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Ask The Expert: Complications for older mums?

Women who have their first babies at an older age are much more likely to go past their due dates, require medical help to start/progress labour and require caesarean sections

Q: "I'm 40 and about to have my first baby, and my doctor says I'm much more likely to experience complications during the birth because I'm an older mother. Why is this?"

A: Dr Rachel Tribe, a Reader in Women's Health at King's College London has just led a study into the physiological changes that could explain increased birth complications for older mothers.

She says: "Doctors have known for many years that women who have their first babies at an older age are much more likely to go past their due dates, require medical help to start or progress their labour, and have pregnancies resulting in caesarean sections. Despite this clinical awareness, there really hasn't been much research into why this is the case.

"To address this knowledge gap, my research team has found that hormones associated with pregnancy and initiation of labour get disrupted with age, and the muscle of the uterus (which is responsible for contractions in labour) doesn't work as well. The muscle isn't as prepared for labour and seems to have fewer sources of energy (called mitochondria) required for muscle contraction.

"This means that it's likely that the muscle in older women cannot generate strong or long enough contractions to deliver the baby quickly, and that the muscle may get fatigued more easily.

"We hope these findings will encourage more clinical research into developing specific approaches to managing older women in labour. Current protocols treat women of all ages as if they are the same – our work shows that age does matter and that 'one approach' will not fit all."

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