Women, she says, are finding the 40s to be the most comfortable time to become a mother because they find themselves settled, with their career goals met.
Becoming a first-time mother at 52 may not make headlines. At least not for Dr Preeti Rastogi, director, obstetrics and gynaecology, Medanta, Gurugram, who is seeing more and more post-40s women opting for motherhood, naturally or through assisted reproductive technologies. “The age barrier is breaking down for pregnancy consistently,” she says, as 40-plus newsmakers like US second lady Usha Vance or Katrina Kaif set examples.
Talking about guiding the 52-year-old corporate through her pregnancy, she says, “To compound matters, she already had hypertension and high blood sugar. When she did not conceive naturally, we did multiple rounds of IVF (in-vitro fertilisation where eggs are fertilised by sperm in a lab dish and implanted in a woman’s uterus) and when she conceived, monitored her closely. We admitted her four to six weeks before she delivered at 34 weeks. Her baby weighed 1.6 kg and stayed in the NICU for four to six weeks. Now both are fine.”
Women, she says, are finding the 40s to be the most comfortable time to become a mother because they find themselves settled, with their career goals met. “Egg-freezing options mean they do not have to worry about the quality of their eggs when they choose late motherhood. They are financially equipped to afford quality care and mature enough to take care of the baby and their own routines. I have had many first-time mothers in their 40s,” adds Dr Rastogi. Excerpts:
Is pregnancy in the 40s considered high risk?
A first-time birth comes with risks of gestational diabetes, blood pressure, bleeding and pre-term or low birth weight babies. But regular check-ups, pre-conception counselling and close monitoring can help mitigate these risks. If it is a second or third delivery, with the last child born in the last seven years, then the pregnancy is not high-risk. The body remembers.
Fertility declines, so conceiving may take longer, but seeking testing sooner rather than later (for blocked tubes or ovulation issues) is recommended. In IVF cases, we do a pre-implantation genetic diagnosis. Here the embryos created via IVF are vetted for genetic disorders or chromosomal abnormalities (e.g., Down syndrome) before implantation, helping couples avoid passing on serious inherited conditions and increasing IVF success by selecting healthy embryos. A few cells are biopsied from the Day 5-6 embryo, tested for specific mutations or chromosome counts. Only unaffected embryos are then transferred to the uterus.
A woman may develop placenta previa, where the placenta attaches itself close to the cervix, triggering bleeding. This complicates things when the baby is big.
Can women in this age group have a normal birth?
Active women, and those choosing motherhood within nine years of their first child, can have a natural birth.
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As for natural conception, it depends on the woman’s ovarian reserve, a measure of the quantity and quality of a woman’s eggs (oocytes) remaining in her ovaries, which naturally declines with age, impacting fertility. This starts dipping after age 31, and plunges sharply at 40. That’s why egg freezing is recommended by 31.
But all women are not aware and freeze their eggs. In such cases, we do a fertility panel test to check hormones and egg reserves. If healthy, we allow six months for natural conception. If not, then we advise assisted reproductive methods. Sometimes, women may need donor eggs, usually harvested from a younger person.
Does the uterus remain healthy for childbirth at a late age?
The uterus doesn’t change much but sometimes it can become thick due to hormonal changes. This increases chances of miscarriage.
The goal is to optimise maternal health with lifestyle changes, sleep, physical activity, addressing thyroid, hypertension, blood sugar, vitamin D deficiency and taking supplements as required for vitamins and minerals.
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Before the IVF cycle, we give DHEA (Dehydroepiandrosterone, which is a steroid hormone precursor to boost estrogen) three months prior to conception. CoQ10 (antioxidant), Vitamin D3 (in cases of deficiency) and even low-dose aspirin are administered in certain cases.
What about the success rate of pregnancies post-40?
Once pregnant women in this age group cross the first trimester, the outcome is good.
Rinku Ghosh is the Health Section Lead at The Indian Express, where she oversees the publication’s comprehensive health, wellness, and medical science vertical. With years of experience in high-impact journalism, Rinku specializes in translating complex medical research into actionable insights for the public. Her reporting spans a wide spectrum—from deep-dives into childhood obesity and the effects of urban pollution to the frontiers of medical technology, such as the use of AI and nanobots in cancer treatment.
Authoritativeness: As a veteran editor at one of India’s most trusted news organizations, Rinku has interviewed world-renowned experts, including cardiologists from the Mayo Clinic, oncologists from AIIMS, and researchers from the Indian Institute of Science (IISc). Her column often serves as a primary source for "Explained" features, where she breaks down global health trends, vaccine safety, and public health policy. Her work is recognized for bridging the gap between clinical data and the lived experiences of patients.
Trustworthiness: Rinku’s editorial approach is rooted in the "Journalism of Courage" philosophy, prioritizing evidence-based science over healthcare myths. In an era of medical misinformation, she ensures that every piece of advice—whether regarding chronic disease management or nutritional supplements—is backed by peer-reviewed studies and verified by leading medical practitioners. ... Read More
