The older obstetric patient

Abstract

A new era has begun in which the modern woman is able to delay childbearing if she wishes, even beyond normal reproductive age. Developments in contraception, obstetric care coupled with greater equality in the workplace have all had an influence in the timing of childbearing for women in the developed world. Older mothers are often well informed and have a great deal of knowledge about labour and its complications. Anxiety in both the older mother and the obstetrician may be responsible for a greater degree of medical intervention, including Caesarean section, in this group. However, with the exception of gestational diabetes and pregnancy-induced hypertension, age per se may not be held solely responsible for a greater frequency of obstetric complications in healthy mothers of 40 years and above. Maternal mortality increases as a function of maternal age. This is in part again related to the increased rate of Caesarean section with its known complications. As with all other measured parameters for this group of women in the literature, data on perinatal mortality and morbidity is conflicting. Most studies show an increase in stillbirths and perinatal mortality; however, there are a few studies that contradict this view.