Pregnancy After 40: The Real Risks, the Follow-Up and the Good News

The test is positive and you are 40, 41 or 43. After the joy, a little worry often follows, fed by family or the internet: "at your age, it's risky". A pregnancy after 40 does call for more attention. But there is nothing "abnormal" about it: most babies born to mothers aged 40 and over are perfectly healthy.

What changes is the likelihood of certain complications, and therefore the level of monitoring. Here are the real figures, without dramatising or downplaying them, what your follow-up will bring you, and the reasons to feel confident.

Pregnant at 40: what really changes?

The main change concerns the eggs. Their number and quality decline from the mid-thirties, the Mayo Clinic points out. This explains two things: it often takes longer to conceive, and chromosomal anomalies in the embryo become more common. Our article on fertility and age explains how this evolves.

The mother-to-be's body, for its part, has sometimes collected a little "baggage": slightly high blood pressure, excess weight, borderline blood sugar, fibroids. These are not contraindications, but things to know about from the start. In Morocco too, later pregnancies are among the reasons gynaecologists give for the rise in caesarean sections, alongside excess weight and gestational diabetes (opinion piece by an obstetrician-gynaecologist in TelQuel, August 2026).

The risks of pregnancy after 40, with figures

Here are the main ones, with the figures published by medical sources. Read them for what they are: probabilities, not predictions.

Two remarks to put these figures in perspective. First, most miscarriages happen in the first trimester, usually because of a chromosomal anomaly in the embryo: it is not your fault, nor the result of exertion or something you ate. Second, a risk of 1 in 50 also means that 49 babies out of 50 do not have Down syndrome.

Down syndrome screening: how does it work at 40?

Screening takes place in several stages, and each one is offered to you, never imposed.

1. First-trimester combined screening, between 10 and 14 weeks in the United Kingdom (NHS): a blood test and measurement of the nuchal translucency at the first-trimester scan. The result is expressed as a "chance of 1 in…": lower or higher.
2. The cell-free fetal DNA test (NIPT), a simple blood test from the mother, more accurate than combined screening. In the United Kingdom it is offered after a "higher chance" result; ask your gynaecologist whether they think it is worthwhile straight away in your case.
3. Diagnosis by amniocentesis or chorionic villus sampling, the only way to be certain. These procedures carry a slight risk of miscarriage (Mayo Clinic), which is why they are only offered when there is good reason.

In Morocco, ask your gynaecologist which tests they recommend, where to have them and how quickly, and check with your health insurer what is reimbursed: conditions vary from one insurer to another.

What follow-up to expect for a later pregnancy?

The follow-up is like that of any pregnant woman, with closer attention on a few points.

• A check-up from the start: blood pressure, blood sugar, heart function if needed, treatments to adjust. Vidal stresses the importance of this full assessment in early pregnancy.
• Blood pressure and urine checks at every appointment, to spot pre-eclampsia early.
• Screening for gestational diabetes, the timing of which depends on your risk factors. Our article on diabetes in pregnancy explains the test and diet.
• Sometimes more frequent scans to monitor the baby's growth and the placenta.
• A discussion about where and when to give birth in the third trimester, especially if a condition develops.

If you are expecting twins, the follow-up is even closer: see our feature on twin pregnancy.

The good news about pregnancy after 40

The Mayo Clinic sums it up in one sentence: after 35, many women have healthy pregnancies and healthy babies. Once past the first trimester, when miscarriages are concentrated, most late-pregnancy complications remain a minority and can be monitored.

Modern follow-up works in your favour. Gestational diabetes, once detected, is controlled through diet, activity and sometimes treatment. High blood pressure spotted early is monitored and treated. In other words, the extra vigilance is not a bad omen: it is what makes it possible to treat in time whatever needs treating.

What you can do starting today

• Take folic acid, ideally before conception and in early pregnancy, at the dose your doctor prescribes.
• Stop smoking and drinking alcohol, and ask for advice before taking any medicine or supplement (Mayo Clinic).
• Move every day, with your doctor's agreement: walking, swimming, prenatal yoga.
• Keep an eye on your weight gain with a goal set with your caregiver rather than "eating for two".
• Do not miss a single appointment, even when all is well.
• Rest on your side as your bump grows: a pregnancy pillow relieves the back and hips. Our guide to sleeping while pregnant shows the best positions, and the full range is in our pregnancy and nursing pillows section.

From the shop

For more comfortable rest during pregnancy

Your back and hips tire more quickly in the third trimester. A pregnancy pillow helps you settle on your side, then comes in handy for breastfeeding.

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Products sold by La Maison du Bébé, publisher of this magazine. Prices as of 12 October 2026; please check the product page.