Pregnancy after 35…

I had the luxury of getting a lovely little stamp (well typed and printed) on all of my pregnancy records: Advanced Maternal Age. If turning 35 isn’t enough about starting to feel that uphill climb, you are now considered “at risk” just because you hit that 35 mark.

Old PregnantNow, I had other risk factors that were much more serious than just my age. I was considered obese and also have hypertension (high blood pressure). Those items, I would think, should be much more at the forefront of someone’s records than “Advanced Maternal Age”. Perfectly healthy women, with no previous issues, still get this stamp of “disapproval” from our lovely medical community.

Please do not misunderstand my words. I loved my OB/GYN. She supported me through miscarriages, first birth (with HBP) and my second birth (with the AMA). She was amazingly supportive throughout the whole thing and only once mentioned the age thing early during the pregnancy.

First, why do we get this tag anyway? This is not a science article, so do not expect a lot of references to specific studies; however, here’s what I’ve learned when trying to find out how my age could affect my pregnancy.

We get this tag because there are certain risk factors that increase as we age. This is generally true, but when pregnant, more so. Ladies, if you’ve been pregnant, you know. If you haven’t been pregnant, you understand. Pregnancy is HARD. It’s truly the most physically challenging thing I’ve ever endured in my life. (No, I haven’t climbed Mt. Everest.) Then add to that our naturally aging bodies. It’s a lot for our system to handle. Sometimes, it’s too much.

Some of the most common complications with AMA pregnancies are (you may have guessed from the above):

  • High Blood Pressure. This can be a result of preeclamsia – a form of high blood pressure only found during pregnancy.
  • Gestational Diabetes. I had this with my second (after I turned 35).
  • Genetic abnormalities. This can include Trisomy 21 (Down Syndrome).

There are other factors, but when my OB talked to me about it, these were the three big ones she brought up – maybe because they were the ones to most likely affect me, but ultimately they did in one pregnancy or another. Due to my other conditions (HBP and Gestational Diabetes), I also saw a perinatal doctor. These are the docs who deal with the realities of high risk pregnancies on a daily basis. Either the baby has high risk factors or the mother, as in my case. When I worked with my perinatal doc, he explained more to me about the AMA risk factors. However, his big three were the above mentioned.

Because of my early miscarriage, we did the early genetic screening on all my pregnancies (including the miscarriage – before knowing). My first screening came back that the baby had Down Syndrome. We found this out the day we also found out she passed. (A whole other blog on that…) It was most likely the heart not developing properly, which is common with babies who have Down Syndrome. However, with that we knew every time after that we would be getting the genetic testing.

This is something that is recommended for women over the age of 35. I highly recommend it for everyone woman! There are many reasons, but for me the research in early genetic testing is critical. It can help doctors determine possible reasons for miscarriages (much like my first) that they may otherwise not know. This testing is not free, but it is affordable. The testing is also very general. It is not like a micro array test where they look through each gene. This is just a general overview making sure there’s no missing or too many genes. They can also let you know the sex of the baby (if you wish to know early).  Best part, they only take blood from the mother! No invasive needle poking in to the womb.

Having HBP and Gestational Diabetes with my second pregnancy forced me to eat very specific foods and be aware what I was eating and when. I learned that pregnant women release a hormone that is part of the cause for the Gestational Diabetes (it inhibits insulin production, increasing glucose levels in the body). This hormone is released in a way that your body has had the hardest time to lower your insulin levels while you’re sleeping. This is part of the reason they give you those icky sugar drinks in the morning. Bleh!

While the process of pricking myself four times a day and taking my blood pressure twice a day was not what I would call fun, I did enjoy the science of it. I enjoyed seeing my numbers come through and thinking about what it was that I ate to cause that number. I enjoyed recording the data and then discussing it in my meetings with the docs. I really learned a lot when I asked questions related to my specific eating habits and how they affected my pregnant body.

I have had HBP since my mid 20’s.

Swollen Pregnancy Feet

A side effect of HBP & Pregnancy – Swollen Feet. Only flip-flops fit them.

So I knew going in with all my pregnancies I would be “at risk” from the start. This, for me, meant more, like a lot more, doctor’s visits. In the end, I went to the doctor’s office twice a week for the last 6 weeks of my pregnancies. And I visited the perinatal doc every two weeks. This is tough to do when you’re working on top of that! You also get more ultrasounds – this is a nice thought. Where Gestational Diabetes can cause the baby to get extremely large in the womb, the opposite happens with HBP. The babies are undersized and underweight. This is why I got more ultrasounds. They wanted to track baby’s progress to make sure she (and then he) were developing within the norm.

My first baby, no problem. She was developing perfectly. I also did a lot during pregnancy on my own to eat right and exercise when I could. I didn’t gain weight until the very end and only gained 15 lbs total. I brag, because that didn’t happen with my second!

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36 Weeks Pregnant with #2

With my second, he was a monster baby. I gained almost 30 lbs total and that was still with me eating well. The scans always said his stomach size was over the 99% percentile… how can one be OVER the 99% percentile? His head size was also quite large. Don’t worry though, it ended up that he was just super crammed in my little belly. He came out 8 lbs 7 oz and 21.5″ long. So sometimes those ultrasounds are not as accurate as we’d like to think. Just know they’re a gauge, not a deciding piece of data.

So, why do I discuss all these things? Mainly to say that pregnancy, no matter what age, is a risk. It is putting a woman’s body through extreme circumstances. As we naturally age, our body doesn’t rebound and recover the way it once did. This means we naturally take on more risks. So add to that a pregnancy, one of the most extreme things a human body can do – MAKE ANOTHER HUMAN – and it’s understandable why this stamp goes on all of those medical forms. I was the walking, breathing, living embodiment of 3 of those risk factors. Some were not the direct cause of my age, but they certainly never got better either.

So, although the thought of seeing that on a form can sting, know that it’s for the best. It means your doctors want to take special care of you and your little human(s). They want you to get the absolute best care you can receive and want to make sure that the life growing inside you is healthy and safe.

It also means you need to be ready. You need to be aware that you may inherit these risk factors, for a time, so you can bring a life into this world. Do what you can ahead of time: get regular check-ups, manage your diet and exercise when possible. And do what you can early on: don’t eat for two, do continue to work-out lightly and see your doctor regularly. This can help make those risks minor. And if you do happen to get the AMA-related diagnosis, you can always make the best of it by learning how you can be the healthiest person for your baby.