Midlife Moms

Planning for a safe pregnancy past 35

Moving through your mid-30s and pondering motherhood? You’re not alone. In fact, about 20 percent of first-time moms in the U.S. today are older than 35.

But risks to both moms and babies increase with advancing age. Women can improve their chances for a successful pregnancy by adopting healthy habits and getting good health care before they conceive and once they’re pregnant.

No True “Age Limit”

There’s no set age when it becomes unsafe for a woman to become pregnant. However, older women may need to deal with issues during pregnancy that don’t apply as frequently to younger women. Health problems that can cause complications before and after pregnancy, such as high blood pressure and diabetes, become more common as women age.

Women older than age 35 are more likely than younger women to have:

• Miscarriage

• Diabetes or high blood pressure related to pregnancy

• Ectopic pregnancy, in which the fetus grows outside the uterus

• Delivery by cesarean section

• Low-birth-weight baby

• Pregnancy with multiples (twins, triplets, or more)

Chances of having a baby with a genetic disorder, such as Down syndrome, also increase with age.

All pregnant women, regardless of age, should be offered screening tests for birth defects. These tests can help evaluate the risk of having a baby with certain complex health needs, but they can’t provide a definitive diagnosis. Women also have the option of a diagnostic test such as amniocentesis or chorionic villus sampling, which can actually determine whether or not your baby has a certain birth defect. 

Preconception Care Is Key

Start taking care of yourself before you become pregnant. Women planning to become pregnant should see a health care provider first.       

For some women, getting their bodies ready for pregnancy takes a few months, but others may need more time. Other steps that can help prevent problems during pregnancy include the following:

• Take folic acid. This B vitamin helps prevent certain birth defects of the brain and spine. The CDC recommends that all women get 400 mcg of folic acid every day from their diet or supplements, even when they are not planning on getting pregnant.

• Quit smoking and drinking alcohol. Talk with your doctor if you need help quitting.

• Get vaccinated. Talk with your doctor about which vaccinations are recommended before, during, and right after pregnancy. 

• Avoid toxic substances or materials that could hurt your unborn baby.

• Talk with your health care provider about any over-the-counter and prescription medicines you take, including dietary or herbal supplements.

• Eat a healthy diet and get regular exercise. If you’re over- or underweight, take steps to get to a healthy weight.

• Reduce stress.

As Age Goes Up, Fertility Goes Down

Fertility declines with age, so women may experience more difficulty getting pregnant the longer they wait. Conception is likely to take longer beginning in the early 30s. Age affects men’s fertility, too, beginning at age 40.

Many factors affect fertility. Ovulation—releasing the egg from one of the ovaries—occurs less often as women age. Eggs are also not as easily fertilized in older women as they are in younger women.

If you’re older than 35, see your doctor after trying unsuccessfully to get pregnant for six months or more. 

Once You’re Pregnant

Good prenatal care is a must for every mom. Doctors can spot health problems sooner when they see mothers more often. And women with chronic conditions may need additional testing, monitoring, or medications. For example, if you have type 1 or type 2 diabetes, the American Diabetes Association now recommends taking low-dose aspirin starting at the end of the first trimester to lower the risk for preeclampsia. Always talk with your doctor before starting any new medications to determine what is right for you and your baby.

Getting early and regular care can increase your chance of having a healthy pregnancy and a healthy baby.