The policy of two children has been relaxed, the wave of two children has come. For post-90s couples, they may still be worried about their first child; for post-80s couples, it is the right time to have a second child; and for post-70s couples, they need to hurry up and try to catch the last train. Is age really so important to the birth of a second child? The main effects of age on fertility are: fertility, eugenics, and maternal health management at an advanced age. 1. Fertility Previous studies have shown that the reserve function of the ovaries begins to decline after a woman is older than 35 years old, and a significant decline can be found after the age of 40. The decrease in fertility is mainly manifested in 2 aspects: firstly, the decrease in the number of follicles and secondly, the decrease in the quality of eggs. 1.1 Changes in the number of eggs The female fetus forms 6-7 million germ cells at 4 to 5 months of age. The number of follicles in the female infant’s body at birth decreases to 1-2 million. After a decade or so, at the time of female puberty, about 300,000-500,000 germ cells remain. The reproductive age of a woman is about 30-35 years, and if she ovulates once a month, 400 dominant follicles can form during that time, which means that each mature egg is formed from more than 10,000 germ cells. In other words, all other germ cells are constantly eliminated in this “marathon race”, or what we call “atresia”. This means that the fertility of women of childbearing age continues to decline with age, and most of the current research evidence suggests that this process is irreversible. 1.2 Decline in egg quality The eggs appear immature – unable to be fertilized. Or over-matured The fertilization rate of mature eggs also declines. 1.3 Indicators to assess the ovaries Age and declining ovarian function show a correlation, but not a one-to-one correspondence. Are there any more reliable objective indicators of fertility? Yes, there are several indicators to assess ovarian function: sinus follicle count, follicle stimulating hormone in the blood, etc. One of the blood tests is called “anti-Müllerian hormone” (AMH), which is a hormone secreted by the dormant primary oocytes in the female body, the more primary oocytes there are, the higher the level of this hormone. With the increase of age, the success rate of assisted reproduction technology for pregnancy is 60%-70% for those under 35 years old, 40% for those between 35 and 40 years old, and 20% for those older than 40 years old. 2, eugenics Due to the issue of the rising age of the birth of a second child, more attention should be paid to prenatal screening for birth defects. On the one hand is the screening of fetal genetic aspects, on the other hand is the screening of body structure. There are 23 pairs of chromosomes, 46 in total. When forming an egg or sperm, the chromosomes split in two and become 23, which may lead to imbalances and abnormalities in the number and structure of chromosomes during the division process. For example, if 24+23, it becomes 47 chromosomes and chromosomal aneuploidy occurs, such as trisomy 21 and trisomy 18. The probability of such abnormalities increases as the age of the parents preparing for a fetus increases. Parents preparing for a second child often already have some knowledge of this when they are pregnant with their first child. It is important to note that due to the increased risk when preparing for a second pregnancy, we need to pay extra attention to screening. In addition, the latest non-invasive testing technology can detect chromosomal abnormalities in the fetus by amplifying the gene sequences on the target chromosomes using a very small number of fetal nucleated red blood cells from the mother’s peripheral blood, with an accuracy rate of 99.9999%. Screening of body structure is mainly done by ultrasound from 18 weeks to 24 weeks of pregnancy. With the development of technology, 3D and 4D ultrasound are now equipped in major hospitals, which can provide higher accuracy and intuitive images for screening. 3, advanced maternal age After the age of 35, the chances of miscarriage, gestational hypertension, placenta praevia, premature birth, premature rupture of membranes, gestational diabetes, postpartum hemorrhage and other complications in advanced maternal age are significantly higher than in women of appropriate age. Miscarriage: embryonic chromosomal abnormalities (previously mentioned trisomy 21 and trisomy 18, both of which increase miscarriage), uterine fibroids, cervical damage, and endocrine abnormalities (progesterone deficiency). We mentioned earlier that the success rate of assisted conception at age 40 is 20%, do you know what is the rate of miscarriage after successful assisted conception at age 40 and above? 20%! In the end, only 70-80% of the babies are delivered successfully. Hypertension in pregnancy: being older than 35 years is one of the risk factors for hypertension in pregnancy. The pathological basis is spasm of the small arteries, which manifests as increased blood pressure, edema, proteinuria, and hemoconcentration, affecting several important organs such as the brain, heart, lungs, liver, and kidneys. Some couples whose first child was delivered by cesarean section, what do they need to pay attention to when preparing for their second child? 1, cesarean delivery is what we people often call a cesarean section, China is the highest rate of cesarean delivery in the world, this is due to a number of factors, one of the possible factors, when the couple’s family plan, did not fully consider the possibility of the future second child, choose a cesarean delivery. So what is the impact of a cesarean delivery for the first child on the preparation for the second child? The modern cesarean section is usually performed by “lower uterine section”, where the scar on the uterus is located in the lower part of the anterior wall of the uterus, where the uterine wall is thinner and there are no large blood vessels, and the tension during pregnancy is relatively low. The impact of scarring on the birth of a second child is therefore reduced to a very low level. It is important to note that pregnancy should not be carried out too early in order to prevent the risk of rupture of the uterine scar due to the excessive tension of the enlarged uterine wall during pregnancy before the scar has fully healed. Therefore, it is important to wait more than 2 years after the cesarean section before conceiving. 2. . Can I choose normal delivery for the second child after the first cesarean? It depends on the reason for the first cesarean and the timing of the cesarean delivery. If the reasons for the first cesarean delivery still exist during the second pregnancy, for example, the pelvic conditions are not ideal and will not change in the second pregnancy, then the second child will also need a cesarean delivery. In contrast, some factors, such as emergency cesarean delivery for fetal hypoxia in the first pregnancy, are no longer present in the second pregnancy and the reasons for cesarean delivery no longer exist, so there is a possibility of natural delivery. The second factor is the timing of the last cesarean, which is also a factor to be considered. Some mothers have had their first child by cesarean section because the opening of the uterus was already open during their own normal delivery. When you are pregnant with your second child, you will have a better chance of a successful delivery because the birth canal has been “exercised” during your first child. For some mothers, the first time there were no contractions and their stomachs never hurt, so they delivered their babies directly by cesarean section, in which case the decision to have a normal delivery requires more preparation and courage. In short, each case should be analyzed on its own merits, and the birth plan should be made together with the obstetrician. With all of the above being said about the possible added “hassle” of preparing for a second child, what are the benefits of having a second child for women and what are the benefits of trying and trying for mothers? The second child is indeed a big decision in family planning, especially for the mother, who has to conceive and raise the baby again, and put more effort into taking care of them when they are small. But, to a certain extent, it is worth it, even if only from a medical point of view. Medical research over the last few decades has been very clear that giving birth and breastfeeding significantly reduces the risk of developing some malignant pathologies in mothers. For example, the incidence of endometrial cancer, ovarian cancer, and breast cancer. After pregnancy, due to the cessation of menstrual flow, the endometrium no longer regularly sheds and bleeds every month, a state that lasts for at least 9 months and may be extended for another 3 to 12 months if breastfeeding. This process reduces the risk of endometrial cancer by reducing the chance of malignant changes during the proliferation and repair of endometrial cells. For similar reasons, endometriosis, commonly known as “chocolate cysts”, may also resolve or even heal due to the cessation of menstruation after pregnancy. By the same token, the ovaries stop ovulating after pregnancy, avoiding the repair of ovulatory trauma, which can reduce the incidence of ovarian cancer. Life details To have a second child, it is recommended that both men and women go to the hospital for a preconception checkup before pregnancy and stop taking contraceptives, antibiotics and other drugs, and have eugenics under the guidance of a doctor. Make a good diet with light and rich in nutrients, eat more fresh vegetables, fruits, coarse grains and legumes, cereals and other foods to fully supplement the nutrition needed during pregnancy. In addition, special attention should be paid to the daily intake of folic acid, which is also very important before pregnancy to avoid fetal malformations. Many mothers are aware of the need for folic acid supplements when preparing for pregnancy, but in order to maintain a certain level of folic acid in a woman’s body, experts recommend starting to take it after marriage to ensure a better nutritional status of folic acid in the early embryonic period. According to studies, it takes 4 weeks for a woman’s folic acid deficiency in her body to actually improve after she has been taking folic acid consistently on a daily basis. This way, during the sensitive period of fetal neural tube formation in early pregnancy, sufficient folic acid can meet the needs of neurological development, and it should be taken consistently during the sensitive period in the first trimester of pregnancy to achieve the best preventive effect. In preparation for the second child, it is also important to take folic acid as early as possible, one capsule daily. The physiological dose is 0.4 mg, while often the folic acid preparation is 0.8 mg. It does not matter, folic acid is a water-soluble vitamin, and those taken more can be excreted through urine without accumulation of poisoning. The adverse effects of tobacco and alcohol to quit or reduce – both sides of the. The best time to have a second child Several studies have shown that waiting 18 to 23 months after the birth of a baby before conceiving a second child is most beneficial to the health of the next baby. If the first child was born in a normal birth, the recovery period is relatively short. Generally, as long as 1 year has passed and the woman’s physiological functions have basically recovered after the birth and after the examination, she can consider having a second child.