Saturday, Nov 26, 2022

Planning Parenthood: What Is The Right Time?

Doctors are of the opinion that having children at a late age owing to different reasons has more disadvantages. For perfect healthy children, it is best to conceive before the age of thirty.

A healthy pregnancy

Doctors are of the opinion that having children at a late age owing to different reasons has more disadvantages. For perfect healthy children, it is best to conceive before the age of thirty.

Better before 30!

In earlier days, pregnancy was the main reason for women under the age of 25 to see a doctor. But now women above 45 years of age are also among those who consult doctors for the same reason. This is because of women postponing pregnancy due to health reasons or personal reasons. However, delaying pregnancy deliberately for a career or inviting circumstances of late pregnancy can have adverse effects on both mother and child.

Circumstances that compel postponement

Rushing through life, competitive spirit in education, and profession are contributing to the psychological stress in women.  With sedentary jobs and long working hours, women are deprived of exercise. As a result of these, health problems that hinder fertility begin. Added to this, there are other health problems that hinder pregnancy, so by the time these problems get corrected, the age advances further.

  • Thyroid: Nowadays, we get to see a lot of people getting diagnosed with thyroid issues, both Hypo and hyper thyroid which to some extent may be related to stress. Both of these problems can hinder pregnancy
  • Obesity: Women are becoming obese at a young age due to lack of exercise, stress, life style changes.  Being overweight can lead to other health problems like blood pressure, diabetes, cardiac problems, poly cystic ovarian disease, infertility etc.
  • Diabetes: The number of women developing diabetes in their teenage years is increasing day by day. Even for this, the reason is diet and lifestyle errors
  • Abortions:/ Miscarriages:  Recurrent pregnancy loss can be attributed to chromosomal problems, thrombophilias or some connective tissue disorders requiring further evaluation and treatment. Child bearing age gets exceeded with this series of miscarriages.
  • Food: Lack of time to cook, easy availability of junk and processed food leads to loss of control over eating healthy food. Unhealthy diet leads to excessive weight gain, thereby hormonal changes adding to infertility issues.

Which age is the best?

Ideally 20 – 22 years of age is the best time to plan pregnancy. At this age women have quality eggs, hence chances of pregnancy are also high for women of this age. But nowadays there are very few girls who are ready for marriage at this age.

Girls who want to take some more time for higher studies and career should plan to give birth to their first child at least before the age of 25 to 30 or atleast by 32 years. The chances of pregnancy in women of this age are about 25 percent every month. Better spacing between births can also be ensured. However, if one crosses even this age and reaches the age of 35, the quality of eggs starts to decrease. With this, the chances of pregnancy too start to reduce and the problems of infertility starts to rise. By the time they seek medical help and treatment begins the age increases further. So it is better to plan pregnancy at least before they reach 30 -32 years of age.

Even after marriage….

Some women postpone pregnancy for three to four years post marriage for varied reasons such as financial issues, career based plans or other reasons. Once they start to plan pregnancy they face tremendous stress and get into depression with every passing menstrual period if they do not conceive at the earliest.  In addition to this, the enquiries of close friends and relatives regarding children adds further stress in women. This stress itself can play a hindrance in conception.

Once a couple seeks medical help there are numerous conditions that have to be evaluated to know the cause of Infertility. Pregnancy does not bear fruit, even when both husband and wife are in perfect health. While 40 percent of women’s inability to conceive lies in their respective husbands, 40 percent lies in women, and the remaining 10 to 20 percent is unexplained reasons. Stress plays a major role in 10 to 20 percent of causes.

Planning pregnancy this way

Women can improve their chances of getting pregnant and having a healthy pregnancy by following ways:

  • Folic Acid: This is a nutrient that supports the development of the baby’s nervous system. It reduces the chances of a baby being born with neural tube defects such as spina bifida.  Neural tube defect is when the baby’s spinal cord does not form normally.  So it is necessary to take folic acid 2-3months prior to planning pregnancy.
  • Medical problems like anemia, thyroid disorders, Hypertension, diabetes should be addressed prior. Tests should be done to ensure that there are rectified prior conception so that woman starts her pregnancy in the best of her health. Women with above problems can give birth to babies with low birth weight, risk of prematurity and other congenital problems.
  • Overweight: If overweight, women may have problems getting pregnant and fertility treatments are less likely to work. Having a healthy diet and doing moderate exercise are advised in pregnancy.
  • Diet:  Refrain from junk food . Eating a variety of healthy food is important for good health. Improve on the protein intake, cut down on oily, processed and fried food. Green vegetables, sprouts, nuts, milk and milk products to be included in the diet.  Citrus and other colored fruits and vegetables for improvement of hemoglobin should be included in the diet plan.  Sweets, Caffeine, and carbonated drinks should be considerably cut down.
  • Exercise: No matter how busy you are in your career, you should devote 30-40minutes per day to exercise , at least five days a week. Even if you achieve physical fitness this way, your chances of conceiving will increase.
  • Supplements: If there are any nutritional deficiencies, they should be replaced with supplements such as Vit B1, B6 B12, Vitamin D, zinc and other minerals.

If you are 30 and above there may be one or other risk:

  • Abortions/Miscarriage: Women over 35 to 40 years of age are more likely to have miscarriages due to poor quality of eggs.
  • Chromosomal problems: Babies born to older mothers have a higher risk of certain chromosomal conditions, such as Downs syndrome.
  •  Gestational Diabetes: Women with gestational diabetes must maintain a tight control of blood sugar through diet and physical activity. Left untreated , can cause a baby to grow larger than average which in turn increases the risk of injuries during delivery.
  • High blood pressure: Advancing age can lead to development of blood pressure in pregnancy which may lead to complications of eclampsia (seizure disorder) and premature delivery if blood pressure cannot be controlled with medications.
  • Premature: For women who conceive at an advanced age, chances of having premature babies and babies with low birth weight are higher
  • Cesarean:  After the age of 35 or above, there’s a higher risk of pregnancy related complications that might lead to cesarean.

Problems in children

Bearing children at an advanced age increases the chances of mother getting easily exhausted and unable to take care of the infants. With this, problems like anxiety disorders, autism, and attention deficit disorder crop up in children. Also, with inability to devote enough time to the child,  the mother and child bonding also does not get strengthened.

I.V.F. problems

More people resort to IVF for late pregnancy. But it cannot be said that IVF will be successful in all cases. Even if the IVF procedure is successful, there are chances of miscarriages, ectopic pregnancy, multile pregnancy in which the risk of prematurity is high as compared to single pregnancy. In some cases, the amniotic sac ruptures prior leading to preterm delivery where the babies have to be nursed in the NICU for a long duration. Premature babies have a risk of respiratory issues, infections, weight related issues, feeding problems which need to be carefully addressed. Growth may not be at par with normal children. Children are prone to child obesity.

Preconceptional counseling

Preconceptional counseling  can improve women’s health and pregnancy outcome.  As part of this counseling, risk assessment of any complications of pregnancy are made, family history is taken. Evaluation is done in case of any poor obstetric outcome. Prenatal vitamins are started. Medication is advised after diagnosis of any medical disorders so that a woman enters pregnancy in the best of her health.

Egg banking

The process of freezing one or more unfertilized eggs to save them for future use. These eggs are thawed and fertilized in the lab to make embryos that can be placed in the woman’s uterus for future use.

It is a type of fertility preservation technique. It is mainly useful for women with cancer who want to have children after having undergone surgery, radiation therapy, chemotherapy for treatment of cancer which can cause infertility.

Nowadays, women are delaying pregnancy due to educational, career or economic considerations. So women of 25 to 35 years age are getting inclined towards egg banking or Elective Oocyte cryopreservation which greatly increases a woman’s potential to have children at later age

Dr. Pratyusha Reddy, Consultant Obstetrician and Gynecologist, Birthright by Rainbow Hospitals, Banjara Hills, Hyderabad.

Dr. Pratyusha Reddy,

Consultant Obstetrician and Gynecologist,

Birthright by Rainbow Hospitals, Banjara Hills, Hyderabad.

First published on: 26-09-2022 at 03:12:14 pm
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