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Today, the first pregnancy at 30 and after is no longer the same a rare event. Despite all possible public opinion (as a rule, people of Soviet hardening and some young mothers), the age difference with the unborn child, many women choose to give birth to their first child at this age. The reasons for such a conscious decision are quite understandable: by the age of 30, a woman is formed as a person, achieves certain career and personal successes, meets a man with whom she would like to raise children together, has a stable material income and is ready to provide for her child.

If you are planning to become a mother at or after 30, then you definitely need to know how to properly prepare for your first pregnancy, avoid possible risks and tune in to a successful birth.

First pregnancy after 30 years: what problems can arise?

"Old-bearing" - this is the label that used to be hung on all women who gave birth after 25 years. To date, such a term does not officially exist (it is generally incorrect and disrespectful), but for some reason it continues to be used, but already for women over 30. According to the criteria World Organization health care, there is the term "age primiparous" and it refers mostly to women after 35.

Why did such a division into age categories arise? The thing is that the older a woman becomes, the more diseases and infections she manages to “accumulate”, and this, in turn, can have a direct impact on the first pregnancy after 30. It is also worth considering the general decrease in immunity and fertility and a number of others. changes in the female body that occur with age. The likelihood of complications during the first pregnancy and childbirth in women at the age of 30 is slightly higher than at the same 25. Therefore, primiparas after 30 usually belong to the group high risk.

Problems with conception

Before you start planning your first pregnancy at 30 and beyond, it's important to know a few things:

with age, the female genital organs become less active. The chance of ovulation is markedly reduced due to the fact that the supply of follicles in the ovary decreases. Be prepared for the fact that the first pregnancy at the age of 30 will not come at a wave magic wand. If in more young age planned pregnancy occurs in a maximum of 2-4 months (with normal condition health), then at the age of 30 it can take a year, or even more. Therefore, if you are planning to give birth to your first child after 30, and then want another one, then do not be surprised if it suddenly turns out that your ovarian reserve has already been exhausted;
obstacle on the way to successful conception a disease such as proliferation of cells of the inner layer of the uterine wall in the ovaries can also become fallopian tubes and so on. Unfortunately, many women of all ages suffer from endometriosis. If at the age of 20-22 the disease still does not prevent the girl from conceiving, then closer to 30 years the situation becomes more complicated;
bad ecology, unhealthy diet, bad habits, constant stress All of these have a negative impact on female body, in particular - on germ cells. As a result, both a 43-year-old woman and a young 21-year-old girl can receive a diagnosis of uterine fibroids. With such a diagnosis, it becomes much more difficult to get pregnant, and even if pregnancy occurs, there is a risk of miscarriage or the development of complications. The percentage of women with a similar diagnosis increases with age, so there may be more problems with planning a first pregnancy at 30;
in addition to fibroids and endometriosis, they can prevent conception inflammatory processes, immunity of the uterus to hormones and various chronic diseases;
about 30% of women over 35 suffer from functional infertility. This happens as a result of the natural aging of the body, the ovaries and uterus cope worse with their functions. Due to lack circulatory system scars and adhesions are formed, small arteries in the fallopian tubes change, ultimately this can lead to inflammatory diseases, which can only be cured with the help of microsurgery.

Risks to consider

The first pregnancy scares many women, and all because doctors and others do not get tired of reminding about possible risks. Unfortunately, there are indeed risks, and it is worth knowing more about them:

the likelihood of miscarriage - rejection of the fetus by the body may be due to natural age-related changes and lack of reserves for bearing the first child after 30 years, as well as aging of the eggs, which may result in genetic disorders, preventing normal development fetus. The body will “feel” that the fetus is developing incorrectly and will try to get rid of it in order to protect itself;
placental pathology - at the age of 30 there are frequent cases of chronic placental insufficiency and premature detachment, which leads to the fact that the weight of the child at birth is extremely small (also because of the likelihood premature birth). There is also a risk of intrauterine fetal hypoxia - when the child simply does not have enough oxygen in the womb;
the occurrence of pathologies in the fetus - the presence of chronic diseases and bad habits in a woman, it can adversely affect the first child during pregnancy at 30 and after. The risk of having a child with Down syndrome is small, but still present;
exacerbation of chronic diseases - by the age of 30, the “baggage” of chronic diseases can accumulate quite weighty, so you need to be prepared for the fact that each of the sores can remind of itself during the first pregnancy. Pathologies are especially dangerous of cardio-vascular system and kidneys, as well as high blood pressure;
the likelihood of diabetes - with age, the risk of “earning” diabetes only increases, which means that someone may simply not have time to become pregnant and give birth before this diagnosis is made. Pregnancy and diabetes are very difficult process, as the risk of preterm birth, diabetic fetopathy, preeclampsia and even stillbirth increases many times. In addition, a pregnant diabetic woman will not only have to follow the standard instructions of doctors, but also adhere to strict diet and inject insulin
inability to give birth on their own - about 26% of women after 30 years of age are prescribed a caesarean section, since they cannot give birth to their first child without surgery due to complications during pregnancy, deterioration in health and the likelihood of a threat to the life of the baby;
problems during childbirth - if there is no indication for a caesarean section and the woman is going to give birth naturally, there is a risk of rupture in the birth canal, the occurrence heavy bleeding, heavy and long labor. This happens due to a decrease in tissue elasticity. internal organs and decrease labor activity;
problems with breastfeeding- this may also apply to pregnant women under 30. Stress during the first pregnancy and possible complications often lead to the fact that the mother does not have milk, so it is necessary to provide the child with artificial nutrition.

There is also the possibility of having twins during pregnancy after 30 years, including the first. Many will say that this can hardly be attributed to risks, but it should be borne in mind that bearing two (or more) children at once will require more strength, not to mention the birth itself. If a woman who planned her first pregnancy at the age of 30 or after 30 is in poor health, then carrying and giving birth to twins will be very difficult for her.

Caesarean section for first pregnancy after 30

As already mentioned, after 30 years, it is far from always possible to give birth to your first child on your own. However, you need to understand that age is not at all an indication for surgery. If the pregnancy was normal, and the woman's body is in good shape, then she is quite capable of natural childbirth.

It is carried out in age-related primiparas in the following cases:

child has big size, while pelvic bones the women are too narrow for her to give birth herself;
the mother has vision, heart, or lung problems that may worsen during natural childbirth;
observed breech presentation fetus (except in some cases);
oxygen deficiency was detected;
during pregnancy, the woman suffered from pain, bleeding and other complications.

What are the advantages of "late" pregnancy?

Now let's talk about the positive aspects of the first pregnancy and the birth of a child in 30 years or after 30:

at 30 years old or a little “for” a woman’s fertility is in middle stage, that is, she has every chance of getting pregnant without unnecessary problems especially if this is your first pregnancy. The main thing is to lead healthy lifestyle life and take care of your health;
the hormonal background at this age is quite stable, as well as the psychological background. At 30, women are more relaxed about life's difficulties, already know how not to worry about trifles and consciously approach planning the first pregnancy, highlighting the health of the unborn baby;
a man by the age of 30 also becomes more prepared to become a father. As a result, the involvement of a man in the upbringing of a child. Also, a man is more responsible and attentive to a woman, understanding her condition during pregnancy and after childbirth and supporting in every possible way;
at this age, the likelihood of an accidental pregnancy is much reduced. If for some reason a woman decided to give birth to her first child at the age of 30, then pregnancy is unlikely to come as a surprise to her - such a decision is made jointly with a man. The child will be born in loving family where both parents will pay enough attention to him;
a woman is more prepared for the birth of a child from a material point of view, she knows how much money is spent on raising a child, and is ready to provide him with everything necessary;
late pregnancy is mostly planned, which means that women of this age category they are responsible for preparation, pass everything, undergo examinations, follow the advice of specialists;
many women who gave birth to their first child after 30 claim that after that they got a second wind, that they began to feel mentally younger and more cheerful. A career has been built, the financial situation is stable - just the right time to plan a pregnancy;
late pregnancy can relieve the symptoms of future menopause to some extent.

Planning your first pregnancy at 30

Planning for the first pregnancy at the age of 30 implies a long and systematic work aimed at preparing the female body for conception, bearing and giving birth to a child. Pregnancy, especially the first one and at this age, is a lot of stress, so you should approach the issue of planning as responsibly as possible and do everything possible so that the first child is born healthy.

Where to begin?

An early visit to the gynecologist and a complete medical examination- the first thing to do even before the immediate planning of pregnancy at the age of 30. Do not save on your health and the health of your unborn child. A woman after 30 is highly recommended to be examined by a geneticist, as well as her partner, in order to identify possible hereditary genetic mutations and pre-warn the birth of not healthy child. If you decide to have a first pregnancy after 30, then you may not have seriously thought about it at an earlier age and do not even suspect what genetic abnormalities may be present. Do not be afraid to take tests and pass necessary examinations- remember, you are doing all this for the benefit of your unborn child.

List of examinations

will lead common list examinations that a woman planning her first pregnancy after 30 years of age should undergo:

hepatitis C, B;
rubella antibodies;
antibodies to simple a virus types 1 and 2;
antibodies to cytomegalovirus;
antibodies to toxoplasma;
tests for genital infections;
examination (ultrasound) thyroid gland;
Ultrasound of the pelvis and abdominal cavity;
Ultrasound of the mammary glands.

Examinations should be done not only by a woman, but also by a man - go to a urologist and pass necessary tests. Testing for chlamydia, cytomegalovirus and gonorrhea is required for both partners.

We prepare the body

Do you want to be 30 years old? Then in urgently get rid of all bad habits. Moreover, this must be done at least six months before a possible conception.
Get rid of excess weight, if any. Firstly, you will already gain kilograms during pregnancy, and secondly, you yourself will be more comfortable and easier. Just no diets! Go to healthy eating, exclude food with dyes, GMOs and other harmful additives from your diet.
You need to physically prepare the body for the first pregnancy. Usually, women after 30 already have time to build a career and rarely find time to play sports. Will have to fix this. If you do not want to go to a fitness club, then work out at home. The most important thing is not to overdo it with loads. Exercise regularly, but not too vigorously. Great option- Sign up for a pool, yoga or dance class. But from strength exercises and bicycles will have to be abandoned. You must bring the body into tone and, by the time of conception, already be prepared for the fact that the next 9 months will be difficult not only emotionally, but also physically. Strengthen your abs and back.
Rest and sleep more. It is very important to normalize so that the body can get enough time to recuperate.
Visiting all specialists is also included in the work plan for preparing for the first pregnancy after 30 years. It is better to eliminate unpleasant little things before you become pregnant, because then you simply will not have time for this, and any negative situation can have a bad effect on your condition and the condition of your unborn child. Even minor caries can worsen at the most inopportune moment and bring you unnecessary problems.

Vitamins and folic acid

Vitamins to strengthen the body are prescribed by the doctor after all preliminary tests. A common practice when planning a first pregnancy at the age of 30 and not only is the appointment of folic acid (folacin). It belongs to the B vitamins and is found in vegetables and cereals.

Taking multivitamins with folic acid can occur both before conception and during pregnancy.

Folic acid when planning pregnancy

Taking folic acid when planning a first pregnancy at age 30 improves a woman's fertility (ability to get pregnant). Vitamin B9 also helps to reduce the risk of pathologies in the unborn child (brain herniation, " cleft lip"and so on), helps the synthesis of RNA and DNA. Most optimal time to start taking folic acid - 3 months before the planned conception. As for dosages, your doctor will tell you about this - it is he who determines how much you need to consume folic acid, based on the examinations carried out and your state of health. Arbitrary in this matter and randomly accept multivitamin complexes not worth it, since an overabundance of certain vitamins is unlikely to benefit your body.

folic acid during pregnancy

Folic acid is responsible for the formation of red blood cells and the formation of the neural tube in the embryo, and its intake helps prevent neural tube abnormalities. Vitamin B9 is also responsible for the formation of the placenta (its lack can lead to a risk of miscarriage), iron absorption, RNA synthesis and reduces the risk of mental retardation in a child.

Taking folic acid helps expectant mother. So, a lack of this B vitamin can lead to m, anemia, pain in the legs, and more.

Dealing with matters

If you want to go on vacation or go on a trip, buy new apartment, make repairs or deal with some other matters, it is better to do it all before conception. Then you simply may not have time for all this, since you will need to systematically go to examinations and visit a doctor who is in charge of your pregnancy, or resolving issues can lead to additional worries and frustrations, and this is completely useless to you.

It is worth taking care of the wardrobe. Keep in mind that you are not 20 years old, and flutter in high heels with huge belly Not sure it's going to happen. And why? Buy comfortable shoes, suitable clothes (as your dimensions change). Today, there are many stores for expectant mothers, you can pick up absolutely any clothes.

What to do if the first pregnancy after 30 years does not occur?

Unfortunately, it also happens that after all the tests and examinations, getting rid of sores and maximum preparation, the long-awaited first pregnancy after 30 years does not occur. However, do not despair. modern medicine can do a lot, including helping you get pregnant. Even if you have been diagnosed with infertility.

In vitro fertilization (IVF) has helped many women who have never been able to get pregnant to finally experience the joy of motherhood. Of course, this is not a guaranteed cure - in only 30% of cases, IVF gives positive results. Some couples try five or more cuts before finally hearing the good news from the doctor.

It is also worth considering that with IVF, the first pregnancy, especially after the age of 30, can cause various complications( , interrupt, and so on). It all depends on the health of the woman.

One of the main good points IVF is that the child receives additional protection from genetic abnormalities.

Unplanned event

Unplanned first pregnancy at 30 years old - such cases are rare, but they do occur. Modern society became more frank and, if you like, free. Some women choose either not to have children at all, well, feeling the need for it, or they decide to have their first child closer to 40. Someone completely neglects the methods of contraception, hoping that by 30 the probability of becoming pregnant is already reduced, and use the method day calculations. However, things often don't work out the way you originally thought.

Unfortunately, the majority of unplanned pregnancies at 30 (including the first) are completed by abortion. Some women calmly turn down the opportunity to have a baby even at that age, while many others dream of finally getting pregnant and becoming a mother.

Pregnancy after 30: the first responsibility

Motherhood is a great happiness for any woman. Especially when it comes to the first pregnancy after 30. Even if you have already prepared for the fact that your life will completely change, then no one is immune from surprises.

The first weeks of pregnancy at 30 are the most difficult. In addition to the fact that you will have to get used to your new status, all this will be accompanied by changes in your body. Be prepared for the fact that your health may worsen - toxicosis will appear, you may begin to react negatively to smells, your appetite will increase, and a drowsiness will haunt you.

As a rule, women at 30 and after continue to work, as they say, "to the last." It is very important to protect yourself from excessive physical activity from the very beginning, stop working overtime, be sure to find time for breaks and eat right.

You should also refrain from visiting places where there is a risk of catching an infection. If for some reason you do not have a rubella vaccination, then you should be as careful as possible. Rubella is extremely dangerous for pregnant women, especially in the first weeks of pregnancy, since the virus is transmitted to the fetus in almost 100% of cases and causes irreparable damage to it. Among the main consequences of rubella during pregnancy: the birth of a child with heart disease, cataracts, deafness, pneumonia, hemolytic anemia. There is also an increased risk of spontaneous abortion, stillbirth or death in the first days after birth.

remember, that vital organs your unborn child is formed just in the first weeks, so you should be as careful as possible and take responsibility for everything that happens to you during pregnancy. Keep an eye on whether the hands and ankles begin to swell, whether there is extraneous turbidity and blood in x, check the chest.

Conclusion

If you decide to have your first pregnancy at 30 or after 30, then be sure that everything will work out for you. Contact a qualified doctor who will help you with planning, be patient, follow the recommendations of a specialist, and then you will give birth to a healthy baby. In no case should age become an obstacle to fulfilling your desire to become a mother!

Deciding on a second child is not always easy, and often this question is put off for several years after the birth of the first child. Not surprisingly, most often a second pregnancy occurs after 30 years.

If you want to have two children, you will have to take a more responsible attitude to your own health, well-being and the advice of doctors. After all, the second pregnancy at a not too young age has many nuances. This question is already perceived by both parents quite objectively, most often they carefully prepare and plan for conception. There is no longer any unnecessary nervousness and anguish in anticipation of the unknown - the path will pass, it has been studied, and in general it no longer raises questions. But there are private points regarding the risks that pregnancy carries after 30 years (the second to a lesser extent than the first) are present. Which of these are myths, and what should you pay attention to?

The modern norm of reproductive age

Not so long ago, obstetricians and gynecologists were horrified at the mere thought that women can give birth not only to the second, but also to the first child, having crossed the boundaries of thirty years. But over time, Soviet stereotypes have replaced Western social currents, in which a second pregnancy at 35 is a variant of the norm, and not an extraordinary case.

If our grandmothers aspired to give birth to children in the optimal reproductive period- 18-22 years old, then mothers pushed this threshold back to 20-25 years of age. Modern women, especially those who have already given birth to their first child, are in no hurry to part with the hope of building a career, their social realization, before retiring to maternity leave. That is why the second birth at the age of 35 has become something familiar, not too out of the normal for both public opinion and medical staff.

The average age at which modern women give birth to the first child, approached the border of thirty years. Well, the second pregnancy after 35 or 38 years became inevitable if the woman wanted to fully recover after the first birth, as recommended by WHO.

However, the positives outweigh the possible and not too significant risks. Statistics prove the fact that if, from the point of view of reproductive system the optimal period for reproduction comes around 22 years, then the emotional and psychological readiness to motherhood is highest in the interval from thirty to forty years. Those women who decide to give birth to a baby after thirty note more positive attitude, calmness, confidence, both in the process of bearing, and after the birth of a child.

In the case of a fairly late conception in relation to the physiological reproductive peak at 22 years old, parents should better prepare for the upcoming conception and bearing a second baby.

Preparing for pregnancy after 30 years

According to doctors, the second pregnancy after 30 years is similar to any other, and has no pronounced differences. However, the deterioration of organs and systems of the body only increases with age. Well-thought-out preparation for pregnancy after 30 years allows you to smooth out stress for the female body and reduce the load on all life support systems.

If you are just thinking about how to prepare for pregnancy after 30, the tips will still be relevant to you. But if you are already expecting a baby, it is not too late to start the right way of life.

It is advisable to undergo a preliminary examination by a gynecologist and therapist.

If you find any problems, you need to go complete treatment without leaving them "for later". It will be difficult for the body during gestation, and you should not add an extra load to it. In addition, in case of exacerbation of chronic or newly acquired diseases after conception, you will be offered to be treated with holy water and chamomile, since practically no medicines can be used by pregnant women.

The same goes for the dentist.
It is necessary to drink a course of multivitamins and folic acid before pregnancy.
During pregnancy, multivitamins should be continued and time should be made for exercise, good rest and proper nutrition.
Also, a pregnant woman after 30 should more closely follow the recommendations of the doctor, including nutritional advice, motor activity, weight correction, hospital referrals. What could be ignored at the age of 20, after the third decade becomes a serious problem not only for the woman herself, but also for her baby.

Possible complications of pregnancy after thirty years

When a second pregnancy occurs after 30 years, doctors determine in advance an approximate front possible problems, dividing them into theoretical (common for the entire sample of pregnant women after 30-35 years) and practical (exacerbation of a woman's existing health problems and chronic diseases).

And if it is necessary to deal with practical complications in each individual case separately, then common complications pregnancies after 30 come down mainly to the problems of hormone production and tissue changes.

Often found:

Premature or, conversely, delayed pregnancy.
Gestosis (toxicosis in the second half of pregnancy, accompanied by a violation of the exchange of fluids in the body).
Quite often, amniotic fluid leaves prematurely in a pregnant woman.
There is a weak labor activity.
The risk of genetic abnormalities in the fetus of women approaching closer to the fourth ten increases slightly.
Typically elevated blood pressure.
Higher risk of developing diabetes in pregnant women.
Endometriosis and fibroids are more common, which can affect both the ability to conceive and the course of pregnancy.

Statistical data

After the age of thirty, the risk of miscarriage increases by approximately 10%. (If in girls from 20 to 29 years old it is only 7%, then from 30 to 39 years old miscarriage can be in about 18% of cases).
The probability of having a baby with Down syndrome at the age of 30 is approximately 1:900, and by the age of 35 the risk is already greater, 1:380. By the way, for young mothers this figure is 1:1300.
The risk of acquiring diabetes mellitus in pregnant women after the threshold of thirty is almost 32%.
Performing operative childbirth caesarean section is 35%.

However, in cases where a mother decides to have a second child at thirty-something, the issue of successful bearing concerns mainly individual characteristics woman and the burden of chronic diseases that she has accumulated over three decades. Otherwise, a pregnant thirty-year-old woman without special problems with health, for the most part, has the same chances of having a healthy child as at twenty years old. Her body is still quite young and has sufficient reserves for the full performance of the reproductive function.

Second pregnancy after 30: positive moments

In bearing a second child is enough mature woman There are many benefits to keep in mind. If there was good preparation for pregnancy after 30, and the woman is healthy and does not have complex chronic diseases, then, oddly enough, only pluses remain.

More often than not, a second child at this age is planned, and the entire family is eagerly awaiting a new family member.
Even if the baby is not planned, the mother treats his appearance joyfully and quite philosophically, keeping nervous system for really important issues. A child is happiness, as your first-born has already convinced you.
Both parents found a certain stability in material terms.
A woman is no longer threatened by the so-called "maternal fever", no one needs to prove her worth as the best mother. You can just enjoy happiness.
Having gained experience in the birth and upbringing of the first-born, the family can carry out "work on the mistakes" on the second offspring, avoiding unnecessary problems and unnecessary mistakes.
The field of 30 years of pregnancy brings a hormonal storm into the body, which shakes and rejuvenates the woman's body, stimulates all life support systems.

Childbirth after 30 years: does age matter?

As we can see, the second pregnancy and childbirth after 30 is practically no different from those that can be observed in an earlier age period. But there are differences in healthy woman and a woman who has certain diseases.

But even with the presence of aggravating factors at hand of good specialists, pregnancy will proceed in in perfect order. However, the risk of childbirth by caesarean section increases significantly, although it relies on objective factors.

Most often, operative obstetrics are resorted to in cases where the health of the mother or child is in danger, or doctors consider the stress during contractions to be excessive for a particular woman.

However, a second pregnancy after 30 years with a ponytail, especially if the ponytail is closer to forty, is accompanied by age deterioration elasticity of tissues, and not only the soft tissues of the perineum or vagina, but even muscle tissue uterus, which also somewhat lacks the intensity of work as muscular organ. All this can lead to an incompletely open birth canal, compression of the umbilical cord by the cervix. Even if the pregnancy went well, the final moment of childbirth can be fraught with many unpleasant surprises dangerous to the life of the newborn. That is why many doctors are inclined in the case of childbirth after thirty-odd years to a caesarean section.

But it is not so important how exactly your baby was born - much more important is the fact that the age of thirty is not a reason to refuse to expand your family. It's just worth taking the issue a little more seriously than twenty-year-old girls do.

The average age at first pregnancy in women is increasing year by year. Along with it, the number of frightening myths and conjectures surrounding childbirth in just over 30 is growing.

Is it true that after the age of 25, a girl is labeled “old-timer”, in which cases it is not worth postponing the birth of the first child, and what do the years threaten expectant mothers with?

Nevidovich Larisa Valerievna
obstetrician-gynecologist of the first category of the women's health clinic "Eva"

There is no concept of "old-timer"

According to the WHO criteria, there is no such thing as "old-timer". In general, the age of up to 44 years is considered young (WHO). There is the concept of "age primiparous" (VP). Once upon a time, girls aged 24 and older fell under it, then -28+. Now this age is after 35. However, most modern authors include primiparous older than 30 years in this group, while the terms "old" and "elderly" primiparous in modern obstetrics are considered incorrect. It is more correct to use the term "older primiparous".

Why did this concept emerge?

The older the woman, the more baggage of infections and extragenital pathology she has ( a large group of various diseases, syndromes, conditions in pregnant women, united only by the fact that they are not gynecological diseases And obstetric complications pregnancy - ed. ). Plus, we don't get younger with age. Many diseases are dormant, and during pregnancy or, in principle, at an older age, when immunity decreases, they begin to manifest themselves.

In age primiparas after 30 years, especially closer to 40, the risk of giving birth to a child with congenital pathology(heart defects, neural tube, gastrointestinal tract, musculoskeletal system). By the way, in Russia they are already doing a non-invasive prenatal NIPT test on the blood of a pregnant woman (from a vein) from 9 weeks to some chromosomal abnormalities fetus.

For these reasons, it is more difficult for obstetricians to manage such patients, because behind the record, for example, “pregnancy at 20 weeks”, three or four lines of diagnoses follow in a loop. And here age does not always play a role. There are women at the age of 40 who do not have this train, and there are young girls at the age of 22 who have this train very impressive.

- But still, there is a division by age ...

This is due to the fact that pregnant women age group older than 30 years, the number of complications during pregnancy and childbirth (obstetric and perinatal risk) significantly exceeds their number in young people.

I repeat: unfavorable factor the course of pregnancy and its outcomes for the mother and newborn (in nulliparous older than 30 years) is not the age itself, but the extragenital and genital pathology “associated” with it, the frequency of which increases with age.

Because, as a rule, by the age of 40 a woman has three or even more chronic diseases. These include: arterial hypertension, diabetes, obesity, etc. Also late reproductive age many women endure any inflammatory diseases genitals. Plus, with age, the frequency of uterine fibroids increases, which is one of the causes of miscarriage and bleeding. Therefore, in obstetrics there are concepts of "high risk", "medium risk", "low risk". When a woman is over 30 and is having her first pregnancy, she is usually at high risk for possible complications of this pregnancy, appearances are more often appointed, more often treatment in a hospital, more complications in childbirth and after them.

Three main reasons for the risk of conception after 30

1. Decreased ovarian reserve

As women age, their ovarian reserve decreases the stock of follicles in the ovary that can develop further and make it possible for the egg to ovulate - approx. ed. ). And if you wanted to have two or three children, but at the same time give birth to the first at 32-33, then perhaps this will work out with the first pregnancy, but whether you will continue to be able to get pregnant again is a question.

Unfortunately, we often see premature ovarian failure. Women come at the age of 36, take a hormone test, and it turns out that there is no ovarian reserve anymore. Those. in such a patient, menopause will begin in a year or two.

2. Endometriosis

Today there is, one might say, a mystery of the XXI century - endometriosis. This is a disease in which cells of the endometrium (the inner layer of the uterine wall) grow outside this layer: in the tubes, ovaries, muscle layer and so on. Nobody knows the reasons for this phenomenon. But endometriosis is detected in very many women.

When a girl or a woman who has painful periods comes to the reception, we are already on our guard. I will make a reservation, painful periods are not a 100% indicator of endometriosis, there may not be a disease, but it is always a bell. In this case, it is better to once again undergo an examination by a gynecologist.

And it turns out this situation: at 21-22 years old, endometriosis does not prevent a girl from becoming pregnant, but the process progresses with age, and already at 28-29 years old it can interfere with conception.

3. Fibroids

Previously, they were found in women aged 43-45. Now we find fibroids in girls at the age of 21-22. And not small fibroids. All this suggests that past infections, ecology, stress, genetics, our nutrition (preservatives, dyes, etc.), the age of high technology ( Cell phones, computers, microwave technology) - all this affects our potential, our sex cells.

It is these three reasons for risk that can already become a reason for a woman to think about pregnancy a little earlier than she probably planned.

Thyroid and menopause

Often in patients who have problems with the functioning of the thyroid gland against the background autoimmune thyroiditis (inflammation of the thyroid tissue caused by autoimmune causes - ed. ), antibodies to ovarian tissue can be produced, i.e. to ovarian tissue. Why these antibodies are produced - we do not know. Previously, it was impossible to detect this, now our laboratories perform these analyzes.

When you see cases like this, you wonder why a young woman develops antibodies that attack ovarian tissue. This leads to the fact that the ovaries do not work as we would like, and fade away.

By the way, the average age of menopause for last years increased. Previously, menopause began at 46-47 years, today this figure is 52-54 years. Unfortunately, very often women at 60 are healthier than girls at 25.

Returning to the topic of risks for pregnancy after 30, I can give the following recommendation: be guided by the age of menopause in your mother. If it is 43-44 years old, then it can be assumed that you may have such heredity, so it is also better to think about pregnancy early.

Conscious pregnancy and talented children

According to my practice, average age first pregnancy in women - 25-26 years. Second birth - 28-31. Now it is extremely rare to meet an 18-year-old girl who came to be registered.

When women come to me at the age of 39, 40 and shyly say that they have become pregnant and that they do not need this pregnancy, I do not quite understand them. If you have the health to endure and the opportunity to educate, then why not give birth to this child? What is there to be ashamed of?

If you recall the times of Shakespeare, then Juliet's mother at 28 was considered a lady of age. But everything is changing. And, despite all the aggressiveness of technology and progress, we began to live longer and better. We can get an education, solve some housing issues and plan a pregnancy. As practice shows, the older the parents, the more consciously they approach this issue.

There is an opinion that if children are from older parents, then they are more talented. I was once interested in this topic: it is assumed that this happens because adult parents pay more attention to children, they know more and emotionally and mentally can give more to their child. They do not run to school and work, throwing a child to grandmothers-mothers, but they understand that a child needs to be taken care of, that they need to be an example for their child.

How to prepare the body for pregnancy

Even before the examination, we advise future parents to take folic acid: 400 mcg per day 3-4 months before conception, because. at conception, eggs and sperm are used, which are ready for the process already in 80-90 days. During this time, you need to be screened for infections. The set to be completed is:

Hypatitis B, C
Antibodies to cytomegalovirus
Antibodies to the virus herpes simplex 1st and 2nd types
Antibodies to toxoplasma
Rubella antibodies
Tests for genital infections
Plus, the work of the thyroid gland is checked and it is recommended to undergo an ultrasound scan of the thyroid gland, small pelvis, mammary glands and abdominal cavity

A man should go to the urologist, just like a woman, say "We are planning a pregnancy" and get tested for infections.

The state of health of the child is largely determined by the state of health of the mother, her age and socio-psychological status.

The most favorable age for conception and birth of children is from 19 to 29 years. The age of a woman in labor over 35 years is considered as a risk factor for a high incidence of complications for both the mother and the child.

For successful late motherhood, these women need careful examination and observation throughout the pregnancy.

Better find unpleasant moments before pregnancy and eliminate them than to learn about them during pregnancy, when it is difficult to influence and avoid them negative consequences.

It is necessary to maintain your health as long as possible in excellent condition, then you can give birth after 35 today. However, you should not delay the first pregnancy until such a time. The birth of a child is happiness. It is necessary to monitor your health outside of pregnancy, and even more so during pregnancy.

Do you know that according to the latest statistical reports it has been established that approximately 60% of women in our country become mothers of their first child after the age of thirty. To a large extent, their actions are justified.

If you conduct a survey of these women and find out from them the reason why they do not give birth until the age of 30, then their opinions will be divided. Someone will say that in our time it is impossible to find the right man from which you can give birth to a child, so that in the future this man becomes a real father for him.

Or it happens that having met the second half, it turns out until the minimum benefits are acquired, such as housing or a car. And someone gives, and when the age limit approaches, he tries to give birth "for himself." Some people can't get pregnant for health reasons. In many respects, these opinions are quite understandable.

Also, many women and their spouses will say with accuracy that giving birth after 30 years is much more useful than at an earlier age. The fact is that it is at this time that the husband and wife have a more serious responsibility for their future offspring. They approach the process of preparing for childbirth thoroughly, taking into account all the upcoming difficulties and problems. But despite this, there are some precautions that should be taken if you plan to get pregnant after thirty.

What are the risks of pregnancy after 30 years and what difficulties may arise?

It has been scientifically proven that the probability of getting pregnant immediately after reaching the age of 30 is slightly lower than, for example, at 25-28 years old. The percentage of probability decreases significantly after 35 years. So, we conclude that the 35-year-old age can be considered the boundary, when you can really fear that pregnancy will not occur soon.

Many doctors argue that getting pregnant after thirty-five is simply dangerous for the unborn child, as the risk that he will be born with congenital diseases increases. In fact, the percentage of children with Down syndrome is much higher when they are born by women in their thirties. But still, the likelihood of such a fact is not high. If you correctly approach the issue of planning childbirth, then the subsequent tragedy can be avoided.

After the studies, it was established that at this age the probability of a miscarriage or a “frozen” pregnancy is very high. Since the female body at this age suffers certain hormonal changes, then it is very difficult for the fetus to adapt to it.

And the last moment is a caesarean section. The fact is that if a woman is going to give birth to a child, while her age is already reaching the 35-year mark, then doctors are obliged to offer her delivery through a caesarean section. Also, doctors should tell the woman about what the consequences may be from what she chooses. natural way childbirth. The most important thing here is to reasonably explain the reason why a woman cannot give birth herself.

First pregnancy

The birth of the first child after the third decade is becoming commonplace in our time. If earlier friends who by this age already had more than one child could involuntarily whisper about such a woman, now many, on the contrary, regard this step as a manifestation of responsibility and prudence. Many women, despite the prohibitions and warnings of doctors, try to get pregnant at this particular age, when they vital status fully entrenched, and they are already firmly on their feet. But even in this case, do not forget that before planning a pregnancy at this age, you should consult your doctor, or even better, undergo a comprehensive examination.

If you are just thinking about giving birth to a child after thirty years, then you need to give up all bad habits about six months before the intended pregnancy. This refers to smoking and drinking hard liquor. The best thing to do is start exercising. The ideal option swimming will become, as many doctors advise this particular sport for pregnant women.

Second pregnancy

If you decide to have a second birth, then you need to consider several features of this age period which affects the second and subsequent pregnancies. Since the woman's body has already experienced such severe stress as childbirth, it will be much easier to cope with this the second time. Most of all, the psychological factor is worth fearing. Many women who are preparing to become a mother for the second time say that it is much more difficult to go through this than the first time.

The fact is that when giving birth for the first time, a woman does not yet understand what she will have to face, so she does not give a full account of what is happening. If a second birth is planned, then the woman begins to frantically remember everything that happened to her for the first time, and then she is seized by panic.

Also, the psychological factor is influenced by the pressure of doctors. The fact is, the gynecologist, who is registered with the pregnant woman, leaves the note “old-bearing” in her card, and this is considered a certain risk group. Many women are afraid of this mark, like fire. Thus, before planning the birth of a second baby after the age of 30, you should listen to the opinion of experts and check your own health.

third child

Few are now capable of giving birth to a third baby, but one should take an example from such women. Most of them will say with accuracy that they were thoroughly preparing for the appearance of a third child. It is widely known that during the third pregnancy, the diseases that tormented the woman during the first and second births become more serious. If we are talking about the banal swelling of the legs, which in mild form was observed during the first pregnancy, then by the time the third baby is born, this may become real problem. This also applies to other diseases that occur in pregnant women.

Let's weigh the pros and cons (the pros and cons of such a period)

Advantages of pregnancy at this age

In this age interval, a woman and her husband feel greater financial independence, which will subsequently affect the upbringing of the baby.
It should also be noted that caring for a child is much easier at this age. A woman will be less tired and tired, since her character is considered to be fully formed. If young mothers constantly complain that the child does not give them rest, then in our case the woman will be more patient.

Cons of such a pregnancy

The main and only disadvantage is the threat of abortion and congenital diseases child. Few women decide to give birth to a second child at this age, so they give birth to only one baby, who is subsequently extremely spoiled.

If you still decide to give birth

The most important points in the preparatory process:

At least six months before pregnancy, you need to give up bad habits, if any (smoking, alcohol, etc.);
If you are involved in extreme sports, then it is better to replace them with calmer ones;
Strictly follow the recommendations of doctors;
Before pregnancy, you need to full examination own health. If any deviations are revealed, then, as far as possible, it is necessary to get rid of them, since during pregnancy they will only get worse.

At whatever age a woman decides to become a mother, she must understand that she will be responsible not only for her condition, but also for the condition of the baby. To a greater extent, this applies to the period of pregnancy itself. Since women often set themselves the goal of only successfully giving birth, they rarely think about the possible consequences for their health, which can be avoided by properly preparing. Therefore, follow practical recommendations which are not so difficult to perform and watch your health.

Fear of childbirth almost every woman experiences because childbirth is usually associated with severe pain . And of course, most pregnant women want an answer to the question: how to give birth quickly and easily. Exist various ways pain management: from breathing techniques to medical interventions.

Some of them can be practiced even during pregnancy.

Every person's body has pain relief system which is somehow activated. Throughout life, a person encounters pain different nature. The pain experienced during childbirth is considered one of the strongest.

At human body developed mechanisms by which it copes with pain. At the biological level, these are hormones: endorphin, enkephalin and oxytocin, which provide a somewhat clouded state of consciousness when in contact with pain and work as natural painkillers.

For the quality work of the natural anesthesia system, it is necessary to provide comfortable conditions during childbirth. For stress caused by fear, tension, presence strangers or too bright light actively secretes adrenal hormones. These hormones neutralize the action of endorphins, enkephalins and oxytocin.

In addition to the natural analgesic system, there are methods of pain relief such as:

Pain relief practices from psychology

You can learn to relax at the moment of intense pain with the help of deep breathing and visual images. In the moment acute pain you need to start exhaling it slowly, making deep breath and a long exhalation, and imagine that instead of pain, the body is filled with warm and bright sunlight(or any other soothing and pleasant image). It is best to practice in advance by doing meditations and studying your body (what path the inhaled and exhaled air takes, how the muscles work during breathing, etc.).

Exercises with fitball, ropes and wall bars

Increasingly, fitballs can be seen in the prenatal wards. With their help, they do various exercises to relax and reduce pain. For example, you can perform this exercise: Sit on a fitball with a straight back and slightly relax your shoulders. The legs rest on the floor and are widely spaced. The pelvis begins to make smooth circular movements: from side to side, clockwise and counterclockwise, forward and backward. The movement is synchronous with breathing - one circle of slow inhalation, one circle of long exhalation. Exhale always through the mouth. The lips are relaxed. This exercise can be done at home as a preparation for childbirth.

Ropes can also be found in modern birthing rooms. To stretch and relax aching lower back you need to perform this exercise: while standing, firmly grasp the rope with your hands, slightly relax your knees (while more emphasis remains in your hands). There will be a feeling of stretching of the entire back. The same exercise can be done at the Swedish wall.

If the antenatal ward turned out to be without additional equipment, then instead of a support, you can use the headboard, chair, window sill or wall.

Partner help

In the case of joint birth, the exercise described above can be performed with a partner. His shoulders will act as a support. A partner can massage the lower back, this will improve blood circulation and relax the muscles, which will help reduce pain.

Breathing during childbirth

Proper breathing can help make childbirth easy. Having mastered the correct breathing technique, it will be easier for a woman to endure pain. Proper breathing the woman helps the obstetrician and childbirth is easy.

The obstetrician guides and prompts when you need to take a deep breath and push, and in which case - to pause in attempts and start breathing rapidly.

In antenatal clinics courses for pregnant women where they talk about breathing technique And stages of childbirth. Such courses also help prepare mentally for generic process. Uncertainty about how childbirth will take place often causes stress in pregnant women. And preparedness and understanding of what will happen on different stages On the contrary, it reduces stress levels.

Medical anesthesia

There are times when medical intervention is indispensable. In childbirth, such types of anesthesia are used as:

Epidural anesthesia: answers to frequently asked questions

epidural anesthesia considered to be a major breakthrough in obstetrics in recent decades. Now it is used in almost all maternity hospitals. during a caesarean section And at natural childbirth to give the mother some rest.

The use of anesthesia also allows you to get a comfortable impression of childbirth, after which women are not afraid to give birth a second and subsequent times.

There is an opinion of some patients that the use of anesthesia is an escape from natural process, that is, a woman does not experience all the feelings that she should experience during childbirth. However, this opinion is not entirely correct. The use of epidural anesthesia allows you to save some sensations - patients feel contractions and even attempts in the straining period. Preservation of sensations (except painful) after anesthesia in a woman during childbirth depends on the dosage and experience of the anesthesiologist.

Many women have such questions: is it worth doing anesthesia and why is it given during childbirth, what are the side effects, etc. Below are the answers to the most popular questions about epidural anesthesia.

What is epidural anesthesia and what is its purpose?

Epidural anesthesia is drug method childbirth pain relief. To stop the pain, an anesthetic is injected into the body in the region of 2-5 lumbar vertebrae. This is the epidural space that contains nerve endings. The anesthetic blocks the nerve plexuses that go to the uterus and thus the sensation of pain decreases and dulls, while uterine contractions are felt, but pain is not.

What are the benefits of anesthesia?

Pain relief allows you to give birth comfortably, gently and through natural birth canal. All this is possible because epidural anesthesia has a powerful therapeutic antispasmodic effect. This effect contributes to a smoother and rapid disclosure cervix or more mild childbirth. Pain relief restores a woman's strength and helps to give birth quickly and easily.

During the active phase of labor, contractions become frequent and prolonged, the cervix begins to open, during the contraction all nerve endings are compressed and their blood supply worsens. This causes pain. Anesthesia helps relieve this pain.

Can a woman agree in advance with a doctor about the use of pain relief?

The decision to anesthetize childbirth is made by the woman who is giving birth and the doctor who takes care of her childbirth. A woman may express a desire to use anesthesia and, as a rule, if there are no contraindications, the doctor will meet.

Anesthesia may be prescribed for medical reasons. During labor, anesthesia can be not only a factor that reduces pain, but also a factor that will improve the birth process.

How many times during childbirth can anesthesia be given?

Epidural anesthesia is used once during childbirth. A conductor is inserted, then a catheter is fixed, which is connected to a syringe, and dosed administration of the drug begins during all childbirth. The catheter is a very thin conductor that does not interfere with the woman's lying on her back and does not cause any inconvenience. The catheter is removed after childbirth.

At what point in labor is it most appropriate to administer anesthesia?

Anesthesia is placed at the moment of more pronounced pain syndrome. This usually coincides with the more active phase of labor, when the opening of the uterine os is three to four centimeters. The decision to administer the drug earlier is made by the obstetrician together with the anesthetist, if there are indications for anesthesia.

Indications for epidural anesthesia.

Childbirth with a large fetus.

Complicated course of the first birth - if there were deep ruptures of the cervix.

Preeclampsia (increased edema and pressure, convulsions, loss of protein in the urine).

Discoordination of labor activity.

Epidural anesthesia is not placed when the patient enters the hospital during the pushing period. This decision is made because the pressing period can be equal in time to the installation of anesthesia, that is, the speed of the birth of the baby is approximately equal to the speed of anesthesia.

What are the possible side effects after using anesthesia?

Headaches, leg numbness, and back pain may occur after epidural anesthesia is used. To avoid negative consequences, anesthesiologists carry out premedication and a number of other preparatory measures. An osteopath and a neurologist, as well as preventive rehabilitation, can help to cope with the consequences.

Finally

If there are no contraindications, then you can go to water aerobics or yoga for pregnant women. With the help of such exercises, the muscles acquire tone and elasticity, and endurance is also trained, which will help make the process of childbirth easier.

If possible, it is worth attending courses for pregnant women or watching training lessons on breathing. Pregnant women are taught how to give birth without pain, how to breathe properly, and also talk about the stages of childbirth. Women who breathe properly during childbirth and follow the instructions of obstetricians give birth faster and easier. Well, you should not rely only on epidural anesthesia and remember that it is prescribed according to indications. You need to explore other ways to relax, such as breathing, fitball exercises or psychological practices. All this together will help a woman give birth easily and without pain.