

In a miscarriage the bleeding is usually brown or bright red in color and occurs over many days. This is accompanied by mild pain and aches. An ultrasound scan will tell you if the fetus is still alive and accordingly your doctor may ask you to take bed rest and avoid any kind of activity especially sexual activity. If at any point of time in your early pregnancy you feel that the fluid has been released from the vagina then you must contact your doctor and stay in bed till any leakage, bleeding or cramps do not totally stop. Then you can continue with your normal daily activities.

Miscarriage brings with it a sense of loss and you grieve over the baby which could have been yours. If the miscarriage is a late one, you can take a photograph of the baby or even get to hold the baby in your arms. One thing is sure that to get over it you must talk about your loss and feeling to someone very close to you and even to your partner. It maybe very normal for you to put blames on certain situations or acts but one thing must be kept in mind that miscarriages are normally due to factors beyond you or your partner’s control. A woman may take a few weeks to a month’s time to recover from a miscarriage depending upon how long she has carried the baby. A menstrual cycle also sometimes occurs four to six weeks after a miscarriage making you perfectly normal to start afresh.

Changes in body during Pregnancy

Pregnancy is one of the most beautiful times in the life of a woman and she must enjoy it to the fullest. The pregnancy timing is calculated in weeks from the day one of last menstrual cycle (LMP). Whenever your pregnancy is confirmed, your first task should be to go and meet the doctor. This visit will enlighten you about various issues and problems you may come across as the pregnancy progresses. During your first prenatal visit to your doctor, a physical examination is carried out in which your weight is recorded, blood pressure and urine is checked and the size of the abdomen is recorded.

Pregnancy period is divided into three parts or trimesters.-

First Trimester – This trimester is roughly for 3 months and starts from day 1 of your last menstrual cycle up to 12 weeks. In the “embryonic stage” from the third week onwards to the eighth week of pregnancy, the embryo develops most of its body organs and is at risk of harm from alcohol, infections and radiation. The embryo is called fetus and by the ninth week of your pregnancy, it grows up to a length of 1 inch. The uterus during this time also grows to about the size a grapefruit from that of a fist.

Other changes that you come across during the first trimester are –

  • Constipation
  • Vaginal discharge – thin milk white discharge throughout the pregnancy.
  • Mood swings – due to hormonal changes
  • Vaginal infections
  • Increased urination
  • Tenderness of breast
  • Nausea

During the first trimester, you have to get an ultrasound of the fetal growth and placenta done. If there are some genetic problems then a genetic testing of placenta (chorioin villus sampling) is done. An HIV (Human Immunodeficiency Virus) infection test in the first trimester will check the passing on of the infection to the new born baby.

Second Trimester – During this time, which starts from week 13 and lasts up to week 27 of your pregnancy, you start looking pregnant and go in for maternity clothes or dresses. The upper part of the uterus ‘fundus’ goes halfway up to the pubic bone and the naval. Then as the pregnancy progresses the ‘fundus’ goes further up, upto 2 inches above naval. This happens by the 27th week. The discomforts of the first timester like nausea, tenderness and fatigue die out and at this time the physical discomforts related to third trimester have still not developed, so you are quite at ease.

Now, the fetus is about 10 inch long and 1.5 lb in weight. From week 18 to week 22, you may feel the movements of the fetus. The starting movements of the fetus are so gentle and soft that at times you may not even be sure of them happening.

The normal changes related to second trimester are –

  • stretch marks
  • heartburn
  • breast changes
  • leg cramps and back ache
  • hemorrhoids and constipation

In the second trimester one needs to get electronic fetal hearing monitoring, fetal ultrasound and glucose tolerance test done to keep a check on the growth of the fetus and health of the mother to be. If there is any genetic disorder problem, then a test of the fluid around the baby called the amniocentesis is done. Certain other tests called triple or quadruple screen, which test levels of Alpha-fetoprotein, estrogen, and human chorionic gonadotropin are also done at this stage.

Third Trimester – From week 28 till the birth of the baby is the period of third trimester. A pregnancy becomes full term between the 38th week to 42nd week and you can deliver anytime but ideal time for delivery is the 40th week. In the final stages, the fetus grows in size and the body organs also grow and there is a lot of movement especially between weeks 27 to week 32. Then the fetus becomes too big to move inside the uterus and by the end of the third trimester, its head is settled in the uterus, causing a great discomfort to you.

Third trimester brings these changes in your body and health –

  • Fatigue
  • A strong pain and ache in the back, hip and pelvic bones. Heartburn
  • Breathing problems
  • Swelled ankles and feet.
  • Frequent urination
  • Insomnia and difficulty in finding a convenient posture to sleep.

A fetal ultrasound is done in third trimester along with hepatitis B and group B strep screening test. By the end of the third trimester you are full term pregnant and will feel that labor is not too far when –

  • The fetal head goes and sets down in the pelvis.
  • Contractions become quite frequent and painful, accompanied by cramps in the groin and low back ache.
  • The water bag may break and the membrane is ruptured. This can happen even before the labor has started and you need to consult your doctor.
  • The cervix begins to dilate and thin.

Morning Sickness in Pregnancy

Morning sickness, also referred to as “nausea or vomiting of pregnancy”, is one of the most commonly occurring complaints in pregnant women. It is most dominant in the first three months (referred to as first trimester) of the pregnancy when the body is adjusting to all the changes caused by increase in the hormones necessary to maintain pregnancy. Morning sickness does not mean that there is something wrong with the pregnancy. It is a result of the body adjusting to the hormonal changes.

Morning sickness can occur at any time of the day or night though its name suggests only morning hours. Actually it is most prevalent in morning hours in most women and is said to have an effect on about 50 to 85 percent of all pregnant women. In around half of the pregnant women, the sufferings end by the 16th week of pregnancy. The most positive part of morning sickness is that most of the women who suffer from morning sickness do not have miscarriages.

Morning sickness brings nausea, which is the most taxing problem of early pregnancy. This happens because it makes you physically and emotionally tired. This is a time when most people around you do not realize that you are pregnant and expect you to behave normally and actively. But actually this is the time when most care and rest needs to be taken. Morning sickness occurs due to an increase in the progesterone hormone which relaxes the muscles in the uterus. This hormone also relaxes the stomach and intestines thus causing an overflow of stomach acids, bringing nausea. Again pregnancy brings with it an extra sensitivity to odors, which bring morning sickness or nausea.

A few given below tips can be followed by most pregnant women to get some relief from morning sickness:

  • Small regular meals should be taken instead of one large meal because large meals unsettle the stomach and cause nausea. In any case don’t stop eating.
  • To avoid feeling of nausea during pregnancy some snacks should be kept handy. This can be taken as and when required.
  • Drink plenty of fluids.
  • Take care to drink slowly. Instead of taking large glasses of drink at one go, it should be sipped slowly. Water in any case is very important to replace any liquids lost through vomiting.
  • Some prenatal vitamins can be taken on a doctor’s recommendation, if there is a loss of nutrients due to vomiting.
  • Good rest and sleep should be a part of your schedule as feeling tired makes you sick and nauseated.
  • If morning sickness occurs first thing in the morning, you should first eat something like a dry toast or biscuit in the bed only and then get up.
  • Also you should avoid thinking about nausea because it gets worse if you pay attention to it.
  • Very oily and greasy foods and cooking should be avoided because this makes nausea worse. Also avoid eating food items that don’t smell good to you, even if you loved them before getting pregnant.
  • At times remedies containing ginger also help to overcome nausea.

If morning sickness persists and troubles you all the times, it is advisable to consult a doctor or a midwife. If the nausea and vomiting are very intense and acute, then some “anti emetic” or anti sickness tablets or injections need to be taken