5 min readJan 22, 2026 07:58 PM IST
First published on: Jan 22, 2026 at 07:39 AM IST
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.
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.
What does pre-pregnancy counselling involve?
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.
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.
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. 
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