It doesn't get more special and momentous than bringing a new life into this world. So, in my view, my job is not to tell women what to do but to give them information so they can make the decision that is right for them and to have the pregnancy experience that they want to have.
First of all, you want to go into this in as healthy a state as you can. You need to be living a healthy lifestyle, moderating alcohol intake, giving up smoking, ensuring you have a healthy diet, doing a moderate amount of exercise and trying to get down to a healthier weight range if you're overweight - and that can be quite a challenge for some people.
And this isn't just for women over 35, it's for any women planning pregnancy. Your GP is a great source of help with prenatal planning who can screen you for issues such as diabetes, heart disease, and high blood pressure which will need to be optimised when thinking about getting pregnant.
I encourage women, in addition to a healthy diet and exercise, to take a pregnancy-specific multivitamin with enough folate in it to reduce the risk of their baby developing spina bifida.
When it comes to pregnancy, we see a higher incidence of complications in older women. I recommend older women see an obstetrician/gynaecologist around the 7-to-9-week mark of their pregnancy to have a conversation about what screening is appropriate.
Delivery and timing of delivery need to be considered, with obstetricians offering options for early delivery (around 39 weeks) in order to reduce the risk of delivery and late pregnancy complications that can be experienced by older women.
After you've had the baby it's really important that you get good support to manage the challenges involved in having a new baby in the home. Women over 40 are at three times the risk of postnatal depression, so it's a good idea to familiarise yourself with support services should this occur.
There's a lot of support available in the community, including your obstetrician, GP and both the private and public hospital sectors.
Soon but not yet
I generally encourage women over 35 to think about whether they want to start a family sooner rather than later. If they want to start a family, they should do so because it becomes more challenging after 40, with reduced fertility and increased chance of developing other health problems.
If a woman wants to delay starting a family, something to consider is getting their eggs frozen for IVF options. They can do this by having a series of IVF cycles and putting the eggs on ice. This ensures that if down the track they do want to fall pregnant that they've at least got younger eggs of better quality, as opposed to later when they would have a decreased quality and quantity of eggs and greatly reduced chances of success.
Of course there's never any harm in seeing a gynaecologist to get a good pre-pregnancy workup to give you the best opportunity of falling pregnant when you are ready.
If women over 35 have been actively trying for a baby and haven't fallen pregnant, then they should see a gynaecologist for an infertility workup.
- Answer provided by Gold Coast obstetrician and gynaecologist Dr Sean Holland, through HealthShare, a digital company dedicated to improving the health of regional Australians. Submit questions, and find more answers, at healthshare.com.au.