Is 35 Really a High-Risk Pregnancy? The Truth About Having a Baby Later in Life
Yiwen Cui, MD
Maternal-Fetal Medicine
If you’re in your 30s and thinking of having a baby, you’ve heard the mantra: Do it soon —before the risk of complications shoots up.
That advice is outdated. Yes, younger women conceive more easily and have fewer challenges moving forward, but there is no doubt: Women 35 and older can and do get pregnant, carry a baby to term and give birth to a healthy child. In fact, the birth rate among older women is trending up, not down. There is no cliff on your 35th birthday.
Why the 35-Year-Old Pregnancy ‘Age Cliff’ Is Outdated
In the 1970s, 35 was a legitimate dividing line. A new test called amniocentesis diagnosed fetal abnormalities, including Down Syndrome, but occasionally caused miscarriage. To avoid the test-or-don’t-test dilemma, women tried to finish childbearing before 35.
Today, it’s clear that the risk of complications from the test is low, and equally clear that chromosomal anomalies increase gradually with age; they don’t spike the day you cross the 35 line. Large trials such as the FASTER (First- and Second-Trimester Evaluation of Risk) trial and the NBDPS (National Birth Defects Prevention Study) prove that issues associated with advanced maternal age increase slowly over time.
The best way to manage the process is to prepare.
6 Preconception Steps for a Healthy Pregnancy After 35
Knowledge is power, so the best way to begin pregnancy as a not-so-young woman is to take several actions before you cease using birth control. The healthier you are to begin with, the more likely you’ll be to have a trouble-free experience. A healthier body is more fertile, too.
Start with a preconception consultation. Visit your obstetrician to get a full checkup and to learn what steps to take in advance.
See an internist, too. Have your heart, blood sugar, blood pressure and other basics checked beforehand, especially if you know of existing issues. That way you can address any health issues before trying to conceive.
Optimize your health. Stop smoking. Get into an exercise routine. Make your diet healthier. Reach and maintain a healthy weight.
Assess your hormone levels. If your menstrual cycle is irregular, or you bleed heavily, your hormone levels might need adjusting. Talk to your doctor.
Get your AMH level tested. An Ovarian Reserve Test will show how many eggs you have left. On average, at 37 women have 25,000 eggs at the ready, down from at least 300,000 when they begin menstruation but way more than the 1,000 remaining after 50. Smoking, diabetes and obesity can lower that number. Egg quality declines with age.
Take prenatal vitamins. Supplements designed for pregnant women are full of nutrients that benefit both mommy and baby. Start taking them before you try to conceive so even the youngest fetus will have access to all necessary vitamins and minerals.
Managing Pregnancy Risks and When to See a High-Risk Specialist
Pregnancy is full of surprises, from high blood pressure and blood sugar to nausea and long-quiet fibroids that suddenly expand. Visit your obstetrician regularly in order to keep potential hotspots under control. That’s essential because pregnancy itself will be a huge stress on your body for nine months.
If you’re 40 and older with chronic medical conditions, consult with a high-risk pregnancy physician beforehand. You’ll be monitored for pre-eclampsia and other conditions, too. You can partner with that doctor to ensure a good outcome.
Don’t be scared, but do plan ahead. In fact, you might want to consider freezing eggs soon in case you’ll need them later on. That reduces the risk of congenital anomalies associated with an egg’s age. Keep in mind that sperm quality worsens as men get older, which can make sperm swim more slowly and change in shape, making implantation more difficult.
Do not fear pregnancy as you age. Embrace it with knowledge, confidence and expert care.
This content is not AI generated.
