Over 35 and Pregnant

Mature Mamas I was a bit miffed that so much fear was woven into pregnancy for women over 35 years old. The terms that the medical system uses for pregnant women 35 and over include geriatric pregnancy and advanced maternal age. Really? You can’t come up with a term slightly less insulting? I propose we swap the old terms for something more empowering like mature mama. After graduating from naturopathic school, I embarked on a 10-year health pilgrimage, which involved healing my digestion, balancing my hormones, replacing nutrient deficiencies, and detoxifying my body of toxic metals, including mercury and lead. I was 39 when I got pregnant, but I was more balanced than I was in my 20s, more nutritionally fit, and much more health conscious. Women who get pregnant in their 20s have had less time on planet Earth, which equates to less toxins that build up in their bodies and less time for any nutrient deficiencies to really take hold. Women over 35 have had more time for toxins and nutritional deficiencies to build up. I encourage older women to begin a naturopathic lifestyle at least one year before trying to get pregnant. This helps with ovulation, and it increases the ease of conception. It also helps correct nutritional deficiencies, creates healthy eggs, and removes toxins, which improves your health and the health of your baby. Because it takes 120 days for a mature egg to form, it’s best to have good nutrition and supplementation for at least four to six months before conception. I was taking progesterone for about one year before we started trying to conceive. I started taking progesterone at night between days 14 and 28 of each cycle to regulate my cycles, increase ovulation, minimize PMS, and ensure that if an egg was fertilized it would indeed stick. Progesterone deficiency is one of the main causes of miscarriage, especially in mature mammas. (See “Quick Tip: Progesterone.”) Quick Tip: Progesterone Progesterone is a natural hormone made by the ovaries. It’s secreted after the estrogen surge that causes the release of an egg and rises starting on day 14 of the menstrual cycle. Counting always begins on the first day of menstrual flow on day 1. Progesterone peaks between days 19 and 21 and drops on day 28, triggering the body to release the endometrial lining and begin a new menstrual cycle. In pregnancy, progesterone holds the uterine lining in place so the egg can securely implant. A progesterone deficiency will cause the lining to release from the wall of the uterus and result in a miscarriage. If you live on planet Earth, you’re under stress. Stress has a way of stealing your progesterone and leaving you deficient. This is called the “progesterone steal” as it is quickly converted into cortisol, a stress hormone. Unfortunately, progesterone does not come from the environment; only the ovaries make it. Generally, the more stress you’re under, the less progesterone you have. A progesterone deficiency can interfere with fertility, menstrual cycles, sleep, moods, and PMS, and it can contribute to miscarriage. I commonly see progesterone deficiencies in women over 35 years old. This is referred to as a luteal phase defect. Because progesterone is so easily converted into stress hormone, it’s one of the first female hormones to decline with age. This affects the menstrual cycle, interfering with fertility. If you’re trying to get pregnant or before you even start trying, your progesterone level should be tested. The best way to test progesterone is via saliva or blood during days 19 and 21 of the menstrual cycle. If you’re found to be deficient and you exhibit symptoms of a progesterone deficiency, a natural bio-identical progesterone should be prescribed from a compounding pharmacy. Progesterone can be dosed in capsules, sublingually under the tongue, or in cream. It should always be prescribed during the second part of the menstrual cycle. Because it can make you drowsy, it should be applied at night before bed. Once a woman becomes pregnant, if I know that she was deficient or that she has had a miscarriage in the past, I recommend that she continue it throughout the entire first trimester. Miscarriages frequently occur in the first trimester, and progesterone deficiency can be the cause. There’s some confusion about progesterone. Here’s what you need to know about it. Natural progesterone is not the same as synthetic progestin. Progestin is a synthetic analogue of the real hormone progesterone and does not act the same way in the body. In order to acquire natural progesterone, you will need to contact a doctor who specializes in natural and integrative medicine, who will test your levels and prescribe it for you from a compounding pharmacy. In the book Birthing from Within: An extraordinary guide to childbirth preparation, the author wrote, “It is not the job of the doctor or midwife to show the woman how to give birth. It is their job is to remind her of what she already knows.” The laws of nature are already in place. When the egg and sperm meet, the mechanisms kick in, and the body does what it knows how to do. The woman needs to be reminded, with gentle coaching, support, and love. Women who step on a path to motherhood later in life need the combination of conventional and holistic suggestions to healthfully move through their pregnancy with ease and without fear. This provides a balanced setting for both mother and baby and ensures better outcomes. Throughout this book, you’ll see that I underwent care with both a licensed naturopathic midwife and a conventional medical ob/gyn. I wanted to compare and contrast the differences in care and also make sure I wasn’t missing out on information that would be vital to my baby or me. It was a good thing I was taking vitamins and supplementing for all those months prior to conception because by week 7, my entire world as I knew it for 39 years came crumbling down.