Patient Education Materials
Pregnancy and Childbirth
Pregnancy After 35
Today, many women are waiting until their mid-30s or later before having their first child.
Women over age 35 can have normal pregnancies and deliver healthy babies. But 35 is the age often used to measure an increased risk of problems with pregnancy.
A woman’s chance of having problems during pregnancy goes up a little each year after a woman is in her early 20s. These problems usually fall into 2 categories: a decrease in fertility (a woman’s ability to become pregnant) and genetic conditions that may affect the baby.
Decline in Fertility
As you get older, it is harder to become pregnant. This is because your body does not release eggs (ovulate) as often. Even though you may have regular menstrual periods, your body may not be releasing eggs every month. There is less chance that your partner’s sperm will fertilize the eggs that are released. Fertilized eggs are less likely to attach to your uterus.
Some physical conditions, such as a blocked fallopian (fah-LOW-pee-an) tube or endometriosis (en-doe-ME-tree-oh-sus), also may decrease your chance of becoming pregnant. These problems are more common in women over age 35.
Also, if you and your partner have been together for a long time, chances are you may be having sex less often. Any of these factors may make it difficult for you to become pregnant.
If you and your partner have sex without using birth control for 6 months without your getting pregnant, you should make an appointment with your doctor for a fertility test.
The most common genetic problem in babies born to women older than 35 is Down syndrome. Down syndrome causes birth defects such as intellectual disability and heart problems, among others. Children born to women of any age can have Down syndrome. But the older the mother is, the greater the risk.
Prenatal testing can detect a pregnancy with Down syndrome. Two tests — chorionic villi (kor-ee-ON-ick veel-eye) sampling and amniocentesis (am-nee-o-sen-TEE-sis) are invasive and have some risk. The most serious risk is losing the baby (miscarriage). At age 35, the risk of having a child with a birth defect is about the same as the risk from the test. For this reason, prenatal testing is routinely offered to pregnant women who are 35 or older.
Another test is the multiple marker screen. It is a simple blood test that measures the amount of a certain substance in the mother’s blood. This test can tell if there is a greater risk of having a baby with Down syndrome or other birth defects like spina bifida and anencephaly (an-en-SEF-a-lee).
It is important to remember that these are screening tests and are not 100 percent accurate. Also, they cannot identify all birth defects or genetic conditions.
Genetic counseling can help you and your partner estimate your chances of having a child with a birth defect. If you or your partner has a family history of birth defects or genetic problems, you should have genetic counseling before you become pregnant.
If you are over 35 and planning to become pregnant, you also need to consider that chronic health problems, such as diabetes or high blood pressure, often develop with age. Miscarriage and stillbirth (the birth of a baby who has died before delivery) rates also are higher in women over age 35. By staying in good physical health, you can avoid many of these possible problems.
Preparing for Pregnancy
One of the best things you and your partner can do is prepare for pregnancy, both physically and emotionally. Even though you may feel your “biological clock” speeding up, you should not become pregnant unless you and your partner are ready for the responsibilities and changes that come with having a baby.
When you and your partner decide you are ready to have a child, you should make an appointment with your doctor to discuss your pre-pregnancy care. The father-to-be may want to come to this appointment.
Early and regular care is important to having a healthy pregnancy. Your doctor may recommend that you take prenatal vitamins, especially folic acid (also known as folate), before getting pregnant to help reduce the risks of some birth defects. Always check with your doctor before you take any medicine or vitamins.