Study shows an increasing proportion of women giving birth at the age of 40+

In Sweden and Denmark, more and more women give birth over the age of 40. Still, in the past decade, the need for assisted reproduction for women over 40 in Scandinavia has doubled, according to a study led by researchers from the University of Gothenburg.

The purpose of the study, which was published in the journal Acta Obstetricia et Gynecologica Scandinavica, was to provide a descriptive and comparative representation of reproductive patterns in women aged 40 years over a 10 year period (2008–18) in Sweden, and Norway Deliver to Denmark.

This cross-sectional study was based on registry data from all women aged 40 to 49 in Denmark, Norway and Sweden: a total of 1.5 million people. Births with or without assisted reproduction, the use of hormonal contraceptives, and induced abortions have been studied.

The results show an increase in the proportion of women between the ages of 40 and 44 using hormone-based contraceptives, usually hormonal IUDs. In Denmark the proportion of women rose from 24 to 31 percent, in Sweden from 27 to 30 percent and in Norway from 22 to 24.

Assisted reproduction rate doubled

At the same time, the birth rate of 40 to 44 year olds in Denmark and Sweden rose steadily: in Denmark from 9.5 to 12 births per 1000 women and in Sweden from 11.7 to 14.3. The rate in Norway was stable at around 11 births per 1000 women per year over this 10-year study period.

The proportion of women aged 40 to 49 who underwent assisted reproduction doubled in the reporting period. In Denmark the increase was from 0.71 to 1.71 per 1000 women per year, in Sweden from 0.43 to 0.81 and in Norway from 0.25 to 0.53.

Assisted fertilization is usually insemination, where sperm are treated outside the body, or in vitro fertilization (IVF), where both the sperm and egg are treated outside the body.

In terms of induced abortions in the 40-49 age group, the largest increase over the 10-year period – from 7.7 to 8.1 induced abortions per year per 1000 – was in Swedish women.

Knowledge of female fertility

PhD, midwife Ingela Lindh was responsible for the study. As a researcher in obstetrics and gynecology at the Sahlgrenska Academy of Gothenburg University, she heads the Midwifery Clinic in Public Health, Västra Götaland region.

“The results confirm that more and more women are postponing parenting – a trend that can be observed in most of Europe. Today, many women want to graduate and establish themselves in the job market before having their first child, which can lead to an increased need for assisted reproductive treatment due to an increased subfertility rate with age, ”she says.

Modern contraceptives, especially highly effective, long-acting such as hormonal intrauterine devices (IUDs), offer a lot of leeway when planning a desired pregnancy. At the same time, artificial insemination births doubled in the three countries.

We also see that more first-time women than before seek help in fertility clinics. Women may not be aware that fertility decreases with age. The study provides valuable information to improve women’s knowledge of their own fertility. “

Ingela Lindh, Researcher in Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg


Journal reference:

Lindh, I., et al. (2022) Reproductive Changes in Women in Their 40s: A Cross-Sectional Study. Obstetrics and Gynecology.

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