Local OBGYN weighs in on later-in-life pregnancy

Women who want to become mothers at an older age face obstacles such as declining fertility, which impedes their ability to get pregnant, and the increased chances of having a child with Down syndrome or other birth defects.

But medical advances — including assistive reproductive treatment like in vitro fertilization (IVF) and other options — are making later first-time motherhood more common.

“After 40, fertility drops so far off,” said Dr. Brian Wildey, obstetrician-gynecologist at Altru Health System in Grand Forks.

Some women delay motherhood in order to pursue educational or career goals.

Others who struggle for years to get pregnant eventually reach the point financially where they can afford IVF treatment, he said.

Advances in medical technology have also alleviated worries about Down syndrome. “Even though there’s no way to fix Down syndrome, we have more ways to detect it,” he said.

Sophisticated blood tests and specialized ultrasound procedures in the first and second trimesters can provide valuable information for a Down syndrome diagnosis.

If a mother is especially worried about Down syndrome, a test called a chorionic villus sampling, or CVS, can be done during the first trimester, he said.

“Obstetrically speaking, we have a lot to offer those ladies.”

Pregnant women older than 35 are still considered to be “high risk” by the American College of Obstetrics and Gynecology, he said.

Women in their 40s also are more likely to have diseases or chronic conditions — such as high blood pressure or diabetes — that can complicate pregnancy, Wildey said. “High blood pressure is more common in a 40-year-old than a 19-year-old.”

These conditions need not rule out pregnancy, but they can make the process of having a baby more complex. He recommends women 40 and older who are considering pregnancy get a “well woman” check-up, including testing for blood pressure and diabetes, and a baseline mammogram to check for breast cancer.

“There are very few instances in which I would say ‘you should not get pregnant,’” Wildey said. “It’s very much a personal choice. We want to encourage women to have that choice — no matter where they are in the life cycle. We’re there to support them.”

Call Knudson at (701) 780-1107; (800) 477-6572, ext. 1107; or send e-mail to pknudson@gfherald.com.

Tags: gf and egf, accent, health, pregnancy, obstetrics, family, updates, lifestyles