Over the last twenty years the number of women waiting until their 40s to conceive has nearly doubled. One of the main determinates of having a healthy pregnancy is being healthy as you enter pregnancy. However, no matter how healthy you are, there are still risks beyond your control. Medical conditions such as high blood pressure and diabetes are more common when a woman reaches her 40s. Also, the number of chromosomal disorders, such as Down syndrome, increases as your age increases. For example, the risk of Down syndrome at age 25 is one in 250. At age 35 is the risk is about one in 300. At age 45 the risk is one in 30, and at age 49 the risk is one in 11. Your total risk for chromosome abnormalities is a bit higher too. At age 35 it is one in 200, while at age 45 the risk increases to one in 21, and to 1 in 8 at age 49. Women in their 30s and 40s have an increased risk of miscarriage. This is most likely due to the increase in chromosomal disorders. In addition, it appears that older women also have an increased risk of requiring a cesarean section. In summary, yes you can have a healthy pregnancy, but your risks at age 49 are SIGNIFICANTLY HIGHER.