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High-Risk Pregnancy

Pregnancy After 40: Risks, Benefits, and What to Expect

Published 6 April 2026
This content is for informational purposes only and does not replace professional medical advice. Always consult your midwife or GP.
At a glance

Medically reviewed content. Last updated: April 2026.

In this article

Pregnancy After 40: Risks, Benefits, and What to Expect

Medically reviewed content. Last updated: April 2026.

Having a baby after 40 is increasingly common in the UK. The average age of first-time parents continues to rise, and more people are starting or growing their families later in life. While pregnancy after 40 does carry some additional risks, with good antenatal care, the vast majority of people over 40 have healthy pregnancies and healthy babies.

How common is pregnancy after 40?

More common than ever. ONS data shows that birth rates for people aged 40 and over have been increasing steadily for the past three decades. In England and Wales, around 5% of all births are now to parents aged 40 or older. In London, the figure is even higher.

The reasons are varied: career priorities, later partnerships, financial considerations, fertility treatment availability, and simply not feeling ready earlier. There is no single right time to have a baby.

What are the additional risks?

Fertility

Conceiving naturally becomes harder after 40. Monthly conception rates drop to around 5% or less per cycle, compared to 20 to 25% for someone under 30. This does not mean it is impossible, but it may take longer, and the chance of needing fertility treatment increases. NICE recommends that people over 40 are offered one cycle of IVF on the NHS if they meet specific criteria.

Chromosomal conditions

The risk of chromosomal abnormalities, including Down syndrome, increases with egg age. At 30, the risk is approximately 1 in 800. At 40, it is approximately 1 in 100. At 45, it is approximately 1 in 30. Screening tests (combined screening, NIPT) are offered to all pregnant people in the UK, and diagnostic tests (amniocentesis, CVS) are available if screening suggests a higher risk.

Pregnancy complications

Certain complications are more common after 40, including gestational diabetes, pre-eclampsia, placenta praevia, a higher chance of caesarean delivery, and a slightly increased risk of stillbirth (though the absolute risk remains low with good monitoring).

Multiple pregnancy

If you conceive through fertility treatment, the chance of twins or multiples is higher, which carries its own additional risks.

What are the benefits?

Older parents often bring significant strengths to parenthood, including greater emotional maturity, financial stability, established careers with more flexible options, a strong sense of identity, and life experience that supports confident decision-making.

Research published in the European Journal of Developmental Psychology found that older parents tend to report higher wellbeing and more positive parenting experiences than younger parents.

What extra care will you receive?

Pregnancy after 40 is typically classified as consultant-led rather than midwife-only care. This means additional monitoring including more frequent blood pressure and urine checks, screening for gestational diabetes (glucose tolerance test around 24 to 28 weeks), growth scans in the third trimester to monitor the baby's development, discussion about timing of delivery (many consultants recommend delivery by 40 weeks for people over 40, or earlier if complications arise), and closer monitoring in late pregnancy.

You will still have midwife-led day-to-day care, but an obstetrician will oversee your pregnancy plan.

What about delivery?

Your care team will discuss the timing and mode of delivery with you. Because the risk of stillbirth increases slightly after 39 weeks for people over 40, many consultants recommend induction at 39 to 40 weeks. This is a discussion, not a mandate, and you have the right to make an informed decision based on your individual circumstances.

Caesarean rates are higher in people over 40, both planned and emergency. This is partly due to the higher rate of complications and partly because labour may progress differently.

How can you optimise your pregnancy?

The same evidence-based advice applies regardless of age, but it becomes even more important after 40. Take folic acid (400mcg daily) and vitamin D (10mcg daily). Eat a balanced diet and maintain a healthy weight. Stay active with regular gentle exercise. Attend all your antenatal appointments and screening tests. Stop smoking, avoid alcohol, and limit caffeine. Manage any pre-existing health conditions (such as high blood pressure or diabetes) in close consultation with your GP.

Key takeaways

  • Pregnancy after 40 is increasingly common and most people over 40 have healthy pregnancies with good care
  • Additional risks include lower fertility, higher rates of chromosomal conditions, gestational diabetes, pre-eclampsia, and caesarean delivery
  • You will receive consultant-led care with additional monitoring and screening
  • Delivery is often recommended by 39 to 40 weeks, though this is a shared decision with your care team
  • Older parents bring significant strengths including emotional maturity, stability, and life experience

Sources

  • NHS. Getting pregnant after 35. nhs.uk
  • NICE Clinical Guideline CG62. Antenatal care for uncomplicated pregnancies. 2008, updated 2019
  • RCOG. Induction of labour at term in older mothers. Scientific Impact Paper No. 34. 2013
  • ONS. Births in England and Wales. 2024
  • Trillingsgaard T, Sommer D. Associations between older maternal age, use of sanctions, and children's socio-emotional development. European Journal of Developmental Psychology. 2018
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Understanding High-Risk Pregnancy: Conditions, Monitoring, and Support

Frequently asked questions

How common is pregnancy after 40?

More common than ever. ONS data shows that birth rates for people aged 40 and over have been increasing steadily for the past three decades. In England and Wales, around 5% of all births are now to parents aged 40 or older. In London, the figure is even higher.

What are the benefits?

Older parents often bring significant strengths to parenthood, including greater emotional maturity, financial stability, established careers with more flexible options, a strong sense of identity, and life experience that supports confident decision-making.

What extra care will you receive?

Pregnancy after 40 is typically classified as consultant-led rather than midwife-only care. This means additional monitoring including more frequent blood pressure and urine checks, screening for gestational diabetes (glucose tolerance test around 24 to 28 weeks), growth scans in the third trimester to monitor the baby's development, discussion about timing of delivery (many consultants recommend delivery by 40 weeks for people over 40, or earlier if complications arise), and closer monitoring in late pregnancy.

What about delivery?

Your care team will discuss the timing and mode of delivery with you. Because the risk of stillbirth increases slightly after 39 weeks for people over 40, many consultants recommend induction at 39 to 40 weeks. This is a discussion, not a mandate, and you have the right to make an informed decision based on your individual circumstances.

How can you optimise your pregnancy?

The same evidence-based advice applies regardless of age, but it becomes even more important after 40. Take folic acid (400mcg daily) and vitamin D (10mcg daily). Eat a balanced diet and maintain a healthy weight. Stay active with regular gentle exercise. Attend all your antenatal appointments and screening tests. Stop smoking, avoid alcohol, and limit caffeine. Manage any pre-existing health conditions (such as high blood pressure or diabetes) in close consultation with your GP.

Sources

  1. NHS. Getting pregnant after 35
  2. NICE Clinical Guideline CG62. Antenatal care for uncomplicated pregnancies. 2008, updated 2019
  3. RCOG. Induction of labour at term in older mothers. Scientific Impact Paper No. 34. 2013
  4. ONS. Births in England and Wales. 2024
  5. Trillingsgaard T, Sommer D. Associations between older maternal age, use of sanctions, and children's socio-emotional development. European Journal of Developmental Psychology. 2018

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