Being pregnant after 40

Most people who become pregnant after 40 years have healthy pregnancies and healthy babies. Taking care of yourself is one of the best ways to support your baby’s health.

During pregnancy, it’s a good idea to:

• eat a healthy diet
• aim for healthy weight gain
• stay active in ways that feel comfortable
• avoid alcohol and illicit drugs (Opens in new tab)
• quit smoking or vaping (Opens in new tab) (if you smoke or vape)
• avoid passive smoking (Opens in new tab) and vaping when possible
• get regular antenatal care

Trying to get pregnant can sometimes feel emotionally challenging, especially if it takes longer than expected. You may also wish to access emotional support, counselling, peer support, or discuss different models of maternity care that suit your needs and preferences.

If you need to talk to someone about your mental health, call Beyond Blue on 1300 22 4636.

Good antenatal care is important for both you and your baby. Antenatal care is the care you get while you’re pregnant. It’s an important way to keep yourself and your baby healthy.

Getting early and regular antenatal care can help you feel informed and supported.

Different types of tests can be used to check your health and your baby’s health. Your care may include:

• blood tests
• urine tests
• ultrasound scans including transvaginal ultrasound
• conversations about your physical and emotional wellbeing

Vaccinations

Your care provider may discuss:

• influenza (flu) vaccine (Opens in new tab) — at any time during your pregnancy
• pertussis (whooping cough) (Opens in new tab) vaccine — preferably between 20 and 32 weeks of pregnancy
• rubella immunity testing, with a vaccination against rubella offered once you have had your baby, if needed

These are options you can discuss with your care team to make a shared decision.

You have options for who supports you during pregnancy and birth. Some people prefer models that offer continuity of care, where you see the same midwife or small team throughout pregnancy.

Some common models of care include the following:

• Public hospital maternity care – care is usually given by midwives and doctors, and most pregnancy care happens at hospital outpatient clinics.
• Shared care – antenatal care is given both in the community by your GP or midwife and the hospital’s maternity team under an agreed plan.
• Midwifery group practice – you receive all your care from a midwife, supported by a small team of backup midwives who step in if needed.
• Private obstetrician (specialist) care – antenatal care is given by a private specialist obstetrician, while birth and postnatal care are usually provided in the hospital by the obstetrician alongside hospital midwives.

You might consider asking:

• What are my birth setting options?
• Where can I give birth?
• Who will I see during pregnancy and birth?
• How are decisions made if my situation changes?

Choosing a care team that aligns with your preferences can support a more positive experience.

Some conditions become more common as you get older. These are possibilities rather than certainties, and your care team can help monitor and support you.

If you are pregnant and over 40 years, you may be more likely to experience:

• high blood pressure
• deep vein thrombosis (DVT) (Opens in new tab)
• heartburn

There are some other complications that increase in older pregnant people. These include:

• ectopic pregnancy or miscarriage
• premature labour
• gestational diabetes
• pre-eclampsia
• placenta problems
• an increased chance of needing a caesarean section

You have a higher chance of having twins or triplets if you become pregnant after age 40.

Some care providers may suggest planning birth around 40 weeks, as the chance of stillbirth increases slightly after this time. This may involve inducing labour. You can discuss this with your healthcare provider and consider your options based on your individual situation and preferences.

Possible complications for your baby

Pregnancy later in life can also increase the chance of some complications for your

baby. These include:

• having a small baby
• needing care in a neonatal intensive care unit (NICU)
• having low Apgar scores
• some genetic conditions (Opens in new tab)

Prenatal screening tests look at the chance of your baby having one of these conditions:

• Down syndrome (trisomy 21)
• Edwards syndrome (trisomy 18) (Opens in new tab)
• Patau syndrome (trisomy 13)

Antenatal tests may include screening tests and diagnostic tests. They are offered to all pregnant people. You can choose what feels right for you.

Screening tests can show who is more likely to have a baby with a genetic condition.

A diagnostic test can confirm if your baby has a condition.

If a screening test shows a higher chance of your baby having a chromosomal condition, you can choose to have further diagnostic testing such as:

• chorionic villus sampling
• amniocentesis

You may also choose to have genetic counselling and speak with a genetic counsellor to explore what results might mean for you and your family. Genetic counselling can be helpful at any stage:

• before screening
• after you get your results
• when considering further testing.

Read more on prenatal screening (genetic screening in pregnancy).

Sexual and Reproductive Health Australia (Opens in new tab) has information on reproductive and sexual health in your state or territory.

Family Planning Australia has a fact sheet on maximising natural fertility (Opens in new tab).

Your Fertility provides information on fertility and ovulation and has an ovulation calculator (Opens in new tab) to work out your fertile window.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists has a planning for pregnancy fact sheet (Opens in new tab).

IVF Australia (Opens in new tab) has information about planning for pregnancy, fertility and how to get pregnant, including an ovulation calculator tool (Opens in new tab).

Maternity Choices Australia (Opens in new tab) is a national organisation that advocates for best practice, person-centred maternity care through information sharing, advocacy and support.

Languages other than English

Parent Line (Opens in new tab) is a free telephone counselling and support service for parents and carers. It offers parenting support for families from culturally and linguistically diverse backgrounds.

The Multicultural Centre for Women’s Health offers a library of pregnancy, birth and postpartum resources (Opens in new tab) in many languages.

Monash Health has health information translated into many languages, including pregnancy care topics (Opens in new tab).

Information for Aboriginal and/or Torres Strait Islander peoples

The Baby Coming You Ready (Opens in new tab) website has information about pregnancy for Aboriginal and Torres Strait Islander people.

Birthing on Country (Opens in new tab) supports culturally safe, community-led maternity care for First Nations families.

Find an Aboriginal Community Controlled Health Organisation (Opens in new tab) (ACCHO) near you.

The National Centre for Indigenous Genomics (NCIG) (Opens in new tab) can help you find genetic services across Australia.

SMS4DeadlyDads (Opens in new tab) is a free service for Aboriginal and/or Torres Strait Islander Dads.

If you, or someone you know, are feeling worried or no good, you can connect with 13YARN (Opens in new tab) on 13 92 76, 24 hours, 7 days a week and talk with an Aboriginal or Torres Strait Islander Crisis Supporter.

Ngangkita Ngartu (Opens in new tab) is an Aboriginal Family Birthing Program at the Women’s and Children’s Hospital in South Australia.

Moort Boodjari Mia (Family Pregnancy House) (Opens in new tab) is a service in Western Australia for Aboriginal and Torres Strait Islander people who are pregnant or non-Aboriginal people who are pregnant with an Aboriginal or Torres Strait Islander baby. Contact them on 08 9462 5092.

Information for sexually and gender-diverse families

Sexual and Reproductive Health Australia (Opens in new tab) has information on reproductive and sexual health in your state or territory, including advice for LGBTIQA+ inclusive services and gender affirming care.

IVF Australia has information about fertility, planning for pregnancy, and options for same-sex couples (Opens in new tab).