You may have heard the term “geriatric pregnancy” to describe pregnancy in women over age 35 — it’s come up a lot recently due to Meghan Markle’s pregnancy at age 37. According to the American College of Obstetricians and Gynecologists (ACOG), however, “advanced maternal age” is the accepted term for pregnancy in women aged 35 and older. The term is intended to highlight the increased risk of complications that can occur with these pregnancies, such as difficulty conceiving, miscarriage, birth defects, high blood pressure, and gestational diabetes.
Women begin life with a fixed number of eggs in their ovaries. As the number of eggs decreases with age, women become less fertile and less able to become pregnant. Women’s fertility is highest in their late teens to the 20s; by age 30, fertility begins to decline—and the decline becomes more rapid after a woman’s mid-30s. For this reason, it’s harder for older women to get pregnant.
And, pregnancies after 35 have a higher risk of complications, for several reasons. First, older women’s eggs are more likely to have abnormal chromosomes, which can cause genetic disorders in the fetus. And, with age, women have a increased risk of having conditions that reduce fertility and increase the risk of pregnancy complications; these conditions include uterine fibroids, endometriosis, high blood pressure, and diabetes. (Younger women with these conditions are also deemed to have high-risk pregnancies.)
The average age at which women in the U.S. have their first baby has been increasing for several decades. As of 2016, the average age of first birth among U.S. women was 26.3 years (up from 22.7 in 1980). Approximately 1 in 6 pregnant U.S. women are older than 35.
But, not every older woman is going to experience pregnancy problems. Many of the risks can be mitigated with a good preconception plan and good prenatal care. So, there are two key things to do increase the chance of a healthy pregnancy:
- See an Obstetrician-gynecologist (OB/GYN) or midwife before getting pregnant and create a preconception health plan. Your provider will help make sure you’re healthy before getting pregnant, discuss your medical history and individual risks, review the medications you take to identify any that might cause problems, and discuss any health issues before you try to conceive. You and your team can help determine the best options based on your specific medical history.
- Make and keep your prenatal care appointments. Prenatal care is vital to prevent, identify, and address complications and ensure a healthy pregnancy and birth. Babies born to women who didn’t get adequate prenatal care are three times more likely to be low-birthweight and to experience other complications. During prenatal appointments, important health indicators are monitored, including your blood pressure, blood sugar levels, and weight. Specific screenings are also performed at key milestones during pregnancy to identify any conditions or risks that may have arisen.
The National Women’s Health Network is committed to ensuring that all women have access to accurate, balanced information so they can make the best decisions for their unique experience.
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