Triplets and Trouble: Pregnancy Risks After 40

"Woman, 59, Gives Birth to Healthy Triplets," one of today's headlines announced. That's great for the babies, I thought, but how healthy is the mother? I won't speculate on the state of her psychological health when she decided to travel from France, where she lives, to a Vietnamese clinic willing to set aside the age limit of 45 imposed in France for in vitro fertilization. (The United States has no such law, but fertility clinics are loath to provide services to those nearing menopause.) But she certainly faced increased health risks, like diabetes and heart disease, carrying multiple fetuses at such an advanced age—to say nothing of the back and joint pain.

While this is certainly an extreme case, childbirth among the 40-something set has tripled since the 1980s, according to a December report issued by the Public Policy Institute of California. Heck, three 40-plus friends of mine told me last week that they were expecting their fourth or fifth child. "Should I be worried that our local pharmacy is dispensing placebos instead of the pill?" I joked to my husband. All kidding aside, some women may assume (wrongly) that they don't need to worry about birth control at this age: About 40 percent of pregnancies after 40 are unintended, according to a survey from the National Center for Health Statistics, and 7 percent of women ages 40 to 44 reported that they recently had sex without contraception.

What has some experts worried is that with added age comes added risk. Older women are more likely to have a miscarriage, experience problems during delivery, develop gestational diabetes, and deliver babies with birth defects. The risk of having a baby with Down syndrome, for example, is about 1 in 725 for a woman who gives birth at 32. But it's 1 in 41 if she gives birth at 44, which was Sarah Palin's age when she bore her son who has Down syndrome.

Older moms are also more likely to develop high blood pressure during pregnancy and do significant damage to their hearts. A study published in the July issue of the Journal of the American College of Cardiology found that pregnancy triples your risk of having a heart attack, possibly because of the body's increased blood supply. This increase may not be a big deal for a young, healthy woman, but it becomes particularly significant in older women, who are already at somewhat higher risk of heart problems.

Of course, there are plenty of women over 40 who give birth with nary a health concern. But I do think that anyone considering pregnancy at this age should, at the very least, talk to her doctor about potential risks.