Do I still have to use birth control?
Yes, unless you don't mind having a baby when you're in your 40s or 50s. Although ovulation is erratic during perimenopause and fertility steadily decreases, unprotected sex can still lead to pregnancy. "There are more unplanned pregnancies as women get older, because they're assuming they're less fertile," Richardson says. In fact, some 75 percent of pregnancies in women over 40 are unexpected. (The rate is second only to that for teenagers.) The chance of becoming pregnant diminishes with each year; nonetheless, record numbers of over-40 women are having babies: In 2005, the birth rate for women over 40 was the highest it's been since 1970.
However, maternal age does increase the risk of medical complications for mothers, which can include gestational diabetes, high blood pressure, miscarriage, and stillbirth, according to the March of Dimes. Babies born to such women have an elevated risk of premature birth, low birth weight, genetic disorders, and other birth defects. If you don't want to get pregnant, "be sure you use birth control until you have gone one year without periods," Richardson recommends.
