Fertility at Forty


Dear Midwife,
I am 40. I have a 20 yr old and I 5 year old. Before the 5 yr old was conceived I was told I could not have anymore children. After I had the 5yr old. I got the IUD. on 2-11-09 I had it removed.

What are my chances in getting pregnant again? I wouldn't mind it. I am already a week late and happy.

I however am scheduled for a mammogram on Tuesday the 17th. Do I need to get checked before I have the mammogram?


If it were me, I probably would have left the Mirena in the two extra years they are talking about :-), but since you are open to conceiving again, I understand. Your chances of conceiving are not large, and even if you do, your chances of miscarriage go up with age. Which is not to say that you might not have a perfectly normal pregnancy.

Call the mammogram people and let them know that you are at risk for pregnancy, and they may want to defer the exam until during your next menstruation, just to be safe.

-- Cynthia, CNM. PhD.

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.