Getting pregnant at the age of 40 can be both exciting and concerning. While it's increasingly common for people to have children later in life, it’s important to be aware of the potential health risks and challenges. At 40, the chances of conceiving naturally decrease, and the risk of complications during pregnancy rises—for both the parent and the baby.

Is Pregnancy at 40 Considered High-Risk?

Yes, pregnancies after 40 are medically classified as high-risk due to the increased likelihood of health issues such as high blood pressure, gestational diabetes, and miscarriage. Additionally, older age may be associated with premature delivery and genetic abnormalities in the baby. However, with proper medical care and a healthy lifestyle, many people over 40 go on to have successful pregnancies and healthy children.

Chances of Conceiving in Your 40s

Fertility naturally declines with age. While individuals in their 30s have around an 85% chance of conceiving, by age 40 that number drops to about 44%. After 45, natural conception becomes much less likely. Nonetheless, assisted reproductive technologies can offer hopeful alternatives.

Fertility Options for Older Parents

  • Ovulation-stimulating medications (e.g., clomiphene)

  • In vitro fertilization (IVF) with frozen embryos or donor eggs

  • Intrauterine insemination (IUI)

  • Surrogacy or gestational carriers

Success rates for treatments like IVF decline with age. For instance, the live birth rate with IVF is about 12% for individuals aged 41–42, and just 5% for those aged 43–44. Using donor eggs from younger individuals can significantly raise success rates to over 50%.

Why Does Fertility Decline?

People are born with a finite number of eggs, which decrease in both quantity and quality with age. After 35, this decline becomes more rapid. With age, eggs are more prone to chromosomal issues, which can affect the chances of conception and lead to birth defects.

Health Risks of Pregnancy at 40

Pregnancy after 40 comes with a higher risk of complications:

  • Gestational diabetes – causes elevated blood sugar during pregnancy and affects approximately 8.5% of those over 40.

  • Preeclampsia – a condition involving high blood pressure that can lead to serious issues for both parent and baby.

  • Miscarriage – rates are significantly higher in the 40s (up to 53%) compared to around 10% in the 20s.

  • C-section deliveries – more common in people over 40, especially when IVF or multiple births are involved.

  • Genetic conditions – the risk of Down syndrome increases with age; at 40, the odds are about 1 in 85.

Premature birth is also more frequent in older pregnancies, which can affect the baby's health and development. Risks include respiratory issues, feeding difficulties, developmental delays, and vision or hearing problems.

Potential Benefits of Having a Baby at 40

Despite the risks, there are notable advantages to having a child later in life:

  • Greater emotional and financial stability

  • More life experience and maturity

  • Potentially better cognitive function in older parents

  • Research indicates children of older parents may experience fewer social problems and greater academic success

How to Prepare for a Healthy Pregnancy After 40

A successful pregnancy after 40 is possible with good planning and medical care. It's recommended to visit a healthcare provider before trying to conceive. Here are some key steps:

  • Live a healthy lifestyle – Eat a balanced diet rich in nutrients, stay active, manage stress, and avoid smoking or alcohol.

  • Get regular checkups – Routine prenatal care can help detect and manage risks early.

  • Use supplements – Folic acid, for example, helps reduce the risk of birth defects.

  • Stay physically active – Aim for moderate exercise like walking or swimming at least five times per week.

  • Seek fertility support – Consider assisted reproduction or egg preservation if needed.

Egg Freezing and Genetic Testing

Freezing eggs during your 20s or 30s may improve your chances of a future pregnancy. The process involves hormone treatments to stimulate egg production, followed by a minor surgical procedure to retrieve the eggs. Some people choose to undergo genetic screening of the eggs or embryos to detect potential abnormalities before implantation.

However, these procedures can be expensive, with one cycle costing up to $17,000, and annual storage fees typically between $300 and $500.

Prenatal Care Makes a Difference

With quality prenatal care, the outcomes for pregnancies at 40 can be similar to those in younger people. Care may involve high-risk pregnancy monitoring, addressing underlying conditions, and delivering at a facility equipped for advanced care.

Final Thoughts

While fertility and pregnancy come with additional challenges after 40, many people in this age group still have healthy pregnancies and babies. By staying informed, making healthy lifestyle choices, and working closely with healthcare providers, the risks can be managed, and the journey to parenthood can be both rewarding and successful.