After turning 42, Tisha Kerr decided she was done having kids. In her mind, Six was perfect. Plus, she was sure her menopause was starting. For the past six months, she had been experiencing all the same symptoms as her friends: hot flashes, her mood swings, her breast tenderness. She and her husband decided that it was probably safe to eliminate birth control. But then, less than a month later, Kerr felt a familiar tingling pain in her ovaries. This was the same pain she had felt every time she got pregnant so far.
Carr felt embarrassed. “Teenagers get pregnant by mistake. 42-year-old women usually don’t get pregnant by mistake,” she told me. But in reality, it’s surprisingly common for 42-year-old women to accidentally become pregnant. According to the latest data from the National Center for Health Statistics, nearly 4 percent of all newborns are born to women over the age of 40. Her 75% of pregnancies in this age group are unplanned. it happens often enough, downton abbey, sex education, and just like that, Grey’s Anatomyand dark I’ve become dependent on it.
Many women believe that once they reach their 40s, they don’t have to worry about unplanned pregnancy. After all, many of us have been told throughout our lives: body clock is runningthat our fertility declines rapidly. After 35 years old, and if you wait too long, there’s a good chance you’ll need some sort of reproductive technique to get pregnant, if you even manage to get pregnant at all. If it’s so difficult to get pregnant at this age, there’s no way it could happen by accident, right?
To understand why pregnancy can and does happen at this age, it helps to think about the strange middle ground that is perimenopause. This phase can last from a few months to about eight years and is usually considered a smooth transition into menopause. In reality, this is similar to the hormonal disruption of puberty. This is when the ovaries burst into life for the first time, causing all sorts of physical havoc as they try to find a new groove.
During perimenopause, your ovaries try to adjust to their new normal again. Just now they are overreacting, interspersing squirts of estrogen to collect a much smaller pool of eggs that are released during ovulation. During this period, he may ovulate twice in one cycle, miss the cycle completely, or experience the following symptoms: Unpredictable flash period. “My ovaries are going a little crazy,” Robin Noble, a gynecologist and menopause specialist in Maine, told me. It can lead to all sorts of weird results. First, extreme hormone spikes can stimulate the ovaries to release extra eggs, which is one reason why fraternal twins are more common in older pregnancies.
If your ovaries continue to ovulate, even if only sporadically, it is possible to become pregnant. Although it is possible to become pregnant, decline with age, especially towards the end of your 30s.According to American Society of Reproductive Medicine, the chance of becoming pregnant during one menstrual cycle is less than 5 percent. The problem begins when these low odds lead women to use less reliable methods of contraception, such as rhythm methods or birth control pills. These methods can be even more risky and more likely during perimenopause due to the surge in hormones and less predictable menstrual cycles.
“I hear it every day,” Rachel Pope, an obstetrician-gynecologist and director of women’s sexual health at University Hospitals in Ohio, told me. “Many women truly believe that their fertility no longer exists, but that’s not true.” In reality, she believes that unless she has had a period for at least a year, she is in menopause. I don’t know if it is. In other words, you really don’t have to worry about pregnancy. For this reason, the Menopause Society recommends that women wear a hormonal IUD or continue taking hormonal contraceptives for one year after their last period, just to be on the safe side.
Adding to the confusion, some of the symptoms of perimenopause (missed periods, fatigue, mood changes) resemble early signs of pregnancy. Lisa Periera, an obstetrician-gynecologist and chief medical director of the Women’s Center, a multi-state group of abortion clinics, says she sees women who are shocked to discover their bodies still have the ability to become pregnant. I see the doctor almost every month. “I’ve definitely been concerned about 47-year-olds who say, ‘I thought I was going through menopause,'” she told me.
Although women in their 40s are anticipating age-related changes in their bodies, they may not be paying attention to the signs of pregnancy, so many wait until 16 or even 20 weeks to realize they’re pregnant. Periera said she didn’t know she was pregnant. That’s what happened to Anne Lewis. In 2017, the 43-year-old mother wasn’t experiencing any signs of perimenopause, but she felt her chances of getting pregnant were rapidly closing. She wasn’t too worried about missing her period for a month or two because her periods had always been irregular. She started having morning sickness and by the time she took her pregnancy test, she was almost four months pregnant.
Lewis and her husband welcomed the news, but also felt overwhelmed. “I think it was probably 60 percent excited and about 40 percent excited.” Oh my god, how do I start over?? ” she told me. She gave birth the following year and was immediately fitted with an IUD.
Facing pregnancy when you think there is no chance of pregnancy can be extremely painful. “I see a lot of people being upset about this,” Pope said. “An unplanned pregnancy can be life-altering, especially now that abortion is banned.” difficult or impossible to access In many states. A common first reaction is denial. Cristina Ficicchia started having irregular periods at age 42, and her gynecologist told her she was experiencing menopause. So when her period completely disappeared, she assumed her menstrual cycle was ending. Then she began to “feel” her pregnancy. “You can kind of tell she’s been pregnant a few times,” she told me. However, even after her pregnancy test came back positive, she asked her doctor to take a test in the office to confirm the result. After making plans for her first two children, Ms. Ficicchia struggled to gather her thoughts about the choices she now faced. “It was a choice that, realistically, I never thought I would have to make.”
Many women face additional pain because they know that getting pregnant after 40 carries greater risks. After that age, the chance of miscarriage increases to 1 in 3, although not significantly higher. according to Go to Mayo Clinic. Pregnant women over the age of 40 are also at increased risk. preeclampsiagestational diabetes, placenta previa, premature birth, high blood pressure, pelvic floor damage, “basically anything that can go wrong,” Pope said. There is also an increased risk of Down syndrome and other chromosomal abnormalities.
After consulting with her obstetrician, Ficicchia ultimately chose to continue with the pregnancy. Despite her growing anxiety, she gave birth to her fourth child, Emerson, at the age of 43 without complications. Carr wasn’t so lucky. After she and her husband adjusted to the news, Kerr told her other children to expect a new sibling and even told her co-workers. Then, at an ultrasound eight weeks later, the technician told her there was no heartbeat in her fetus.
After finally being able to imagine having another baby in her future, Kerr was devastated. “I was pretty comfortable with where I was in life and then this thing happened and everything turned upside down,” she said. She’s still trying to make sense of the loss, and she still dreads the weekly emails she receives from pregnancy websites telling her what to expect at each stage of pregnancy or promoting breastfeeding products. ing. “If I had known what was going on in my body, none of this would have happened,” she told me. “I wasn’t informed.”
Of course, even for the most knowledgeable people, such as doctors who spend their days explaining perimenopause to their patients, the body can be confusing. When Pope missed her period in July and started feeling tenderness in her breasts, she knew what was going on: menopause. The 38-year-old was on the early side. Still, she thought, “Maybe this is it.” Considering that she and her husband had used IVF for her two children and planned to use it again, the chances of a natural pregnancy seemed low.
“Then my husband, who is a GP, said, ‘Maybe you should try a pregnancy test,'” she said. In fact, Pope was not menopausal. She was in her fifth week of pregnancy.