- Sep 21, 2023
More and more women are choosing to start having children later in life. If you are aged 35 or older, you will fall into the “Advanced Maternal Age” category. In Ireland, for example, the number of first-time mothers over the age of 35 has nearly doubled in recent years.
There are pros and cons to every type of labour that mothers experience and a majority of these variables are either down to underlying medical reasons or age.
And to quote our kids… “But why?!”
As women get older and closer to their menopausal years, there is an increased chance of experiencing risks during pregnancy and childbirth, which therefore results in a higher chance of babies being delivered by elective or planned c-sections.
What are the risks for older mums having c-sections
The term “c-section” is so commonly used today that people almost forget it’s major surgery. Having a caesarean comes with its risks but some of these are heightened for women in the advanced maternal age bracket. Your doctor or midwife will discuss these with you and recommend the best course of action for your pregnancy and labour, in your and your baby’s best interests. You may also find that your aftercare is more closely monitored if you experience any sign of complications.
Increased risk of gestational diabetes
This type of diabetes is only present in pregnant women. If left untreated, your baby may grow larger than average which increases the risk of injuries for the mother during delivery. It also heightens the chances of your baby being born prematurely or other complications for your newborn after birth.
This can be managed through diet and exercise, and sometimes medication is prescribed too.
Increased risk of high blood pressure
Pregnant women with high blood pressure will be closely monitored alongside your baby’s development as they grow. There is also a chance that your baby will be born sooner than your due date because of the implications high-blood pressure can have on the mother and baby’s health.
The placenta plays a huge role in a woman’s pregnancy. The placenta attaches itself to the uterine wall and “feeds” essential nutrients and oxygen to your baby for their growth and development. Risks such as pre-eclampsia, placental abruption, low-lying placenta, or placenta praevia put your and your baby’s health in jeopardy, meaning swift action and close monitoring from your doctor and midwife.
Chromosomal conditions and genetic disorders in pregnancy
As you get older there is a higher chance of your baby having chromosomal conditions or genetic disorders, such as Down Syndrome. This is because your eggs degenerate as you get older and have a higher chance of carrying a chromosomal abnormality.
Multiple births; twins, triplets or even more!
As your body gets older, it starts to release more eggs with each menstrual cycle as it prepares for menopause, resulting in multiple babies being carried. Women choosing to start a family later in life may also undergo fertility treatments such as IVF which can also result in multiple births.
Due to these risks in expecting older mums, the chance of having a c-section delivery is increased. Having a c-section doesn’t completely rule out vaginal births in future pregnancies but your doctor will advise you on the safest options available to you based on your physical health and how your delivery went in previous pregnancies.
Timeline of c-section recovery
Planned or not, caesarean births require a minimum of 6 weeks to recover from. And when we say recovery, we mean that at 6 weeks you might be able to hold your baby and the carrier at the same time. It’s super important that you allow your body to heal in its own time and only do certain activities when it is safe to do so (and your doctor has signed off on these).
As keen as you are to hit the gym and go to that HIIT class, exercise should be gentle in the beginning. Exercises such as yoga and pilates are popular with new mums because they involve simple stretches that get your body moving in a safe, controlled way. You can also do these classes with your baby when your body is strong enough to take the baby’s weight.
First few days
After the operation, you will most likely stay in the hospital with your newborn for a few days so that your midwife can carry out further check-ups and support you with caring for your newborn.
You may be encouraged to walk slowly 12 hours after your surgery, which will feel uncomfortable, but it will do you more good than harm. When you start to move your body recognises this and starts to get things back in motion such as movement in your bowels, releasing gas that’s built up in your body from the surgery and lowering the risk of producing blood clots in your legs.
Choosing to wear a postpartum support band for c-section recovery will help you a lot, especially in the early days when you’re feeling sore and can’t lift much. There are a number of benefits to wearing a support band post-surgery. Felicity tried Lola&Lykke’s Core Restore Postpartum Support Band and said “It’s going to be 9 weeks post c section tomorrow and this time around I feel much stronger quicker and feel as if my recovery has been quicker too! Having my core supported by this band has really helped. It keeps my posture straight and supports the core muscles so they can heal!”
Lola&Lykke’s Core Restore Postpartum Support Band
If you have already made it home from the hospital, you’ll be visited by a Health Visitor in your home to check in and see how you’re getting on.
6-week newborn health check
Can I just say, this appointment is as much for you as it is for your baby. Your baby will be weighed, measured, and checked over (particularly assessing the movement in their joints) and you may be asked about how they’re getting on with feeding, sleeping, etc.
In this appointment, your doctor will check your incision to see that it is healing well. They may also check your abdomen to see if the muscles have returned to their normal position or if there are signs of Diastasis Recti (muscle separation). If all is well, your doctor will confirm that you are able to partake in light exercise again, drive, and other activities that were all on hold post-op! Just remember that 6 weeks isn’t a long time, and your body needs you to take it easy so it can heal efficiently.
6-12 months postpartum after c-section
It is recommended that you do not try to conceive another baby before 6 months of having a c-section. Doing so will put you at risk of uterine rupture and further complications in your pregnancy and postpartum recovery. The recommended timeframe to conceive is between 6-15 months, or to leave at least 15 months in between births.
Your incision at this point should be healed although you will see that a scar will form where the incision was made. Some women say they experience a tugging feeling or some pain which is caused by the scar tissue attaching itself to organs in that area. Some women also have numb areas of their tummy long after the c-section. If you have any concerns, discuss these with your doctor so they can signpost you to the correct care.
Learn more and read our e-guide: C-Section Recovery
Breastfeeding after a c-section
Compared to giving birth vaginally, your milk may take a bit longer to come in if you have had a c-section. Your baby will continue to drink colostrum from you until it transitions into mature milk (roughly 10-15 days after birth). Having a wireless breast pump in the hospital for those early days will really help you to establish your milk supply, especially if your baby is having difficulties with breastfeeding.
Ask your midwife to help you try a few different feeding positions so that you can nurse your baby comfortably. You may want to use a nursing pillow to support the weight of the baby so you’re not taking on their weight in your arms.
We touch on this more in another blog post: Breastfeeding After a C-section
Real mum story recovering from a c-section
I talked to Karen, a teacher and mum of one, who shared her experience of recovering from a caesarean just six years ago when she gave birth to her son, 15 days before he was due.
How old were you when you fell pregnant?
On this occasion, I was 43 and had D (my only child) at 44. This was my 9th pregnancy after multiple rounds of IVF that all resulted in pregnancies.
Wow, that sounds intense. Can you tell us more about your pregnancy with D?
Every step from the initial IVF was a complication. I probably averaged one or two hospital visits each week of the pregnancy but some weeks were every day and some were A&E in the middle of the night. Every test ended in more tests and every test came out as what was regarded as the worst result. I saw multiple consultants, doctors, nurses and midwives in the hospital and at times had to visit the private hospital that neighboured my hospital to carry out more extensive tests and as a means of gaining results quicker.
Did you naturally fall into labour, which then resulted in an emergency c-section or was it an elected c-section?
Towards the end of the pregnancy, more issues were being dealt with (size of my baby, heart defects, possible downs, stillbirth... the list was endless). An unknown midwife stepped in and read my notes, consulted the top consultant and between them booked a bed and told me to come in immediately and they would get my baby out while alive. That midwife (despite working in Chelsea) turned out to live by where I work in Buckinghamshire and receives a gift from D every year on his birthday. She saved my baby and gave him and us life.
What support did you get from medical professionals throughout your pregnancy and after-care?
I started off in a private unit for IVF and then went into the NHS system when pregnant. I had more appointments, tests, and visits than I could count or keep track of. My only complaint was that in the NHS system, I didn’t ever have one consistent person as mine. I felt jealous of others who had a midwife. I had to retell the whole backstory every time I visited and that was extremely draining as it had been incredibly traumatic getting to the point where I might actually get to meet my baby. I did end up with many more scan photos than others though.
Did you feel prepared for a c-section prior to labour?
Yes and no. I am better off not knowing as I hate anything medical and am needle-phobic (nuts if you know what IVF entails). Having said this, the journey to actually having a baby involved so many full sharps boxes, tests, operations and so on, that I was incredibly familiar with the hospital and this helped tremendously. There had to be an upside!
What can you tell us about your recovery? How did the procedure affect you then and now?
The c-section was the easiest part of my whole journey. I was terrified as we didn’t know what our end result was going to be. The anaesthetist was great and did a dummy test on my arm and then proved how little I would feel as I was shaking and nearly passing out with fear. I lost huge amounts of blood and my baby needed multiple tests and an extended stay in hospital-twice. But, my baby was alive and didn’t have any of the major concerns that were on the radar (a list hadn’t been written as I was told it was too long and probably over 3 maybe 4 figures in length). There was no space in the ward and I was told I’d have to wait in a corridor. At this point, my baby was in my arms, and I remember saying they could wheel me into the carpark it really didn’t matter!
Afterwards, due to my baby’s health problems, I was only able to breastfeed a little and this upset me, so I tried to express for months until it became pointless. Being completely besotted with my baby I never left his side in the hospital which didn’t aid my recovery as other mums having had c-sections were walking around which I learnt after was the best way to recover.
Six years later I still have some areas of no feeling but am gradually getting a stronger core. Unfortunately, I have an issue with a muscle under my rib cage which prevents me from doing some exercises and movements. I grew up as a club swimmer and I am still working on getting this back to my best as a means of strengthening and conditioning. As an older mum, this takes longer I feel.
What advice would you give to other expecting mums having experienced a c-section?
Don’t worry like I did. The end result is worth it all.
We’re here for you mama
Regardless of your age, you can still have a healthy pregnancy, labour, and newborn baby. Yes, there are risks as you get older but at least these are now calculated risks knowing more about c-section recovery and what the postpartum period may look like for you. As always, we are here to support you every step of the way mama. Drop us a message if you have any questions and we would be more than happy to help.
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