Oscar-winner Hilary Swank, 52, recently announced she’s expecting her third child — three years after welcoming twins at 48. Her Instagram caption read: “This one releases in December.” Also read | Katrina Kaif is expecting first baby at 42: Gynaecologist says late pregnancy is no longer unusual, can be safe
She’s not the only one. Katrina Kaif welcomed her first child with Vicky Kaushal in November 2025, at 42. Sienna Miller welcomed her third child after 40, as did Deepika Padukone. Forty-plus motherhood suddenly feels normal.
It’s hopeful and powerful: but is it the full story?
We asked Dr Geetanjli Behl, associate director, obstetrics and gynaecology, Medanta, Gurugram, if shifting social timelines means biological timelines have shifted too. “Pregnancy after the age of 40 is receiving increasing attention, with more public figures sharing their experiences of becoming parents later in life,” she said.
“These stories have opened up conversations about fertility, reproductive choices and changing family timelines. For many women, the possibility of having a child in their forties offers hope. However, while pregnancy at this age is possible, it is important to understand the medical realities, potential risks and role of timely healthcare,” she added.
In several countries, births to women in their forties have become more common over recent decades, noted Dr Behl. “However, patterns vary across countries, and an increase in births among older women does not mean that fertility itself is improving with age. A woman’s reproductive potential generally declines as she gets older, particularly after the mid-thirties. This is largely because the number and quality of eggs decrease over time,” she shared.
Translation: More 40-something births does not mean higher fertility at 40. It means more attempts, more assistance, and more awareness. Can you still get pregnant naturally in your 40s? Yes. Is it the same as at 30? No.
“Yes, natural conception is possible in the forties, including after the age of 45, as long as ovulation and other reproductive factors permit it,” Dr. Behl clarified. “However, the chances of conception generally decline significantly with age, and pregnancy becomes less likely as menopause approaches,” she said.
And IVF isn’t a magic undo button: “Fertility treatments, including in vitro fertilisation (IVF), may offer additional options. Success depends on several factors, including ovarian reserve, overall health and whether a woman’s own eggs or donor eggs are used. IVF using donor eggs may improve the likelihood of pregnancy for some older women, but it does not eliminate the medical risks associated with carrying a pregnancy at an older age.”
Here’s myth Dr Behl wants to bust ASAP: “It is also important to understand that ovarian reserve tests cannot reliably predict an individual’s chances of natural conception on their own. A fertility specialist can assess personal circumstances and recommend appropriate investigations.”
The risks nobody talks about
Many pregnancies after 40 are healthy and uncomplicated, she added. “Pregnancy after 40 can result in a healthy mother and baby, but certain complications become more likely with increasing maternal age,” Dr Behl said.
Statistically, as per the doctor, these things become more likely:
⦿ Gestational diabetes: Your body gets more insulin-resistant with age.
⦿ Hypertension + preeclampsia: High blood pressure in pregnancy needs close monitoring.
⦿ Miscarriage: More common because chromosomal abnormalities in eggs increase with age.
⦿ Chromosomal conditions: Like Down syndrome — which is why screening is so important.
⦿ Preterm labour + C-section: Both rates are higher in older maternal cohorts.
“These are increased probabilities, not inevitable outcomes. A woman’s medical history, existing health conditions and pregnancy care all influence her individual risk,” she added.
So what about pregnancy at 52?
This is where the headlines really skip details. “Pregnancy at 48 or 52 is medically different from pregnancy at 40 or 42,” Dr Behl said. “Natural conception becomes increasingly uncommon as ovarian function declines, and spontaneous pregnancies after menopause are not possible using a woman’s own eggs. Pregnancy may sometimes be achieved through assisted reproductive techniques, including donor eggs or previously frozen embryos, following specialist assessment,” she explained.
Carrying at that age is also physically different: “At these ages, pregnancy requires particularly careful evaluation because the risks of hypertension, diabetes and other complications may be higher,” warned Dr Behl. “Fertility treatment does not reverse the effects of ageing on the body, and not every woman will be medically suitable for treatment. Celebrity pregnancy stories can demonstrate what is possible, but they rarely provide the full picture of fertility treatment, medical supervision or individual circumstances,” she added.
If you’re thinking about it in your 40s, do this
Don’t wait for a perfect time to get a check-up. “For women considering pregnancy after 40, preconception counselling can help identify potential risks and prepare for pregnancy,” advises Dr Behl. “Consulting a gynaecologist or fertility specialist early is particularly important, as fertility declines with age and delaying an assessment may reduce available options,” she added.
Her prep checklist:
1. Full medical evaluation: Heart, metabolism, chronic conditions, meds.
2. Targeted screening: BP, diabetes, thyroid before you try.
3. Nutrition: Folic acid early, on medical advice.
4. Lifestyle: Keep moving, no tobacco, no alcohol.
And the part we don’t talk about enough: “Emotional and practical preparation matters too. Couples should discuss fertility treatment options, financial considerations, support systems and the demands of parenting. These conversations can help families make informed decisions without feeling pressured by societal expectations or other people’s experiences.”
“Motherhood does not follow a single timeline, and pregnancy after 40 is neither impossible nor risk-free. While advances in reproductive medicine have expanded options for some women, they have not eliminated the natural decline in fertility or the increased risks associated with maternal age,” Dr Behl added.
“The most important step is to understand individual circumstances, seek timely medical advice and make reproductive decisions based on reliable information rather than celebrity headlines. With appropriate assessment, careful monitoring and informed choices, women can better understand their options and prepare for the healthiest pregnancy possible,” she concluded.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
