The Royal College of Midwives State of Maternity Services Report 2013, out this week, shows an increase in the number of older and obese mothers and a baby boom in 2012. Dr Tracey Mills, from The University of Manchester's School of Nursing, has provided the following reaction to the findings.
Dr Mills said: "The numbers of women having babies later in life has increased dramatically in the last 10 to 20 years and the number of women over the age of 40 having a baby has almost trebled.
"The problem is that birth at advanced maternal age is associated with higher rate of still birth and major pregnancy complications such as hypertension.
"What we don't really know for definite is whether this is due to age itself and the aging reproductive system or whether it is also that as women get older they are more likely to have co-existing medical conditions such as diabetes, obesity or other chronic diseases.
"Older women have more time to develop poor health and are more likely to have co –existing health problems.
"When a woman is having a baby in her 40s there is often a feeling represented in the media or among women that if she is slim, healthy and exercises then she'll be fine but the studies which have been done suggest that this might not be the case because body system, blood vessels, heart, joints and so on have all still aged."
Midwifery training has changed to reflect these changes, Dr Mills added. "The demographic of women using maternity services has changed and so when we train midwives we are now making them more aware of the impact of age on pregnancy outcomes both in terms of things to look out for and for the women to look out for themselves.
"Here at The University of Manchester, we've increased our emphasis on public health issues such as advanced maternal age and obesity in pregnancy to respond to the changes we are witnessing. When I trained as a midwife 20 years ago you didn't really have to think about obesity in pregnancy but now it is seen more often. We do sessions about recognising the risk factors and the additional risk factors for women over 35. However when women come to midwives they've got over one of the major risks of aging and pregnancy which is infertility just by getting pregnant. I think it is important to make people aware of the risks associated with pregnancy later in life as not managing to get pregnant can result in psychological health issues too."
The increase in the number of births in the UK needed to be addressed generally in the health system, she added.
"The rise in births places additional pressures on the system when midwives are trying to offer improved services and have more technology around to use. There are lots of demands on the system including the increasing diversity of the ethnic and cultural population which services have to respond to on the frontline. We have an aging midwife population with many coming up for retirement and it is about having enough to replace those who leave."