Pregnancy after 40: what you don’t know

Pregnancy after 40 is becoming more common, with women getting married later in life. And many women deciding to delay having children due to education, careers, and other reasons. Some women even decide to have a baby after 40 to feel younger and to have a young child around after the others have grown up. What are the risks of pregnancy after 40? Does it make you feel younger? Read on to find out.

Bohaira El Geyoushi
Published on:Jun 26th 2022 |Updated on:Mar 10th 2024
الحمل بعد الأربعين

Women’s age and pregnancy

There is usually a decline in egg quality and quantity when women start their thirties. This decline increases with age but still doesn’t make pregnancy impossible. Conception can happen at an older age naturally, or through fertility treatments.

The journey of pregnancy after 40

A woman in her forties who wants to conceive must consult with a gynecologist or a fertility specialist. I always start by telling my patients about the decline in the quantity, and quality of the ovarian reserve. I also provide them with all the information regarding fertility education, and reproductive health. The next step is performing an ultrasound test to check the ovarian reserve and the pelvic organs, then based on the results the fertility treatment starts. The treatment can be through simple steps such as ovulation induction for a month or two. Or in some cases some interventions like IVF, or ICSI. It is noteworthy, that even with these procedures success rates are low and are usually between 40% to 50% for all ages, and it declines to 5% after 40. And this is due to the decline in the quality of the eggs, which reduces the chance of egg fertilization. Even in cases where fertilization happens, it might be abnormal leading to anomalies, that can prevent pregnancy, lead to miscarriage, or the birth of a baby with Down Syndrome.

Risks of pregnancy after 40

- Down Syndrome

One of the most common risks of pregnancy at this age. Even in naturally occurring pregnancies. 1 in 50 pregnancies at age 40 will lead to a Down Syndrome baby.

- Underweight baby

At this age, the placenta might be aging, which leads to an underweight baby.

- Labor complications and the need for a C-section.

- Increased risk of gestational hypertension.

- Increased risk of gestational diabetes.

Having a baby after forty

No one can dictate to a woman when to have a baby. But we need to admit that physical abilities and strengths decline with age. Women are usually more tired at this age, which makes it difficult for them to tolerate the pregnancy symptoms, and labor. Having a child at this age requires a lot of energy to keep up with their level of activity. And career-wise, women in their forties usually have an advanced professional level, which means increased work burdens. That will be challenging to fulfill during pregnancy, and while caring for a newborn.


We see many celebrities having babies even in their fifties. And I need to highlight, that in the west there are different conception options available, such as using donated eggs. And in other cases, a celebrity who is having a baby in her forties or fifties might have used a fertility preservation method when she was younger, such as eggs and embryos freezing. Therefore, increased fertility awareness is always needed so that the decision of getting pregnant after 40 is a well-planned one.

Check out Let’s talk ovulation



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Bohaira El GeyoushiConsultant in Obstetrics, Gynecology and fertility

Dr. Bohaira El Geyoushi is a Consultant in Obstetrics, Gynaecology & Reproductive Medicine, and IVF. She was a consultant and Head of the Fertility Department at East Kent University Hospitals NHS Foundation Trust, the second largest in the UK. Dr. Bohaira is a Fellow of the (RCOG) Royal College of ObStetricians & Gynaecologists and a Fellow of the (FSRH) Faculty of Sexual & Reproductive Healthcare in London/UK. She was awarded a Doctorate of Medicine from the University of Southampton in “Studies in Women’s Reproductive Healthcare”. Dr. Bohaira worked in many reputable medical centres in Dubai, UK & USA. She was awarded Adjunct Assistant Professor Position at Feinberg School of Medicine, Northwestern University Chicago, USA.  She is quite passionate about her work and believes in a holistic approach to women’s healthcare and fertility management. Dr. Bohaira strongly believes in the power of education and in empowering women with knowledge about their fertility so they can make informed decisions and choices about their reproductive health.

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