Editor’s Note: We’re thrilled to welcome Dr. Jessica Shepherd to Lux & Concord! Dr. Shepherd is a national women’s health expert and an OB/GYN at the University of Illinois at Chicago. She’s appeared on Dr. Oz, WGN, NBC Chicago, and more. Each month, she will be contributing a column to L&C about a pressing issue in women’s health. We’re so excited to have her on board! Be sure to also check her out on Twitter at @JShepherd_MD, and visit her women’s health site, Her Viewpoint.
Whether you can’t wait to have children or you’re leaning towards staying child-free, pregnancy and conception are a topic every woman will have to address at some time in their lives, and one that seems to come up more and more frequently as you enter your late twenties and early thirties.
With the thought that pregnancy could now be on the near horizon, and not just something you’ll deal with when you’re older, comes questions about your health, the effects of your birth control pills, and of course, with more women than ever waiting until later in life to have children, the question of “how late it too late?”
Here, the facts you need to know when it comes to getting pregnant in your twenties, thirties, and beyond.
1. Is there a best age to get pregnant?
There is no best age to get pregnant however there are risks with becoming pregnant in your late 30s to 40s. As the decade progresses, fertility decreases significantly for most women. Women in their 20s will have a chance of conceiving about 20-25% per month and that is due to the increased number of eggs within their ovaries. The risk of miscarriage is also lower at 5-10%.
When women reach their 30s it is also important to note that getting pregnant in their early 30s is easier than in their later 30s. The ability to get pregnant in her 30s is about 15 percent per month. Over the age of 40, there is a sharp decline in how easy it is to conceive and drops to 5 percent per month. Although In Vitro Fertilization is much more available today and provides a way for women to conceive, the pregnancy rate is only 10 percent per try.
2. Are there advantages/disadvantages to getting pregnant in your 20s vs 30s?
A woman in her older 30s may be at increased risk for miscarriage, birth defects, and pregnancy complications such as twins, high blood pressure, gestational diabetes, and difficult or longer labors. After the age of 35, the risks of miscarriage and genetic abnormalities increase and your health care provider should provide you with information for genetic screening and counseling.
Some studies show that while there may be a greater likelihood of pregnancy complications in older women, it does not necessarily mean that their babies will have problems than babies of younger women. Having a great relationship with your OB/GYN is essential to getting the correct information and allows women to make decisions based on their scenarios.
3. Does using birth control affect your chances of getting pregnant later?
Birth control works by preventing ovulation and therefore does not prevent pregnancy later. With all the various types of birth control, there are those that are long acting and those that are short acting. When women stop taking birth control, there is not a long time frame before she will start ovulating again.
After taking birth control pills, a woman’s period should start again within three months. The injectable birth control Depot Provera which is given every three months can take longer to have ovulation return and can take up to one year for your fertility to return to normal after the injection wears off. The intrauterine device (IUD) is a long term form of birth control and can come with or without a hormone insert. When these are taken out, there is a immediate return to ovulatory cycles and pregnancy can occur very soon.
4. Are there health tips women who may be three to five years away from pregnancy should be aware of or can start implementing?
When women are three-to-five years away from pregnancy, the most important way to maintain pelvic health is to -Visit your OB/GYN or health care provider every year. -Get STI checks frequently as some infections can affect your fallopian tubes and prevent transportation of a fertilized egg in the future. -Know your options and risks for conception if you are going to be over 35 years old when you start trying to conceive, make sure to have the discussion early! -Get your PAP screening test as recommended.
5. What about women who may be only a year or two away from pregnancy? Women who are 1-2 years from conception may consider taking prenatal vitamins and folic acid 3-6 months prior to starting to conceive. This will ensure the best nutrition for a embryo if an unplanned pregnancy occurs. Organ formation begins very early in pregnancy and these supplements help prevent conditions such as spina bifida or spinal cord defects. Women should also visit their health care provider to discuss medical conditions that may affect the pregnancy and plan ahead.
6. Are there questions you should ask your doctor if you’re thinking about having a baby soon?
Women should have very open conversations with their doctors when considering conception in the near future. Discussion topics should include; tracking ovulation, preconception counseling, the plan for the pregnancy and what to expect with bodily changes.
7. What are the best birth control options for women who don’t want children for at least five years?
There are so many options for women today when it comes to birth control and they can be taken many ways- by mouth, inserts into the vagina, devices placed in the uterine cavity, injected into the arm, and also devices placed in the arm.
For women who decide that they do not want to get pregnant for five years or more, long-acting reversible contraception (LARC) methods are very effective. These types of birth control include the intrauterine device (IUD) and the birth control implant. They are easy to use and are inserted in the doctors office. Even though they last for up to three-10 years, they are reversible. When used for the recommended time, the long term, LARC methods are more effective than birth control pills, the patch, or the ring.