Pregnancy After 35: What You Should Know About Advanced Maternal Age

Michelle Roberts-Borden, MD, is board-certified in obstetrics and gynecology. She practices at Loudoun OB/GYN & Midwives and delivers babies at the Inova Loudoun Ladies Board Birthing Inn.  

If you’re preparing to welcome a baby after 35, you’re not alone. More women are having babies in their late 30s, 40s and even into their 50s.

It’s great that women have more choices about whether and when to have children. But so-called “geriatric pregnancies” can carry more risks. Fortunately, many of these risks are manageable with good planning and prenatal care. If you’re pregnant (or thinking about getting pregnant) past age 35, here’s what you should know.

Risks of Advanced Maternal Age

It’s absolutely possible to have a healthy pregnancy after age 35. But with increasing age comes increasing risk. Older moms can be at elevated risk of pregnancy complications, including:

• Infertility (trouble getting pregnant)
• Miscarriage or stillbirth
• Ectopic pregnancy
• Placenta problems
• Gestational diabetes
• High blood pressure
• Birth defects, including chromosomal abnormalities such as Down syndrome
• Intrauterine growth restriction (a condition in which the developing baby doesn’t grow to a normal weight)

If all this sounds alarming, take a deep breath. These complications aren’t a given, no matter your age. And there are steps you can take to reduce your risk.

Reducing Risks: Before Pregnancy

One of the biggest things you can do to ensure a healthy pregnancy is to be as healthy as possible before you conceive. If you’re planning to have a baby soon, now is the time to start establishing healthy habits: Exercise regularly, eat a nutritious diet and try to reach or maintain a healthy weight. Starting your pregnancy close to your ideal body weight is a big factor in lowering risk. 

Reducing Risks: During Pregnancy

Healthy habits are important during pregnancy, too, of course. Continue to eat a balanced diet and get regular exercise. How much weight you should gain depends on what you weighed when you got pregnant, so talk to your doctor for advice.

Good prenatal care is another key ingredient for a healthy pregnancy. There are a number of things we can do to help patients manage the risks associated with advanced maternal age. Those include:

• Prenatal testing. We have a variety of tests we can use to identify birth defects early in pregnancy. Newer blood tests can identify chromosomal abnormalities with a simple blood test, at no risk to the developing baby.
• Fetal scans. We can use ultrasound to monitor the baby’s development over the course of the pregnancy.
• Timing of delivery. Older mothers have a greater risk of complications when they go past their due date. Doctors often recommend that moms of advanced age have their babies by 40 weeks. We can induce labor to help that happen. (Many women worry that inducing labor increases the chance of needing a C-section. But recent research showed that inducing women at 39 weeks did not make them more likely to need a C-section.)

Prenatal testing and fetal ultrasounds may not be right for everyone. Every woman and every pregnancy are different, and you should talk to your healthcare provider to find the options that are right for you.

Postpartum Health

Bringing baby home is an exciting time, but it’s also a lot to adjust to. As mothers are healing and recovering, they can do several things to stay in good health:

• Make sure you have adequate help and support, especially if you’re recovering from a C-section.
• Watch for signs of postpartum depression.
• Follow up with your healthcare provider to discuss any complications or concerns that arose during pregnancy. Problems such as high blood pressure or gestational diabetes can be of concern for the mother’s health in the future, but your doctor can help you manage these problems.

Healthy Pregnancy for Older Moms

It’s important to remember that while there are some risks that go along with being an older mom, women have been having babies past 35 since, well, forever. By making healthy lifestyle choices and getting good prenatal care, you’re setting yourself up for a healthy pregnancy and childbirth experience. 

Inova’s prenatal care and childbirth centers provide a variety of options to meet your needs. Learn more about Inova Childbirth and Maternity Services.