Health complications that come with giving birth while over 35 years old

The questions were inevitable: family and friends started wondering when Miriam* was going to have a baby as soon as she hit 30. She is a pilot and at the time, she would be away for work for five to six weeks at a time. She was also working towards becoming a captain, which, as soon as she attained the position, required a few years of proving herself, solidifying the position.

In 2009, Miriam was involved in a plane accident and during the six-month recovery period, she had time to think and realised she was missing out on motherhood. She was 33-years-old then. Apart from her demanding job, she and her partner worked in separate towns. She changed jobs so she could 'settle down' and moved to Nairobi to join her partner. She doesn't fly actively anymore.

In October 2015, when she was 39-years-old, she found out that she was pregnant. Unfortunately in December that year, she suffered a miscarriage. "After that I wasn't in the right frame of mind to start trying again," says Miriam. In fact, she stopped thinking about it altogether. Regular exercise helped get her out of the funk. "I started doing a lot of exercise, lots of boot camp and the good thing about exercise is, apart from helping you in keeping fit, it helps clear your mind. Before that, all I thought about was trying to have a baby. With exercise I got peace of mind. My thinking changed from desperately wanting a baby to 'If I get pregnant, well and good. If I don't, so be it.'"

She fell pregnant at 40.

OLDER MOTHERS ARE BETTER, LESS WORRIED MOTHERS

Older mothers are less likely to punish and scold their children while raising them, and that the children have fewer behavioural, social and emotional difficulties. Women are increasingly having their first baby later in life because of factors such as education and career advancements, improved contraception and high living costs. Medical experts have warned about the risk factors associated with advanced maternal age, that is, when a woman is 35 or older whether the childbirth is the first or not.

BEST AGE FOR MOTHERHOOD

As far as health is concerned, 24 to 30 is the best age to get pregnant because a woman is at the peak of fertility. Too early or too late carries risks of complications. As age increases, so does the risk of other problems that may affect fertility such as uterine fibroids, adenomyosis and endometriosis. The biggest risk an older woman faces, though, is difficulty conceiving because of the sharp decline of fertility at 35. When a woman gets closer to menopause - which on average occurs between 45 and 55 years of age - the decline is much faster and that is genetically programmed so a woman doesn't make a baby when they've hit menopause. Ageing affects both men and women. The difference is for a woman, once she has hit menopause, her chances of naturally having a baby end at that point. Men produce sperm throughout their lives. A man has a potential to make a baby as long as he is alive. The sperms are probably fewer and of poor quality but still there. Risks of complications such as gestational diabetes, hypertension, spontaneous abortion (or miscarriage), premature delivery, low birth weight, stillbirth and chromosomal abnormalities increase with advanced maternal age.

SO WHAT TO DO IF OVER 35 AND BROODY?

When you're over 35 and planning to have a baby, Dr Ndegwa-Njuguna advises that you should have regular hospital visits and care such as folic supplementation, eating healthy foods (which includes plenty of fruits and vegetables), and regular exercise so that the body is fit enough to carry a pregnancy to term. "Being overweight is a big problem. It reduces the likelihood of your getting pregnant and even when you are, obesity increases your chances of hypertension and diabetes. Exercise regularly but don't overdo it. Walking half an hour a day is good enough. Swimming is excellent because it engages the whole body. Light aerobics and yoga also count," she says.

"Women who have postponed motherhood tend to have enormous social and cultural pressure to deal with on a daily basis," says Ruth Mwangi, a counseling psychologist with Life Pillars Counseling and Consultancy. "Particularly in more conservative contexts, they are constantly seen as 'different' and this can negatively impact on self-esteem and even social interactions." Ultimately, Mwangi says, every woman has to make choices in life that are in their best interest and in motherhood, for the baby.