Mahira Khan’s pregnancy at 41 has renewed attention on pregnancy after 40. While many women have healthy pregnancies in their 40s, doctors generally recommend closer monitoring because fertility and certain pregnancy-related risks can change with age.
Pakistani actor Mahira Khan has announced that she is expecting her second child at the age of 41, turning the spotlight once again on pregnancy later in life.
Mahira shared the news with her followers through a photograph from the 2026 Toronto International Film Festival, showing her baby bump. Alongside the announcement, she wrote, “We make plans and then there is Allah’s plan.”
While the news was met with congratulations, her pregnancy has also prompted discussions about what changes when a woman becomes pregnant after 40.
Pregnancy at this age is certainly possible, and many women have healthy pregnancies and babies. However, maternal age is one of several factors doctors consider when assessing pregnancy risk.
Why Can Pregnancy Be Different After 40?
One of the most significant age-related changes involves fertility.
Women are born with a finite number of eggs, and both ovarian reserve and egg quality decline with age. The decline becomes more pronounced with increasing age and can make conception more difficult.
Lower egg quality is also associated with a greater likelihood of chromosomal abnormalities, which can contribute to miscarriage and certain genetic conditions.
However, being over 40 does not mean that complications are inevitable. Overall health, medical history, blood pressure, blood sugar, weight, lifestyle and access to prenatal care can all influence pregnancy outcomes.
Dr Richa Arora Miglani, Head of Laparoscopic, Robotic and Cosmetic Gynaecology at RG Hospitals, Rajouri Garden and Pitampura, explained that Mahira’s experience of pregnancy may differ from her first pregnancy.
“Pregnancy after 40 is possible and many women have healthy pregnancies, but doctors generally consider it a stage that requires closer monitoring,” she said, according to the source material.
Is It Harder to Conceive After 40?
Conception can become more difficult after 40 because of changes in ovarian reserve and egg quality.
Some women conceive naturally, while others may need fertility evaluation or treatment. Doctors may recommend preconception counselling to assess medical history, menstrual cycles, ovarian reserve and other factors affecting fertility.
Depending on the individual circumstances, fertility treatments such as IVF may also be considered.
Assisted reproductive technology, however, does not completely eliminate the effects of age on egg quality. Outcomes can depend on factors including age, ovarian reserve, overall health and whether a woman’s own eggs or donor eggs are used.
Women over 40 who are trying to conceive may therefore benefit from seeking medical advice relatively early rather than delaying a fertility evaluation.
Does Miscarriage Risk Increase With Age?
The likelihood of miscarriage increases with maternal age, with chromosomal abnormalities being one of the factors associated with this change.
Other health conditions can also affect pregnancy loss, including thyroid disorders, diabetes, high blood pressure and certain uterine conditions.
An increased risk does not mean that miscarriage is unavoidable.
Doctors may recommend appropriate early pregnancy assessments and screening based on a woman’s individual medical history and risk factors.
Gestational Diabetes May Require Closer Monitoring
Age can also be associated with a higher likelihood of gestational diabetes, although it is not the only risk factor.
Gestational diabetes occurs when blood glucose levels become elevated during pregnancy. Body weight, family history, previous gestational diabetes and existing metabolic conditions can also influence risk.
Healthcare providers may recommend blood sugar testing according to an individual’s risk profile and the stage of pregnancy.
When gestational diabetes occurs, appropriate monitoring, nutrition, physical activity and treatment recommended by a healthcare professional can help manage blood glucose levels and reduce associated pregnancy risks.
Blood Pressure and Pre-eclampsia
Pregnancy after 40 is also associated with an increased risk of high blood pressure and pre-eclampsia.
Pre-eclampsia is a pregnancy-related condition involving high blood pressure and possible organ involvement. It can become serious if not recognised and managed appropriately.
Symptoms that require medical attention can include a severe headache, changes in vision, significant swelling, upper abdominal pain or breathing difficulties.
Not every headache or episode of swelling indicates pre-eclampsia, but concerning symptoms during pregnancy should be discussed promptly with an obstetrician.
Regular blood pressure monitoring and other antenatal checks are therefore important.
Why Is Chromosomal Screening Discussed More After 40?
The probability of certain chromosomal conditions, including Down syndrome, increases with maternal age.
This is linked primarily to age-related changes in egg chromosomes. As a result, doctors may discuss prenatal screening with pregnant women, taking their individual circumstances into account.
Screening options can include non-invasive prenatal testing (NIPT) and ultrasound examinations such as the nuchal translucency and anomaly scans.
It is important to distinguish screening from diagnosis. A screening test estimates the likelihood of a condition; it does not necessarily establish a definitive diagnosis.
If screening indicates an increased likelihood, a doctor may discuss whether additional diagnostic testing is appropriate.
Can Pregnancy Feel More Physically Demanding After 40?
Pregnancy places additional demands on the cardiovascular system, muscles, joints and other parts of the body.
Some women may experience fatigue, body aches, sleep difficulties or other physical discomforts. But age alone does not determine how pregnancy will feel.
A healthy 41-year-old may have fewer pregnancy symptoms than a younger woman dealing with an underlying medical condition.
Fitness, sleep, nutrition, previous pregnancies, work demands and general health can all affect an individual’s experience.
Therefore, Mahira Khan’s reported experience should not be treated as a template for every woman who becomes pregnant after 40.
Does a Long Gap Between Pregnancies Matter?
Mahira is expecting her second child many years after becoming a mother for the first time.
A long interval between pregnancies does not automatically mean that complications will occur. However, doctors may review the previous pregnancy and delivery when assessing the current pregnancy.
Previous complications such as gestational diabetes, high blood pressure or a caesarean delivery may be relevant to current care.
The mother’s present health is also important. Depending on the individual situation, doctors may review blood pressure, blood sugar, thyroid health, medications and other existing conditions.
If the previous delivery involved a caesarean section, the obstetrician may also discuss delivery options for the current pregnancy.
What Should Women Planning Pregnancy After 40 Do?
Women considering pregnancy after 40 can benefit from a preconception consultation with an obstetrician or fertility specialist.
Depending on individual circumstances, this may involve:
- Reviewing existing medical conditions and medications
- Assessing fertility and reproductive history
- Checking blood pressure and blood sugar
- Reviewing vaccination status
- Discussing healthy weight, nutrition and lifestyle
- Taking folic acid as advised by a healthcare professional
- Planning appropriate antenatal screening after conception
Once pregnancy occurs, regular prenatal appointments become particularly important. Additional scans, blood tests, glucose monitoring, blood-pressure checks or fetal growth assessments may be recommended depending on the mother’s individual risk profile.
When Should a Pregnant Woman Seek Medical Help?
Certain symptoms during pregnancy require prompt medical assessment.
These can include vaginal bleeding, severe abdominal pain, leaking fluid, severe headache, vision changes, fainting, chest pain, breathing difficulties or high fever.
Later in pregnancy, a noticeable reduction in fetal movement should also be reported immediately.
Persistent vomiting, difficulty keeping fluids down, painful urination or sudden swelling should also be discussed with a healthcare professional.
Pregnancy After 40 Is Possible, but Personalised Care Matters
Pregnancy after 40 is neither impossible nor automatically unsafe. Many women have healthy pregnancies in their 40s.
At the same time, advancing maternal age can be associated with increased chances of fertility difficulties, miscarriage, gestational diabetes, high blood pressure, pre-eclampsia and chromosomal abnormalities.
Mahira Khan’s pregnancy has brought these issues into the public conversation, but her experience remains individual. The broader takeaway is that women planning pregnancy after 40 should receive personalised medical advice and appropriate prenatal monitoring rather than relying on assumptions or social-media discussions.
Age is one factor in pregnancy care—not a verdict on whether a woman can or cannot have a healthy pregnancy.