More women than ever before are choosing to have children into their late thirties and forties. Did you know 15% of women who give birth nowadays are 35 and older? New research and better medical technology have made so-called advanced age pregnancies safer than ever before.
At Shenandoah Women’s Healthcare (SWHC), we believe pregnant women at every age deserve support, resources, and the best care available. We want you to feel excited and empowered.
This advanced age pregnancy guide will take you through the important issues that many older mothers face. We’ll also go over specific steps you can take at every stage to help promote a safe, enjoyable, and healthy pregnancy.
What Does “Advanced Age” Really Mean?
Traditionally, women over 35 are considered “advanced maternal age.” Does this mean your likelihood of a safe, healthy pregnancy suddenly plummets on your 35th birthday? Not at all. In fact, there’s actually nothing particularly special about 35.
Various risk factors tend to increase gradually as women age (we’ll go over those next) but every woman and every pregnancy is unique. When it comes to a healthy pregnancy, there are also other factors that, in many cases, are more important than age. These include your health and genetic family history.
So whether you’re 25, 35, or 45 the best thing you can do before and during pregnancy is work with a medical provider you trust to understand any potential risks and what you can do to mitigate them. In fact, all the suggestions in this post are great advice for anyone considering pregnancy, regardless of age.
Now let’s look at some of the most important questions and issues to discuss with your provider.
Will it Take Longer to Get Pregnant?
(If you’re already pregnant, skip to the next section.)
As women get older, it can become more difficult to get pregnant. Women are born with a limited number of eggs. As you get older, the number of eggs you have decreases and your eggs may become less easily fertilized. For most women, menopause is when the possibility of getting pregnant ends.
So what should you do?
Make a Preconception Appointment
If you’re thinking about having a child, the first step is to make a preconception appointment. Eat a healthy diet and avoid risky substances like alcohol, tobacco, caffeine, and illegal drugs. Clear all your current medications or supplements with your provider. Here’s a useful list of safe medications during pregnancy.
Learn About Genetic Testing
Before you become pregnant is a great time to learn about the benefits of genetic testing. This will help identify the likelihood that you will pass on genetic conditions to your child. It is possible to “carry” a change in a gene that’s linked to disease without showing any symptoms of the disease itself. Also, some diseases require a gene change to be inherited from both parents for the disease to occur, so it’s important to test both parents.
Consider Fertility Care
If you’re over 35 and you’ve been trying to conceive for more than 6 months we may recommend an infertility evaluation. We can:
- See if you’re ovulating using blood tests, and/or ultrasound examinations
- Check the health of your fallopian tubes and uterus with a specialized x-ray
- If necessary, recommend fertility treatments and strategies to further increase your chances of becoming pregnant
- Answer any questions you have at every stage
Am I More Likely to Have Twins?
Did you know your odds of having twins increases as you get older? It’s true! In addition, some fertility treatments (like in vitro fertilization) can increase the possibility of having more than one child.
Talk to your provider about your chances of a multiple pregnancy (two or more children at once), and whether or not those chances rise with each fertility treatment you try.
You should know: Learning that you’re having twins can be a shock at first. But in our experience, most parents find having twins to be a wonderful experience, even if it was a little scary at first.
Should I Be Worried about Complications During Pregnancy?
As a general rule, certain pregnancy complications become more likely as women age. Just remember, you are a unique person, not a statistic. At SWHC, our healthcare providers can assess your risk for complications on an individual level. We’ve helped countless women well over 35 years old have completely safe pregnancies with very few or no complications.
It’s a good idea to talk to your women’s healthcare provider about a few issues early on:
This is a type of high blood sugar that affects some pregnant women. It’s actually very common — especially as women get older — and it’s extremely treatable with the right lifestyle changes. In some cases, medication is also helpful. In order to both prevent and treat gestational diabetes, we generally recommend a healthy diet, limited sugar, and gentle physical activity that’s been cleared with your provider.
High Blood Pressure
Researchers have found that elevated blood pressure during pregnancy is more common among older women. A healthy, low-sodium diet and gentle physical activity are your best defenses. If you still develop high blood pressure, we may recommend medication.
Babies born to older mothers have a higher risk of chromosome abnormalities such as Down syndrome. Researchers estimate that a baby’s chance of being born with Down syndrome is about 1 in 353 if you’re 35 and 1 in 85 if you’re 40. Talk to your provider about the pros and cons of prenatal testing for chromosome abnormalities.
Studies suggest that somewhere between 10-25% of clinically recognized pregnancies end in miscarriage. But women 35-45 have about a 20-35% chance of miscarriage. At SWHC, we know that a miscarriage can be absolutely heartbreaking. We’ll do everything we possibly can to help you have a safe pregnancy and carry your baby to term.
How to Minimize and Eliminate Risk Factors
There are a few things you can do to increase your chances of a healthy pregnancy and decrease the risks to you and your baby if complications do arise.
- Get regular prenatal care throughout your pregnancy. Discuss your risk factors for various complications and issues, and talk about what you can do about them.
- Continue to eat a healthy diet and avoid risky substances.
- With the guidance of your provider, see if it’s possible to get some gentle exercise on a regular basis. Work with your provider to determine how much weight gain is healthy for you.
- Have regular ultrasounds. We traditionally recommend an ultrasound in the first 12 weeks, and then two more in the second and third trimester.
What Should I Expect During Labor and Birth?
Photo: george ruiz
Modern medicine has made labor and birth safer now than ever before. That’s true whether you’re 25 or 45. However, if you’re closer to 45, there are a few things you should know:
Older mothers are more likely to need a C-section. The older you are, the higher your risk for certain conditions that may require a C-section. For example, one of the risk factors for placenta previa (when your placenta blocks the opening in your cervix) is being older than 35. Women over 35 are also at a higher risk for preterm birth — when a baby is born before 37 weeks.
What You Can Do
Do what you can to mentally and physically prepare for labor and birth. Work with a certified nurse midwife and/or physician you trust. Well before your due date, discuss a labor plan that fits your individual needs and desires, but be open to changing your plan if necessary. A good labor plan can really bring peace of mind, especially if this is your first pregnancy.
Are You Ready to Begin Your Journey to Motherhood?
Whether this is your first child or you’ve already become a mother many times over, this is an exciting time in your life! We at SWHC would be thrilled to help and support you and your family as you welcome a new person into your life.
At our Harrisonburg clinic, we want to empower you by helping you understand all your options so you can make the best choices for you and your baby, no matter what you age. We even offer you the option of Centering Pregnancy, where check-ups, support, and education all take place in a group setting with a nurse-midwife and other women due in the same month.
Whether you just found out you’re pregnant or you’re just beginning to consider it, you probably have many questions we didn’t get to today. We would love to go through them with you.
Call Shenandoah Women’s Healthcare today at (540) 438-1314 or request an appointment online.