What Makes a Pregnancy After 35 Different?

It’s no secret that women are waiting longer to have children. According to one study, nearly 19% of pregnancies are among women 35-plus — but this group of expectant moms may still be referred to as having a “geriatric” pregnancy. 

“Geriatric pregnancy is definitely an outdated term!” says Nancey Hahn, MD, an OB-GYN with Axia Women's Health. (Louder for the people in the back.) Instead, “advanced maternal age” is typically used, which, though not much better, Hahn says, “helps us quickly identify patients that are in a different risk group.” But why is the risk different anyway? Hahn explains.

What made pregnancy after 35 considered “geriatric”? 

In part, it has to do with pregnancy-related health risks. “Moms after age 35 are at higher risk of pregnancy-induced high blood pressure, pregnancy-induced diabetes, having babies that are small for gestational age, or preterm delivery,” says Hahn. C-section rates are also typically higher for first-time moms who are over 35, she says. “This may be related to the increased rates of hypertensive disorders and diabetes,” she explains. 

Also important to know: “After age 30, the quality of a woman’s eggs begins to decline,” says Hahn. While every person is different, this can make it harder to conceive and potentially increases the chance of a miscarriage. “This is because poor quality eggs are more likely to have genetic errors that prevent the growth of an embryo,” she says. 

How is prenatal care different for women over 35? 

It sometimes entails more testing and monitoring. That can range from doing additional ultrasounds to check baby’s growth to offering more invasive genetic testing, like an amniocentesis. 

In the third trimester, women over 40 may also have weekly nonstress tests. Their providers may also encourage them to schedule an induction so they deliver by their due date, says Hahn.  

I’m over 35 and want to get pregnant. How can I prep for it?

Here are some ideas:  

• Focus on your health. “Limit alcohol, don’t smoke, eat a healthy diet, and exercise regularly,” says Hahn.

• Talk to your provider. “Ideally, you should meet with your OB-GYN and discuss your fertility plans well before you plan to conceive,” says Hahn. Once you’ve gone through your personal and menstrual history, talk about ways to optimize conception and schedule any screenings needed. If you’ve been trying for more than six months, consider talking to a fertility specialist, she adds.

• Stay positive. Remember that even though your fertility isn’t the same in your mid-30s as it is in your early 20s, research still shows that at 35 the chances of getting pregnant in a year are around 66%. And if you’re feeling stressed, there are a variety of things that can help.