You’ve worked so hard to get here. Maybe you’re still trying, or maybe you’ve just seen those two pink lines. Either way, there might be a quiet worry sitting underneath it all: what about the pregnancy itself, now that I’m over 40?
This episode came from a conversation with a new patient. She was nervous about her chances of conceiving over 40, and then she told me she was just as nervous about the pregnancy. She’d heard so much about the “extra risks” that she felt completely overwhelmed.
If that sounds like you, this one is for you.
I’m joined by Dr Chelsea Watt, a specialist Obstetrician, Gynaecologist and Sonologist with advanced training in high-risk obstetrics and diagnostic ultrasound. Chelsea sees women in their 40s all the time, and she brings such a calm, steady warmth to a conversation that can feel really scary. Together we unpack what pregnancy over 40 actually looks like, what’s monitored and why, and which fears are backed by evidence and which ones you can let go of.
In this episode, we cover:
- Why “advanced maternal age” (AMA) is a description of one part of you, not a diagnosis or a prediction of how your pregnancy will go
- What extra monitoring and scans typically look like over 40, and why most of the screening is the same care every pregnant woman is offered
- Chromosomal screening explained: the NIPT blood test, the 13-week first trimester assessment, and how PGT-tested embryos fit in if you’ve done IVF
- The evidence-based risks that are more relevant in your 40s (gestational diabetes, preeclampsia, placental and growth concerns) and how closely each one is monitored
- What you can do before and during pregnancy to reduce your risk, and why the preconception window is so often overlooked
- A typical appointment schedule for a pregnancy over 40
- Why asking for extra scans for reassurance is completely valid
- Myth-busting: no, being over 40 doesn’t automatically make you high risk, guarantee gestational diabetes or mean you need a caesarean
- The questions to bring to your obstetrician, especially if you feel anxious before every appointment
Myths Chelsea busts in this episode:
- “Over 40 automatically means high risk.” Age is one non-modifiable risk factor. It flags things to watch, but it doesn’t mean something will go wrong.
- “You’ll definitely get gestational diabetes.” The risk is around three times higher, but it is far from a certainty.
- “You’ll need a caesarean.” Age on your pregnancy card doesn’t decide your mode of birth. That’s a conversation between you and your care team.
- “Your body won’t cope at 40.” As Chelsea says, 40 is fabulous!
One thing I said in this episode that I really want you to hold onto: we spend months preparing the nursery, choosing the paint colours and the cot. But the most important nursery your baby will ever have is the one inside you.
Your age is a number we can’t change. But there are so many other numbers we can change. Egg and sperm take around 90 days to develop, so even a few months of focused preparation is a window of opportunity to pass on the best DNA possible to your future baby and help create your healthy pregnancy over 40.
If you came into this episode feeling nervous, I hope you’re leaving a little lighter.
You deserve to feel informed and supported through every stage, and you deserve a care team that makes that possible.
Timestamps
- [00:00] Welcome and why this episode matters
- [01:14] The old label on my own pregnancy chart, and what AMA really means
- [03:27] What extra monitoring looks like over 40
- [06:08] NIPT and first trimester screening explained
- [07:11] PGT-tested IVF embryos and screening
- [08:23] Gestational diabetes, preeclampsia, placental and growth concerns
- [10:24] What you can do to reduce your risk
- [12:42] Pregnancy as a marathon, and the most important nursery
- [14:06] Letting go of guilt and focusing on what you can control
- [16:27] A typical appointment schedule for pregnancy over 40
- [19:16] Finding your team, and why extra reassurance scans are valid
- [22:05] Busting the myths about pregnancy over 40
- [25:02] Feeling anxious before every scan? Questions to ask
- [29:12] Pregnancy as a glimpse into parenthood
- [29:52] Why preconception is the best investment in your child’s health
- [31:26] Chelsea’s message to newly pregnant women over 40
About Dr Chelsea Watt
Dr Chelsea Watt is a specialist Obstetrician, Gynaecologist and Sonologist providing pregnancy, birth and women’s healthcare on the Southern Gold Coast and in Northern New South Wales. She completed her specialist training across Queensland and NSW in regional, rural and tertiary referral hospitals, and has advanced training in high-risk obstetrics and diagnostic ultrasound.
Connect with Chelsea:
Website: https://drchelseawatt.com.au/
Instagram: https://www.instagram.com/dr_chelsea_watt/
Resources mentioned
- Free Fertility Over 40 Guide: If you’re trying to conceive over 40, this is a great next step. Download it at tashajennings.com/fertilityover40
If this episode helped you, please share it with a friend who might need to hear it too.
Mentioned in this episode:
Fertility Over 40 Guide
Learn the 5 Things you need to do NOW to boost your chances of pregnancy over 40!
If you have been told your eggs are ‘old’. You have low AMH. You’ve struggled with miscarriage. You have been recommended IVF or had failed cycles. It’s been suggested to use donor eggs.
Then this guide is for you!