Pregnancy Over 40: What You Should Know 


Sometimes, a pregnancy over 40 is a long-hoped-for joy. Sometimes, it’s an unexpected surprise. Sometimes, it’s both! Either way, the team at Virginia Women’s Center is there to support and guide you through the experience.

Dr. Alex Vaclavik, a Richmond OB/GYN at Virginia Women’s Center’s 6600 West Broad office, shares the advice he gives moms-to-be.

Take things one day at a time.

For expectant moms over 40, Dr. Vaclavik recommends maintaining cautious optimism in early pregnancy. “Unfortunately, pregnancies later in life are at a higher risk of miscarriage,” he says. Women may be especially anxious if this is a long-awaited pregnancy. One calming mantra used by women who have experienced previous miscarriages is simply, “Today, I am pregnant.”

Focus on your own wellbeing. 

If you’re in your 40s, you may be dealing with other health problems that typically crop up in this decade, such as diabetes or high blood pressure. Your goal is optimizing your health early on in pregnancy. Stay active, hydrate, eat a balanced diet and remember that pregnancy “isn’t quite eating for two,” Dr. Vaclavik says. Also, talk to your OB/GYN about any chronic conditions or medical issues you have. Be sure to let your other doctors know when you find out you are pregnant, as you may need to adjust your medications or be seen for additional follow-up during the pregnancy.

Expect extra pregnancy checkups. 

Moms over 40 sometimes don’t realize they’re pregnant until a little later — they may think they’re entering menopause, or simply not expecting it. It’s important to make up for any lost time, Dr. Vaclavik says, by starting a prenatal vitamin and seeing your doctor right away. Your Virginia Women’s Center OB/GYN will review your medical history and medications, do some preliminary lab work and order an ultrasound to confirm how far along you are.

 As your pregnancy continues, your doctor will monitor you and your baby closely. “With older moms, we tend to keep a closer eye on the growth of the baby,” Dr. Vaclavik says. There’s also an increased risk of conditions like pre-eclampsia and gestational diabetes.

Know that help is available for navigating high-risk pregnancies.  

Older moms do have a higher risk of having a baby with genetic or chromosomal abnormalities. For pregnant women who are 40, the chances of having a baby with Down syndrome — a condition in which an individual has a full or partial extra copy of chromosome 21 — is 1 in 100.

Many mothers-to-be are anxious about the possible risks and scared of undergoing invasive tests. Dr. Vaclavik reassures them that there are effective, non-invasive screening tests available and that they can decline screenings, too. Expectant parents can get compassionate guidance from Laurie Tams, a licensed genetic counselor who’s on staff at Virginia Women’s Center.

Plan ahead for baby’s arrival. 

Research shows that older moms are more likely to deliver via a C-section or to have other problems that lead to an induction. Even if your birth goes according to plan, you can expect to be exhausted and overwhelmed by the challenges of parenting a newborn.

Here’s an advantage moms over 40 have: You know how to delegate! Call on your network of family and friends to help you. If your financial resources permit, consider hiring a night nurse or postpartum doula to give you a break. The more you can rest, the more you can enjoy the magical moments with your new baby.

Just found out you’re pregnant? Schedule an appointment at Virginia Women’s Center by calling 804.288.4084.

Dr. Alex Vaclavik is a much-loved provider at VWC’s West End, 6600 West Broad Street, location.  He works closely with Privia Women’s Health and VWC’s informatics team to develop patient safety and quality initiatives and applications.  When he’s not caring for patients, Dr. Vaclavik is busy spending time with his wife laughing and chasing their three young children.  Little known fact — Dr. Vaclavik was once a contestant on Who Wants to Be a Millionaire!