A million-in-one pregnancy for the “Million Dollar Baby” star?
Oscar-winning actress Hilary Swank recently announced she’s expecting her third child in December, putting a spotlight on pregnancy later in life and the possibility of conceiving during the transition to menopause.
At 52, Swank is among a growing number of women embracing motherhood in their 50s. But just how likely is pregnancy during perimenopause, and what are the potential health risks?
An expert weighs in on the realities of getting pregnant as menopause approaches, including what women should know about fertility, complications and their chances of conceiving.
Actress Hilary Swank recently announced she’s pregnant at 52 — around the age when most women reach menopause.
The average age of menopause in the US is between 51 and 52, while perimenopause, the transitional phase leading up to menopause, typically begins in a woman’s 40s.
Already a mother to 3-year-old twins, Swank joins other women who have experienced pregnancy later in life, when the chances of conceiving naturally decline dramatically.
In 2017, just 840 births were recorded among women ages 50 and older in the US, with a birth rate of 0.8 per 1,000 women between 50 and 54, according to the National Center for Health Statistics.
Still, getting pregnant during the menopause transition isn’t impossible, whether through natural conception or assisted reproductive technologies such as in vitro fertilization (IVF).
However, pregnancy at an advanced maternal age comes with additional challenges and health risks, according to Dr. Natasha Spencer, an obstetrician-gynecologist at Orlando Health Physician Associates.
“If a woman is experiencing ovulation/cycling, although irregularly and/or sporadic, it is always possible to achieve pregnancy naturally — however, with a lower probability,” Spencer told The Post.
“Moreover, older women experience an increased rate of early pregnancy loss, both trisomic and euploid, primarily due to a decline in egg quality.”
While women can still get pregnant during perimenopause, the odds of conceiving naturally are slim, and pregnancy later in life carries increased health risks.
Spencer explained that age-related changes in uterine function and hormone levels can also contribute to pregnancy loss, with many miscarriages occurring between six and 14 weeks of gestation.
Assisted reproductive technologies, including IVF, can offer older women additional pathways to pregnancy, although success is far from guaranteed.
Several factors can influence IVF success rates, including “female age, type of infertility diagnosis and past reproductive-obstetric history,” Spencer said.
Fertility treatments such as in vitro fertilization (IVF) may improve the chances of pregnancy for women going through perimenopause.
Although pregnancy complications can affect women of any age, the risks tend to increase with advancing maternal age, particularly when other health factors are involved.
Carrying twins or other multiples, having a history of complicated pregnancies, and living with conditions such as diabetes or high blood pressure can further increase the likelihood of complications.
These risks can affect both the mother and her baby.
Older expectant mothers face a greater risk of miscarriage, ectopic pregnancy, placenta previa — a condition in which the placenta covers the cervical opening — prolonged labor, and severe maternal complications, including maternal mortality.
“Some fetal/neonatal risks include chromosomal and gene abnormalities, congenital malformations, low birth weight and preterm births and perinatal mortality,” Spencer added.
Once a woman reaches menopause, defined as 12 consecutive months without a menstrual period, natural conception is no longer possible because ovulation has ceased. Menopause may also be accompanied by symptoms such as hot flashes and night sweats.
However, women who have reached menopause may still be able to carry a pregnancy using assisted reproductive technologies.
Spencer explained that pregnancy may remain possible “through assisted reproductive technologies via egg donors or embryos created by them earlier in life.”
Despite the increased medical risks, becoming a mother later in life may also come with certain advantages.
“Most women of advanced age will ultimately have good pregnancy outcomes and are able to cope with the physical and emotional stresses of pregnancy and parenting better,” Spencer explained.
“Increasing maternal age may also be associated with improved health and development for young children.”
