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Pakistani superstar Mahira Khan recently shared the news that she is expecting her second child. However, what should have been a moment of celebration has unexpectedly sparked discussions about her age. The 41-year-old actress announced her pregnancy by sharing a graceful baby-bump photograph from the Toronto International Film Festival 2026, winning hearts with her radiant appearance and confidence."We make plans and then there is Allah's plan," she wrote while sharing the news with her followers. While the announcement was met with love and congratulations, conversations around pregnancy after 40 once again brought attention to a question many women face: Does pregnancy become significantly different after the age of 40? The answer is that pregnancy after 40 is possible, and many women have healthy pregnancies and babies. However, doctors consider it a pregnancy that may require closer monitoring because certain risks increase with age. These include fertility difficulties, miscarriage, gestational diabetes, high blood pressure and chromosomal abnormalities.
Why does pregnancy become different after 40?
The biggest biological change is related to egg quantity and quality. Women are born with a limited number of eggs, and both the number and quality of eggs decline with age. This decline becomes more noticeable after the mid-30s and may make conception more difficult after 40. As egg quality decreases, the chances of chromosomal abnormalities also rise. This can increase the risk of miscarriage and certain genetic conditions. However, this does not mean that every woman over 40 will face complications. Age is one factor among many. A woman's overall health, medical history, weight, blood pressure, blood sugar, lifestyle and access to antenatal care can also influence pregnancy outcomes.
Is it harder to conceive after 40?
Conception may become more difficult after 40 because of age-related changes in ovarian reserve and egg quality. Some women may conceive naturally, while others may require fertility evaluation or treatment. Doctors may recommend preconception counselling to assess medical history, menstrual cycles, ovarian reserve and other factors affecting fertility. Depending on the situation, fertility treatments such as IVF may be discussed. However, assisted reproductive technology cannot completely reverse age-related changes in egg quality. The chances of success depend on several factors, including the woman's age, ovarian reserve, general health and whether her own eggs or donor eggs are used.
Risk of miscarriage may increase
The risk of miscarriage rises with maternal age, mainly because older eggs are more likely to carry chromosomal abnormalities. Other factors, such as thyroid disorders, diabetes, high blood pressure and certain uterine conditions, may also influence the risk of pregnancy loss. This does not mean that miscarriage is inevitable after 40. It means that early pregnancy care and appropriate screening become especially important. Doctors may recommend early ultrasound examinations and screening tests to assess the baby's development and identify any potential concerns.
Higher chances of gestational diabetes
Gestational diabetes develops when blood sugar levels become elevated during pregnancy. The risk may increase with age and can be influenced by body weight, family history, previous gestational diabetes and existing metabolic conditions. If gestational diabetes is not managed properly, it can increase the risk of excessive fetal growth, delivery complications and other pregnancy-related concerns. Doctors may recommend blood sugar testing early in pregnancy for women with risk factors, followed by routine screening at the stage advised by their healthcare provider. A balanced diet, pregnancy-appropriate physical activity, regular monitoring and prescribed treatment can help manage blood sugar levels.
Blood pressure and pre-eclampsia need monitoring
Pregnancy after 40 is also associated with a higher risk of high blood pressure and pre-eclampsia. Pre-eclampsia is a pregnancy-related condition involving high blood pressure and signs of damage to organs such as the kidneys or liver. If untreated, it can become serious for both the mother and baby. Warning signs may include severe headache, blurred vision, sudden swelling of the face or hands, pain in the upper abdomen and breathlessness. Not every headache or episode of swelling indicates pre-eclampsia. However, these symptoms should be discussed with a doctor, especially during the second half of pregnancy. Regular blood pressure checks and urine tests are important parts of antenatal care.
Why chromosomal screening becomes important
The risk of certain chromosomal conditions, including Down syndrome, increases with maternal age. This is mainly linked to changes in egg quality. Pregnant women may be offered screening tests such as non-invasive prenatal testing, also known as NIPT, depending on their medical history and the advice of their obstetrician. Ultrasound examinations, including the nuchal translucency scan and the anomaly scan, may also be recommended to assess fetal development. It is important to remember that screening tests estimate risk. They do not always provide a definite diagnosis. If a screening result suggests a higher risk, the doctor may discuss further diagnostic tests.
Can pregnancy after 40 feel more physically demanding?
Pregnancy places additional demands on the heart, lungs, muscles, joints and circulation. Some women may experience greater tiredness, body aches, sleep difficulties or physical discomfort. However, pregnancy experiences vary significantly. A healthy 41-year-old may have fewer symptoms than a younger pregnant woman with an underlying health condition. Fitness levels, sleep, nutrition, previous pregnancies, work-related demands and general health can all affect how pregnancy feels.
Therefore, Mahira Khan's experience should not be treated as a universal pattern. Her pregnancy may feel different from her first pregnancy, but every woman's experience is individual.
Does a long gap between pregnancies increase risk?
Mahira's second pregnancy comes many years after her first. A long gap between pregnancies does not automatically mean that a woman will develop complications. However, doctors may review the previous pregnancy and delivery, including whether there was a caesarean section, gestational diabetes, high blood pressure or any other complication.
The mother's current health is also important. Doctors may assess blood pressure, blood sugar, thyroid function, weight, medications and existing medical conditions. If the previous delivery was a caesarean section, the obstetrician may also discuss the safest delivery plan for the current pregnancy.
What women planning pregnancy after 40 should do
Women considering pregnancy after 40 should ideally consult an obstetrician or fertility specialist before trying to conceive. Preconception counselling may include reviewing existing medical conditions, checking blood pressure and blood sugar, discussing fertility, reviewing medicines, updating vaccinations and starting folic acid as advised.
Once pregnancy occurs, regular antenatal visits become important. Depending on the individual risk profile, the doctor may recommend additional scans, blood tests, blood pressure checks, glucose testing and fetal growth assessments. Women over 40 who are trying to conceive should also seek fertility advice without unnecessary delay, as fertility declines with age.
When should a pregnant woman seek urgent medical help?
Pregnant women should seek prompt medical attention for vaginal bleeding, severe abdominal pain, leaking fluid, severe headache, vision changes, fainting, chest pain, breathing difficulty or high fever. Later in pregnancy, reduced fetal movements should also be reported immediately. Persistent vomiting, inability to keep fluids down, painful urination or sudden swelling should be discussed with a healthcare professional.
Pregnancy after 40 is neither impossible nor automatically unsafe. Many women have healthy pregnancies in their 40s, but age-related changes can increase the likelihood of fertility difficulties, miscarriage, gestational diabetes, high blood pressure, pre-eclampsia and chromosomal abnormalities. The focus should not be on judging a woman's age, but on ensuring that she receives appropriate medical care, timely screening and regular monitoring. Mahira Khan's pregnancy is a reminder that motherhood can happen at different stages of life. It also highlights why women planning pregnancy after 40 should receive personalised advice from their healthcare providers rather than relying on social media debates or assumptions.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.