The woman over age 40 is more likely than a younger woman to have a previously diagnosed condition such as hypertension, varicosities, or hemorrhoids. In addition, by age 40 a woman usually has a major role change to undertake during pregnancy because often, she is well established in a career or has an accustomed routine at home or in her community. She needs to think through how this pregnancy and childrearing are going to fit into and change her life.