The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.
OVERVIEW
Whether you’re just beginning to think about starting a family or actively trying to conceive, it’s essential to understand how your age impacts your fertility and your chances of a high-risk pregnancy, as well as the steps you can take to optimise your health.
Age affects not just how many eggs you have, but also how healthy they are – which is why conception can take longer or need medical support when you’re older. Women are born with all the eggs they’ll ever have — around 2 million. By the time you’re 37, this number will have dropped to about 25 000. By 51, you’ll be down to 1 000 eggs. This means that while it is still possible for you to fall pregnant, it could be harder for you to conceive. Your risk of pregnancy complications also increases as you age.
Your health and wellbeing also significantly impact your ability to conceive, as well as your pregnancy and your baby’s development. Pre-existing conditions, lifestyle choices, and mental health can all affect pregnancy outcomes. Maintaining a healthy weight, engaging in regular physical activity, eliminating smoking and alcohol, and following a balanced diet are crucial for a healthy pregnancy.
Your partner’s health also contributes to the health of both your pregnancy and child. Growing evidence shows that a father’s health before and during pregnancy can affect sperm quality, placental development, and the mother’s immune system, potentially leading to complications like miscarriage, preterm birth, or developmental issues in the child.
No matter your age or health status, support and preparation are vital when planning a pregnancy. Early antenatal care is crucial for identifying and managing pre-existing conditions and reducing the risk of complications. Proactive healthcare empowers you with the best chance of a safe and joyful pregnancy.
MATERNAL HEALTH IN SOUTH AFRICA
Maternal health is a significant concern in South Africa, with our maternal mortality rate still relatively high, despite improvement in recent years. The leading causes of maternal death in South Africa include HIV/AIDS; excessive bleeding, either during pregnancy, during childbirth or after delivery; and high blood pressure leading to gestational hypertension, preeclampsia and eclampsia.
Pre-existing medical conditions contribute significantly to pregnancy-related complications and deaths in South Africa. It is essential to establish whether or not you have a chronic illness like hypertension or diabetes as early as possible so that these can be effectively managed in order to decrease the risk of adverse outcomes for both you and your baby.
Most maternal deaths are considered as preventable. The biggest challenge is late access to antenatal care, with delays in seeking antenatal care associated with a higher likelihood of pregnancy complications. Only 47% of South African women accessed antenatal care during their first trimester in 2016. Between 2017-2019, 72% of the women who died had attended antenatal care, but only half had booked before 20 weeks.
HOW YOUR PARTNER’S HEALTH AFFECTS YOUR PREGNANCY AND BABY
Making a baby is a team effort! A man’s health and lifestyle before and during conception can significantly impact a healthy pregnancy and the baby’s well-being. Factors like age, weight, smoking, alcohol consumption, and chronic illnesses in the father can increase the risk of preterm birth, low birth weight, and other complications for the baby:
MoreEARLY TO MID TWENTIES: FERTILITY IS AT ITS HIGHEST
Ages 21 to 25 is generally the most fertile phase in a woman’s life. Your egg quality is typically at its peak, and your chances of natural conception are at their highest – around 25-30% each month.
Considerations:
MID TO LATE TWENTIES: STILL GOING STRONG
Your fertility remains high throughout your twenties, though it may start to decline slightly after age 28.
Considerations:
EARLY TO MID THIRTIES: CONCEPTION MAY TAKE A LITTLE LONGER
Fertility begins to decline more noticeably around age 32. While many women still conceive easily, it may take longer.
Considerations:
MID TO LATE THIRTIES: TIME FOR CAREFUL CONSIDERATION
Fertility declines significantly after 35, and the quality and quantity of eggs decreases. However, many women in South Africa and around the world have successful pregnancies in this age range.
Considerations:
OVER 40: STAY POSITIVE BUT REALISTIC
After 40, the chance of natural conception is lower (about 5%-10% per menstrual cycle), and egg quality is often significantly reduced. Your chance of a high-risk pregnancy also increases, which includes an increased risk of miscarriage, ectopic pregnancy, gestational diabetes, high blood pressure, and certain chromosomal abnormalities in the baby, like Down’s syndrome. However, many women still conceive—naturally or with assistance—and have healthy pregnancies.
Considerations:
TIPS FOR CONCEPTION
Most couples will fall pregnant within a year if they have regular sex and don’t use contraception. Regular sex is defined as having sex every 2 to 3 days throughout the month.
You’ll have the best odds of getting pregnant and having a healthy baby if you start trying in your 20s or 30s, but this isn’t the right timing for every woman. Other factors besides your and your partner’s health need to be considered when deciding to start a family:
- Are you in a solid relationship or do you have the support system to have a child on your own?
- Are you ready to temporarily put your career on hold?
- Are you financially secure enough to support a child?
Take your time to prepare your mind, body, and life for this next chapter. If you have any concerns about your ability to fall pregnant, see your gynaecologist or visit a fertility specialist. There are also proactive choices you can make to improve your chances of becoming a parent:
HIGH-RISK PREGNANCIES
A high-risk pregnancy is one where there’s an increased chance of complications for the mother, the baby, or both. This can be due to pre-existing health conditions, complications arising during pregnancy, or lifestyle factors. It doesn’t necessarily mean a problem will occur, but it does mean extra monitoring and care may be needed.
Factors that can contribute to a high-risk pregnancy:
What to do if you have a high-risk pregnancy:
FURTHER READING
Visit these sites to learn more: