The Manipulations You May Face During an AMA Pregnancy

by: HeHe Stewart
If you're having an advanced maternal age (AMA) pregnancy, it's important to be aware of the manipulations you may face from doctors and medical professionals throughout the birth experience.
ultrasound of an ama pregnancy

Many women have shared stories of birth trauma with me and almost always there’s manipulation of some sort sprinkled throughout. Sometimes, it’s outright and sometimes it’s truly disguised as “caring advice” or a “gentle nudge.”  

More: I'm Having a "Geriatric Pregnancy." Am I Really At Risk?

There are a few places in this journey that birthing people will face the most manipulation. During these times, it’s ultra important to explore your options, know the choices you have, and understand your rights as a patient of the medical system and as a consumer. These places of manipulation often include (but are far from limited to) reasons for labor augmentation like going past your guess-timated due date, during pushing, being told they have a “big baby” or “low amniotic fluid.” There are so many reasons that medical providers may manipulate their patient, but there are absolutely zero reasons that are ethically and morally sound. 

“Under no circumstance is it ever okay to manipulate a birthing person or their partner. The right and responsibility to make any and all decisions about that person’s body lies with the birthing person and no one else.”  

Manipulations You May Face with an AMA Pregnancy

dealing with an ama pregnancy

Manipulation in the birth world is not exclusive to pregnancies. Actually, it’s prevalent across the board of all women’s health. However, it’s especially tricky for older pregnancies and there are a few places that older moms have reported having regrets when they look back on their birth experiences. It's no secret that older pregnancies face higher rates of intervention and one reasoning behind this is that doctors pressure first-time, older moms to be induced by bit of scare tactics because they have been led by modern medicine ideology that older pregnancies automatically mean death and doom. 

Induction 

Women who are over 35 years old face increased pressure to induce based on their status of “Advanced Maternal Age.” Matter of fact, many things about your birth management will change once you receive this label. This induction rate leads to a higher rate of cesarean births among women 35 years and older. If you are interested in learning about your rights and creating a birth plan specifically for your Advanced Maternal Age pregnancy, check out Tranquility by HeHe Maternity Concierge’s consults. 

Birth Weight 

Ultrasounds that predict your baby’s size and weight can be up to two pounds off. That’s right; your perfect eight-pound baby may come at six pounds or at whopping ten pounds. Another thing to keep in mind is that the general population of pregnancies have their own variations of birth weight. Being over the age of 35 increases your chances of low or high birth weight less than 2.5%.

 

<35yo

35-40yo

40+yo

Low Birth Weight

5.81%

6.13%

7.63%

High Birth Weight 

10.06%

12.32%

11.96%

This chart was adapted from Evidence Based Births and date from Jolly et al. 2000

Jocelyn Brown, a Licensed Homebirth Midwife in Los Angeles, California shares her thoughts on where she felt expecting parents face the most fear-based care manipulations during the birth experience and she explained, “One challenging issue - and a big fear tactic -  that we don’t have a lot of control over, is the risk of stillbirth for advanced maternal age. In one study, for women under 35 the stillbirth rate was 0.47%. It increased to 0.61% for age 35-40, and then over 40, it was 0.81%. When adjusted for maternal health, healthier women of any age have lower rates of stillbirth overall, but older women will always have a somewhat higher risk than younger women. The risk goes up even more when the pregnancy goes past the due date. I am very frank about these risks with my clients and offer induction after the due date, but don’t require it. Of course, induction comes with its own drawbacks, so it’s very important to me that people have access to hard facts and make their own choice.”

Staying in Control of Your Own Birth

staying in control of your own pregnancy

There are a few things you can do to make sure you are staying in control as an older mom:

  • Hire a doula to help you know your options.
  • Join a moms’ group so you can ask real life moms about their experiences (in person or Facebook groups are equally great!)
  • Read sensible books that expose you to real life birth stories (not birth stories fabricated by social media and television).
  • Explore all ends of the spectrum for all of your choices to avoid the feeling of “I wish I had known.”
  • Use a birthing method like The TBH Approach to help you navigate this transitional time in life.
  • Be intentional with the team you put together including your provider, partner and any other support people.
  • Finally, focus on your mindset and master the way you think and talk about your upcoming birthing experience. 

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