Lidia Yudina, AIF: Leyla Vladimirovna, there has not been a significant increase in the birth rate yet. Is demography a social or medical problem?

Leila Adamyan: When a woman decides to give birth, she focuses on the situation in her family and in her country. Therefore, demography is primarily a social problem, since it depends on the material condition, lifestyle, working conditions, plans for the future. However, we have a growing number of infertile couples, so the medical contribution to the demographic problem is very high. A separate story is maternal, perinatal and infant mortality. These are the main indicators by which healthcare is evaluated in all countries of the world. In our country, the birth rate has increased, while the level of infant and maternal mortality has decreased. Creation of a network of perinatal centers, where mother and baby can be provided with any type of medical care, is the most ambitious project that has been implemented in healthcare in recent years.

Childbirth is stressful

- 32 perinatal centers throughout the country - not too many, considering how many rural maternity hospitals are closed.

I am against the closing of small maternity hospitals, where there are medical personnel and appropriate equipment. But as an obstetrician-gynecologist with 45 years of experience, I know how many complications can occur during childbirth, and therefore I think that a pregnant woman after an examination should receive a referral to that maternity hospital or perinatal center where she can receive adequate medical care.

- More and more women in labor can be classified as old-bearing ...

Previously, this was the name of 30-year-old women in labor. Now in Russia, as well as throughout the world, they often give birth closer to 40 years. The term "old-timer" is in the past, but the problem has not gone away. Reproductive tasks need to be solved on time. By the age of 40, women accumulate diseases (cardiovascular, gynecological), which make an undesirable contribution during pregnancy and childbirth.

Pregnancy and childbirth - stress for the body, even in young age, and at mature women chronic diseases can worsen and new diseases often occur. It is not childbirth that rejuvenates, but the joy of having a child. However, doctors, regardless of age, support a woman who plans to give birth. Especially when it comes to first births. After all, pregnancy and childbirth for women serve as an inoculation against all diseases. It has been proven that, for example, breastfeeding is of great importance not only for the baby (providing strong immunity to infections and adaptation to the external environment), but also for the mother, since (this has been proven by science and practice) it serves as a prevention of breast diseases.

Freeze and give birth

Recently there was information that all women in labor in our country will undergo mandatory genetic testing.

I am of two minds about this. Examinations can be included in the order of medical care only after there is confidence in their reliability.

- What age do doctors consider critical for pregnancy?

38 years is considered a critical age for IVF planning. At this time, the woman looks great and feels good, but examinations already show the depletion of the supply of follicles and ovarian tissue.

However, one must not forget about individual features organism. The difference between passport and biological age can be quite significant. There are women who become pregnant on their own at the age of 50, and there are those who are forced to resort to the IVF procedure much earlier. A woman can accurately find out her reproductive milestone by undergoing an examination (analysis for the level of sex hormones, ultrasound to determine the ovarian reserve of the ovaries and a blood test for anti-Mullerian hormone).

- Can doctors today help a woman prolong her reproductive age?

Today, a woman can give birth at any age. Firstly, IVF efficiency is 30-35% (which corresponds to the probability of natural pregnancy) and is growing from year to year. Secondly, every woman who does not plan a pregnancy in the coming years has the opportunity to resort to cryopreservation - to freeze her eggs, ovarian tissue or embryos in order to use them in the future. This procedure is recommended for women with cancer before starting treatment, as well as for those who, for objective reasons, do not plan pregnancy in the foreseeable future. In our country, there are already children born after cryopreservation.

Which of the stars became a mother after 40 years

46 years old: Ilze Liepa. She gave birth to a daughter at the age of 46 and after 3 months she returned to the stage.

Ballerina Ilze Liepa with her daughter Nadezhda at her benefit performance at the New Stage of the Bolshoi Theater in Moscow. Photo: RIA Novosti / Ramil Sitdikov

44 years old: Olga Kabo. She gave birth to her second child - a son - at the age of 44.

Olga Kabo. Photo: www.globallookpress.com

42 years old: Olga Drozdova. She gave birth to a son at 42. She and Dmitry Pevtsov tried to give birth to a child of 15 years of marriage.

People's Artist of the Russian Federation Dmitry Pevtsov, his wife, People's Artist of Russia Olga Drozdova and son Yaroslav at the 90th anniversary evening of the Moscow State Lenkom Theater. A photo.

The ideal age for the birth of the first child - what is it, what does it depend on and what causes it? A hundred years ago (not such a long gap in history), a woman giving birth to her first child at 25 was a rare occurrence. By this age, the mother of the family managed to give birth to at least two children, because they got married earlier - after 20, the chances of a happy marriage fell rapidly.

Today it is impossible to say that it is too late to give birth after 25. Moreover, statistics show that in Russia and the countries of the former Soviet Union the first childbirth on average began at the age of 25-26 years. It turns out that women began to become pregnant after receiving a profession and the first years of fixing in the workplace.

Favorable period: at what age is it better to give birth

It is impossible to give a monosyllabic answer here, since in addition to physiology, social factors should be taken into account. Many modern women decide to get pregnant only after they have received an education, have their own housing, in a word, some social guarantees, as they say, in your pocket. At the same time, the Western way of thinking has not yet been adopted: they are increasingly trying to give birth after 30 and later, when not only the material and career issues have been settled, but also the experience of traveling, the so-called “life for oneself” is also behind them.

Based on physiology, the reproductive period of a woman can be conditionally divided into several sub-periods. All of them are suitable for the birth of a child - reproductive functions work, a woman is physically able to conceive and give birth.

Periods of age of motherhood:

• 17-20 years old;
• 20 to 30 years;
• 30 to 40 years;
• 40 years and above.

There are no universal tips here. For some, the natural development of events will be earlier motherhood, when a very young girl decides to become a mother. Without education, perhaps without a stable material base, nevertheless, a woman easily decides to have a child. And a certain percentage of such cases are very successful - at a young age, the body quickly recovers, does not react so sharply to lack of sleep, a young mother manages to do a lot and is optimistic about the future.

But to say that this is the most favorable period for the birth of a child is definitely impossible. physical health may be slightly ahead of the psychological viability, the so-called conscious parenthood. At this age, not all girls understand that having a child is in full readiness for parenthood - understanding the aspects of upbringing, caring for a baby, round-the-clock responsibility.

What is the best age to have a first child?

Gynecologists themselves believe that the second period of a woman's reproductive age (the one from 20 to 30) is the most suitable. Approximately at 25-26 years old, there is a peak of physiological and psychological readiness for the birth of a child. The organism is still young, but no longer growing, only preparing for childbearing.

What is the favorable age of 25-27 years;

• The woman does not yet have chronic diseases complicating pregnancy;
• Gynecological health is also normal at this age (on average);
• This is a good age for conception, as there are still several healthy years left in terms of health for subsequent pregnancies.

It must be understood that this age is considered optimal and because it is easier to conceive a child in these years. The ovaries work at full capacity, but after 30 their functions will slowly begin to fade. So, today, in many women, by the age of 35, the ovaries age prematurely, the supply of eggs dries up (they are laid even before the birth of a girl), and there may be problems with conception.

Suitable age for having a second child

In this case, the factor of recovery of the mother's body after the first birth is also taken into account. It is desirable that at least two years pass between births. In this case, there are more chances for a successful pregnancy, and it will be easier for the mother herself to bear the child when the first one has grown a little.

An interval of 3-4 years is considered the optimal internatal period. If the first birth occurred in the period of 25-27 years, and the second - in 28-32 years, both psychologically and physiologically the woman falls into the conditional norm. This, of course, is nothing more than averaged data - scientists simply calculated in which cases women recovered faster, when the second birth was easier, etc.

In addition, when the second child is born 3-5 years after the first:

• The uterus still "remembers" the first birth process, the birth canal is most ready for new births, which makes them shorter and easier;
• It is not so difficult for a woman to psychologically pause in her career, two maternity leave in a row, many endure easier than a new parental leave after another career breakthrough.

Well, the birth of a third child, if you really want to meet the norm, should not be postponed until the age of 35. The main thing is that women clearly assess their opportunities, risks, understand how much strength is needed for subsequent pregnancy and raising another baby. It is more correct to find out the recommended age not in generalized medical advice, but from your gynecologist and therapist.

The "ceiling" of motherhood: until what age can you give birth

Everyone knows that in Europe and the United States, the bar for female reproductive age is only rising. Thanks to the latest technologies there are more and more women in childbirth, and when a woman has children after 45, no one faints with surprise. If the hormonal background is able to support pregnancy, the woman is healthy, how old she is - a secondary question.

But risks are risks. Therefore, you need to firmly assess your condition - to be examined more often, to understand that not everything can work out the first time. There is a threat of the birth of a child with genetic pathologies, but today it can be detected at a time suitable for terminating a pregnancy. This is not the greatest consolation, but both a woman and a man of age who decide to get pregnant should think sensibly and anticipate possible scenarios.

To have a healthy baby, older pregnant women need:

• Get registered on time and go through a complete list of examinations, it will be longer than the list of younger expectant mothers;
• Be sure to consult a geneticist;
• Even before pregnancy, resolve issues of chronic diseases as much as possible;
• Visit a psychologist, if the expectant mother herself is restless on the eve of an important upcoming event, she wants to talk to someone.

How many children to have in total, when to give birth to them is a purely personal question. These days, a woman is given more opportunities for motherhood, the deadline is increasing, it is considered the norm to give birth after 40. The deadline, average age are increasingly conditional.

The normal age for pregnancy is when you consciously, taking into account your psychological, physiological and material readiness, decided to become a mother. Ideally, with full agreement on this issue with her husband. And you need to think about it not for a couple of weeks, but to come consciously.

Every woman has her own biological clock - everything is individual here. You need to look after your women's health. Until the age of 30, it is worth visiting a gynecologist once a year in the absence of complaints. After 30 years - 2 times a year.

Active death of eggs begins at 37-38 years. Therefore, it is better to give birth to the first child before this age. Of course, you can give birth at the age of 18, but this is a rarely considered and desired pregnancy.

Pregnancy should be planned in order to avoid risks and threats.

Before conception, you should check your health, and if necessary, heal. Visit a gynecologist, dentist, get rid of bad habits and monitor proper nutrition, exclude fast food.

Dr. Komarovsky believes that if the parents do not have health problems, it is worth planning a conception for January-February in order to give birth in the fall. This will help organize the hardening of the child before the winter months.

If health is not very strong, then it is worth trying to conceive in the fall, when there is a sufficient amount of vegetables and fruits in the diet, and the body has rested after the summer months.

WHAT THE STATISTICS SAY

And here is how the age of the mother has changed at the birth of the first child in the world

Mean age of mother at first birth, OECD countries, 1995 and 2014

WHEN AND WITH WHAT DIFFERENCE IS IT BETTER TO HAVE A SECOND AND THIRD CHILD

The second and third child is usually already planned. Therefore, you can guess the age difference between children.

The difference of 6-7 years also has its advantages. The older child already goes to school, and it is easier for the mother to take care of the younger one in his absence.

It is worth remembering that the greater the age difference between children, the less common interests and they will have points of contact.

late birth in modern world become the norm, and age is no longer a hindrance.

The female body retains childbearing function up to 45-50 years. Therefore, the second and third child can be safely given birth during this period.

The level of medicine and life has grown. Women who take care of their health, lead an active lifestyle and eat right, and at 40 and 50 years old can bear and give birth to a healthy child without any problems.

Western doctors believe that a woman pregnant at the age of 40-50 can be compared with a young girl in terms of health, since pregnancy and childbirth have a healing effect on the body.

The risk of stroke, cholesterol is reduced, menopause occurs later, and menopause is easy.

The rector of the Institute of Perinatal Psychology, Galina Filippova, believes that childbirth at a mature age gives parents an extra 15 years of life, prolonging their psychological youth. They acquire a goal - to raise and put on their feet their newborn child.

Scientists from the UK write that children born after 40 are easier to adapt to the world around them and smarter than their peers. The reason for this is that after 40 parents are more calm and balanced, not impulsive and more attentive to children.

Every girl has enough questions related to the first pregnancy. And one of the very first is, of course, at what age it is better to have children. Of course, often only a few are able to plan their future up to the year in which they should conceive and give birth to a child - we all depend on external circumstances.

Someone has been ready for a long time, but so far there is no loved one nearby. Someone has a person and a mutual desire - but it does not work out due to reasons beyond their control. Anything happens. But still, it’s better to know until what age you can give birth, because in fact, not everything is as scary as you can hear from our grandmothers.

At what age to have children

The 21st century is famous for its information availability on almost any issue - this is its strength, however, this is also its weakness. If our mothers or grandmothers were content with indisputable information passed on to them from previous generations, then today any question has many answers. Because each modern woman must have a head on their shoulders, be able to filter out informational garbage and draw the right conclusion for themselves.

By and large, a woman can give birth during the period of her life when she has her period - from about 12 to 50 years. In practice, of course, the average age of those giving birth ranges from 20 to 35 years, and it is this period that can be called the most favorable for the birth of the first child.

The fact is that in order to determine the optimal age, it is not enough to be content with only physiological factors - a significant role is played by the psychological stability and readiness for global changes of the spouses, and women in the first place. And this is an individual factor. Many girls are ready to start a family and raise children from the age of 20, but many are also not ready by the age of 30.

At what age to give birth to children: up to 20 years

As a rule, at such a young age, pregnancy occurs unplanned, and in such unpreparedness there is a danger of change for a girl’s body, which is not strong enough. Thanks, however, to the same information accessibility and high-quality contraceptives, such young women in labor in enlightened countries are almost never found, but there are exceptions to every rule.

Such an early pregnancy can be called dangerous for many reasons:

1. Forming, not yet well-established hormonal background.
2. Insufficiently mature nervous system.
3. Too active metabolism.
4. In general, the unfinished formation of the body.

In other words, the body is formally ready for the onset of pregnancy, but it is still too unstable, less and less significant changes are constantly taking place, and pregnancy is another colossal change that changes the hormonal background and carries serious burdens on the not fully formed girl's body.

Psychological maturity before the age of 20 still, as a rule, does not occur. Nowadays, many girls at this age are still dependent on their parents both morally and financially, they are in the midst of studies, friends, and entertainment. After all, children are for life. But to give birth to them, say, at the age of 18, means to exchange your irretrievable student youth for diapers and undershirts. It’s good if grandparents are ready to provide all possible assistance, or the girl married a wealthy man, but such cases, as a rule, are still exceptions.

Those who give birth at a young age, however, have a number of advantages. Of course it is minimum difference at the age with your child - to be young beautiful mom everyone wants. But it's not even just that - in such a relationship between a mother and a child, there can be more trust and understanding, if you want it.

Then, it is no secret that for the most part we do not live in the most ideal environmental conditions, and early pregnancy minimizes the factors of the negative impact of the external environment on both the health of the mother and the health and development of her unborn baby. It is one thing to inhale polluted air for 18 years, another for 40; And from this point of view - the earlier to become pregnant, the better.

One can single out such a plus - as they say, “shoot back”, now you can live for your own pleasure. Build a career without taking maternity leave, travel, enjoy life while others are just starting to wash diapers. But still the key to a happy ending is so early pregnancy- this is planning, a conscious decision of both spouses, external assistance, then such a family has every chance to live a long and happy life.

At what age to give birth to children: 20 - 30 years

Here we should highlight another threshold - 25 years. You can hear that after this age a woman is called old-bearing. But the good news is that this is no longer relevant for our generation. And the reason for this: improving the quality of life, qualified medical care and nutrition. Yes, the ideal is still far away, but compared to how we lived and what we ate just 100 years ago, our country has moved far ahead: as a result, we got more good health and an increase in average life expectancy. That is why our grandmothers gave birth for about 20 years - as long as there is health, it was necessary. But for our generation, by and large, this does not apply.

Of course, if a girl has a number of permanent bad habits, she does not take care of her health, does not make annual medical examinations, then even with a high quality of life she may have a number of problems with conceiving and bearing a baby at any age.

In general, 20-30 years is an ideal period for the conception of a new life in terms of both physiology and psychology. The body is already fully formed, age-related sores will not soon make themselves felt - so it’s better to get pregnant now. Most women under 30 are already psychologically set up to start a family, and if not, then the next threshold is not as scary as it seems.

At what age to give birth to children: 30 - 40 years

Pregnancy after 30 years is no surprise to anyone, although our grandmothers and great-grandmothers would probably be shocked. It is difficult to say where the trend for pregnancy at this age came from, however, it is still gaining momentum. Today, women, along with men, are building a career in a variety of fields, and going on maternity leave means an undesirable pause in business and let competitors go ahead. Yes, such is the share of a woman - despite full equality, giving birth and raising children is still their lot. And every year it becomes more and more difficult to break out of the usual rhythm of life.

Still, it should be borne in mind that if there is an opportunity, it is better not to pull up to 40 years, at least up to 35. If there is no opportunity (at least there is no one nearby), then this is not a reason to become depressed. Fortunately, medicine has stepped far forward, all that is needed is to plan a pregnancy in advance and regularly visit a doctor and take the necessary tests on time.

There are several reasons why you should not delay pregnancy for too long:

1. In the period of maturity, there may be problems with conceiving and bearing a baby.
2. Previously unseen chronic diseases with all the ensuing consequences may appear.
3. The risk of developing congenital pathologies in the crumbs increases.
4. The risk of complications of the birth process increases, which endangers the health of both the mother and her baby.

However, all of the above is relevant only for those women who do not care about their health. If you want to give birth to a baby, you need to approach this process very responsibly: give up bad habits, lead healthy lifestyle life in general, paying particular attention to your diet in particular. Each girl has her own priorities, and at 40 you can look and feel many times better than a twenty-year-old girl, depending on who devoted her life to what.

By the way, for mature female body pregnancy and childbirth will have a healing rejuvenating effect.

At what age to give birth to children: after 40 years

If there is such a situation that a woman has no children by the age of 40, then you should not despair, but it is also undesirable to deliberately bring the situation to such an extent. The fact is that in pregnant women, the risk of developing an ectopic pregnancy, miscarriage, the occurrence of complications due to hypertension, the birth of a child with defects and pathologies significantly increases. Only the constant monitoring of the doctor leading the pregnancy and genetics will bring the situation to the right track.

If we talk about how old a woman can give birth, then, by and large, until menopause occurs - theoretically. In practice, everything is somewhat more complicated.

You should know that at the age of 40+, menopause is just around the corner - 10-15 years are left before its onset, but it does not happen overnight. In the ovaries, the ability to produce eggs gradually decreases. But not only age affects this process - lifestyle also makes itself felt. Thus, the chances of conception fall every year. Pregnancy itself can be significantly complicated - it is more difficult for an aged woman to cope with such loads, especially in the presence of chronic diseases.

At what age to give birth to a second child

Now you know at what age to give birth to the first child is best. As for the second baby, all recommendations regarding age are the same. It is better to plan any pregnancy in a row, even if the woman is in full bloom and shines with good health. And if the baby is not the first, then it is better to prepare for pregnancy with the whole family, now everyone should be psychologically tuned, and mom, and dad, and the eldest child.

The difference between children may be due not only to the age factor of their mother. Parents themselves must decide how they will be more comfortable. For example, it is harder at first with older children, but as they grow older, they communicate and play with each other. And it’s good for parents that there is more free time, and children always have each other: the smaller the age difference, the wider the range of their common interests.

If, say, we make a difference at the age of 3-5 years, then the older child can help take care of the younger one, which again makes parenting easier. It happens that the difference between children reaches 10-15 years, and here the help of the elder is in question - it depends on relations in the family and his upbringing. At this age, the child becomes a teenager, he has friends, his own interests. And, probably, it is wrong to hang up the care of the youngest entirely on him. Someday he will have his own children, in due time. But you can attract, ask for all possible assistance, but nothing more. Each child should have his own childhood - provided that there is a normal full-fledged family.

To summarize: at what age is it too late to give birth

Now you know what the boundaries are ideal period for pregnancy and childbirth are very blurred - both young and aged women give birth to absolutely healthy children if they approach this issue with all responsibility. There would be a desire, but the opportunity itself will definitely follow!

Video "The best age to give birth"

Despite the fact that the question of the optimal age for the birth of a child is of interest to so many women, there has never been a single answer to it. Most doctors and psychologists agree that optimal age- this is one in which a woman is at least morally, and even better and financially ready for the appearance of a child. And there are many reasons for this.

Pregnancy 20 and 40 years

Each age has its own advantages.

For example, young mothers better tolerate stress, which is pregnancy for the body. The fact is that a young body more quickly and painlessly adapts to hormonal and other changes associated with pregnancy. Typically, young future mother a lot of energy, there are practically no chronic and age-related diseases.

But the expectant mother of an older age, say, after 35 years, may not have so much energy. But on the other hand, she feels more secure and confident in the future, because by this time she, quite likely, managed to make a good career and acquire personal housing, as well as make some savings.

However, in addition to the material, moral and physical aspects, there is also a physiological one. The older a woman gets, the harder it is for her to get pregnant. Of course, everything is individual, and in each specific case, everything can be the other way around, but the statistics should still not be discounted if you plan to have offspring someday.

Risks of late pregnancies and childbirth

More recently, a woman who gave birth to a child after 20 years old was considered an “old-timer”. But times are changing, and today fewer girls are having children before the age of twenty. There are several reasons for this: firstly, life expectancy has increased. Secondly, the functions of a woman in society have expanded, the fair sex has ceased to be a shadow of men and keepers of the hearth. They successfully develop, make a career, and it is quite difficult to combine pregnancy, childbirth and raising children (at least until they are several years old). That is why childbirth is postponed until the age of 25, and even after 35 years.

However, doctors and psychologists say that late pregnancies and childbirth are associated with certain risks.

As for the psychological side of the issue, the main snag here is that every year it will be more and more difficult for a woman to decide on such a responsible step. As a woman's confidence in her own financial situation grows stronger, her confidence in her own physical strength and ability to be a good mother to a child may decrease. At best, this will end in tangible stress and yet the birth of a child, at worst, a rejection of motherhood.

Judging by medicine, there are even more nuances here. Medical statistics show that the older a woman is, the more difficult it will be for her to give birth to an absolutely healthy child.

Here, for example, are statistics on the risks of giving birth to a child with congenital chromosomal disorders (Down syndrome), depending on the age of the mother:

• at twenty-five, one in 1250;

• at thirty, one in 1,000;

• at thirty-five, one in 400;

• at forty, one in 100;

• at forty-five, one in 30;

• at forty-nine, one in 10.

Giving birth over the age of 35 can also be associated with a number of serious problems. The most common complications include:

• gestational diabetes. This form of diabetes develops for the first time during pregnancy. According to studies, women over the age of thirty-five are twice as likely to develop this disease than younger women;

• hypertension. High blood pressure during pregnancy can be caused by gestational diabetes or a number of other diseases. In a more severe form, this disease is called preeclampsia;

• placenta problems. The most common is placenta previa, in which the placenta covers all or part of the uterine opening. Presentation is dangerous because it can provoke severe bleeding that threatens the life of the mother and child;

• premature birth. Pregnancy after 35-40 years can often be complicated by premature birth. Premature babies often have a range of health problems;

• stillbirth. Research by modern scientists has shown that the risk of having a stillborn child increases by two to three times after the age of 40. However, the causes of stillbirths remain unclear.

Best age to have a baby

Despite all the above risks from a medical and psychological point of view, nevertheless many researchers recommend having a baby when you are ready for it as much as possible. Are you twenty years old, and the instinct of motherhood has already awakened in you? if you have loving husband, as well as material and moral support from loved ones - give birth to a child and give him your love.

You are forty years old, and you have everything except children, but do you want to? Pass a thorough medical examination, drink a course of vitamins - and give birth to a healthy child, to whom you can give everything, and even more.

Every woman at any childbearing age has every chance to give birth to a healthy child. To do this, do the following:

• undergo regular check-ups with a doctor;

• receive regular and early prenatal care;

• take vitamins, starting before pregnancy and be sure to continue it in the early stages;

• give up alcohol and nicotine;

• eat right, giving preference to healthy food and filling the diet with vegetables and fruits;

• test the body for resistance to various viral diseases and, if necessary, vaccinate.