By Senior Physician Zhong Xi Ming, Eu Yan Sang
“Elderly Primarygravida” or “Elderly Multigravida” are the intimidating sounding terms that are given to expectant mothers who are over 35, with the former used on first-time mothers and the latter for mothers expecting their second or subsequent child. There’s actually nothing magical about the number 35, it’s just a general guidelines to what is considered an advanced maternal age (AMA). However, AMA women do face an increased risk of miscarriages and stillbirths and have a higher chance of having conditions such as gestational diabetes, high blood pressure, pre-eclampsia, low lying placenta and dysfunctional labour during their pregnancy.
According to an ancient Traditional Chinese Medicine (TCM) text, Huang Di Nei Jing, a woman’s life develops in seven-year cycles, with the women’s peak condition for reproduction at 28. This is due to the belief that the kidney is responsible for the growth and development of a person, and governs the reproductive function of the body, and its Qi (vital energy) changes every seven years. At 35, the body’s digestive system (yang ming meridian) is weakened and her fertility starts to decline. However, the right lifestyle choices and habits play a part in minimising the risk and complications that may arise in an AMA pregnancy.
Conceiving later in life
Don’t wait till you are thinking of getting pregnant before making changes in your lifestyle, especially in you may be approaching the AMA age. Consider going for prenatal checks and making the necessary lifestyle changes as you prepare to conceive to ensure that you are in the optimal condition. For older women who are trying to conceive, your TCM doctor may recommend various treatments such as herbal medication or acupuncture that tonify the kidney and liver systems, as well as nourish the womb, blood and Qi, to prepare the body for pregnancy.
Maintaining a healthy pregnancy
No matter what age you are, a healthy, well-balanced diet is important for all expectant mothers. Sticking to a healthy diet aids the development of your baby and reduce discomforts during your pregnancy, laying the foundation for a better delivery. You are also building up nutrients stores for breastfeeding after.
The ideal pregnancy diet according to TCM, focuses on nourishing the blood and Qi, a crucial source of nutrition for the developing baby. Have a moderate diet that doesn’t comprise of too much or too little food, and is a good mix of the five flavours: sweet, sour, bitter, hot and salty. Include a variety of fresh, light and nutritious food that are neutral in nature and easy to digest. Stay away from raw, cold foods such as raw seafood such as oysters and uncooked sashimi, reduce any excessive intake of caffeine and avoid foods that are ‘cooling’ in nature like watermelon, celery.
When you eat is just as important as what you eat, so have regular mealtimes and avoid undereating, overeating and binge eating – this, in particular, may lead to excessive weight gain and add to the already increased risk of gestational diabetes that AMA women have. If you have been diagnosed with gestational hypertension, limit your sodium intake, monitor weight gain and stay physically active, unless advised otherwise by your doctor. Expectant mothers with gestational diabetes should reduce sugar intake by reducing added sugar in their foods, and choosing nutritious carbohydrates such as wholegrain foods instead of highly processed carbohydrates.
Feeling stressed is common when you are pregnant, and it happens more frequently when you are an AMA woman. However, fretting about your pregnancy and impending parenthood is natural, just don’t let it become unmanageable and have it interfere with your health and daily activities. According to TCM, gestational hypertension is often due to imbalances of the liver, spleen and kidney systems, and strong emotions such as stress, anxiety, anger and depression can contribute to this imbalance. Excessive stress and emotions also disrupt the body’s internal balance and affect the flow of blood and Qi in the body. Thus as far as possible, you should maintain a peaceful, positive mood during your pregnancy to allow for the smooth flow of Qi and blood, both which are vital to fetal development.
Zhong Xi Ming is a senior physician at Eu Yan Sang Premier TCM Centre @ Paragon. She received her Graduate Certificate in TCM from Hubei University of Chinese Medicine Faculty of Medicine in 1984. Eu Yan Sang combines the best of east-west healthcare practices with the 33 TCM clinics and 2 integrative medical centres in Singapore, Hong Kong, Shanghai and Malaysia.
Click here for a guide based on TCM principles of what to eat when you are expecting.