Safety and Risks of Pregnancy After Age 35

Doctor holding a stethoscope on pregnant patient's stomach

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Having a baby at any age can be fun and exciting. It can also cause worry. For mothers who delay childbearing and pregnancy until their late thirties and early forties, there may be some added concerns to address. While the number of these women has increased steadily over the years, the number of moms over 40 is growing even more rapidly than before. This actually is beneficial from the point of view of scientists, because they now have more data to address the concerns of these women.

Once, older women were told they had very grim prospects of getting pregnant and giving birth to a healthy child. Science has now shown us that this is not necessarily true.

Areas of Concern for Women Looking to Conceive After Age 35

Here are some areas of concern for midlife moms.

Fertility

Fertility is certainly not an issue with every mother over the age of 35. However, everyone, including men, will have a decline in fertility beginning in their thirties. This may not be a perceptible decline nor is there a set age at when this begins.

With aging, there are fewer eggs in the ovaries, and the quality of the eggs declines. Changes in hormone levels can also affect fertility.

There have been many technological advances in fertility treatments, enabling many women who previously would have had trouble to conceive. Good preconception care can help you prevent and identify these potential problems before they are of concern.

Genetic Testing and Prenatal Screening

Genetic testing and counseling are very personal issues. Since some rise in birth defects is apparent with maternal age, which may also slightly increase the miscarriage rate, counseling and testing are offered to most women over the age of 35. Some women and their families choose to do no testing, while others choose all the testing that is available. There is no one right answer.

Genetic counseling might be a good option, even if testing is not an option for you. This can even be done prior to conception. The counseling involves a detailed interview with a genetic counselor and perhaps blood work from you and your partner.

Some testing can be as simple and harmless to the baby as the maternal serum alpha-fetoprotein test (also known as the triple screen). This is a screening test for neural tube defects and Down syndrome. Additional tests might include carrier screening and non-invasive prenatal testing.

Other potential testing includes amniocentesis, chorionic villus sampling (CVS), and ultrasound. Some of these tests do carry risks to the pregnancy. Talking to your doctor or midwife about the potential risks versus the benefits to you is very important in any decision you make.

Pregnancy Problems

Simply being over a certain age shouldn't predispose you to many pregnancy complications.

Though most studies show that women over 35 have a higher chance of pregnancy complications, the complications are often linked to a preexisting condition (like high blood pressure) rather than age or pregnancy.

This is where preconception counseling can help you find out what you need to do to get healthy before pregnancy. For example:

  • Take folic acid to help prevent neural tube defects
  • Eat a balanced diet
  • Start an exercise program
  • Get all pre-existing medical conditions under control
  • Avoid cigarettes, alcohol and other drugs

Labor and Birth Complications

You may have heard that there are more problems during birth for women over 35. Certain complications that occur more frequently in midlife moms, like blood pressure problems, often incur the need for interventions like cesarean section and induction of labor.

While there is an increase in the length of labor and prolonged second stage, which might explain the higher cesarean rates for this age group as well, many say that this is simply from the increased medicalization of birth for women over 35. Prenatal care and taking care of yourself can help prevent and lower some of these potential complications, as well as seeking out a practitioner who believes in a philosophy of normal birth regardless of age.

A Word From Verywell

With proper and early prenatal care, preferably starting prior to pregnancy, many women over 35 can have a successful pregnancy and birth, although some may need assistance to conceive. Many mothers who fall into this category feel more ready, emotionally and financially, for the demands of a child than they did when they were younger.

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  1. The American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and The Practice Committee of the American Society for Reproductive Medicine. Female age-related fertility decline. Fertil Steril. 2014;101(3):633-634. doi:10.1016/j.fertnstert.2013.12.032

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