Dr Kireki Omanwa is a fertility specialist and the President of the Kenya Obstetrical and Gynaecological Society. He is also a lecturer at the University of Nairobi. He speaks to Saturday Nation about what to consider before getting pregnant at over 40.
What are the potential risks and complications associated with pregnancy in childbirth for women aged 45 and above?
In extremes of ages, in the younger period let's say below 20 and those above 40, complications are more common, especially in pregnancy. In the lower extremes, the body is yet to mature so they may have problems with delivery. The older cohort will have challenges with high blood pressure and diabetes. Because of that, they may end up delivering prematurely. Other challenges include miscarriages but these two issues – high blood pressure and diabetes – are what we normally see.
When you do IVF, the chances of having twins, or triplets are elevated. This can also predispose them to problems such as postpartum haemorrhage when they deliver. As such, they must be given the utmost care.
Are there any specific medical tests or screenings that are recommended for women considering pregnancy at a later age?
Not really. We don't have any specific screen tests for older women. However, we like to look at their sugar levels right at the beginning – blood and weight levels – because sometimes all these things contribute to the outcomes. When pregnant, we have to monitor them a lot more than if they were in their 20s as they are high risk.
What advice do you give to women in their mid-40s who are considering pregnancy in terms of preconception health and lifestyle adjustments?
The first thing is that they have to take care of themselves by eating nutritious meals. Also, they need to be mentally and psychologically prepared. Pregnancy is “trauma” in the sense that it will change the wellbeing of the patient. When the baby comes, they take over the woman's body. Sometimes if you have taken long trying to have a baby and then the changes come, you may be a bit disconcerted. I, however, remind my patients that it is for a short time and that their lives will change forever once they have babies. However, many that I encounter are okay with the small discomfort.
What are the most common misconceptions or myths about pregnancy and childbirth among Kenyan women, and how do you as a fertility expert and a gynaecologist, educate them about these realities?
Many assume that motherhood is smooth sailing because of how it is depicted in the media. It is not and requires a lot of hard work and mental fortitude. But on the positive side, you find that older women are more mature and better prepared to take in all these things in their strides. I have noticed that they end up adjusting very easily.
