The number of women in the U.S. giving birth at age 35 and older has steadily been growing. Between 1990 and 2023, birth rates increased 71% among women ages 35-39, 127% among women ages 40-44 and 127% in women 45 and older, according to the CDC. Researchers cite several reasons for this increase, including changing social expectations and values; prioritizing education and career earlier in life; waiting longer to get married; and improvements in reproductive technologies. No matter the reason, there are several things to keep in mind when considering pregnancy if you are 35 or older.
The Pregnancy Journey
First, as women age, our fertility is reduced – a process that begins in the early 30s. By mid-40s, most women have difficulty conceiving naturally, and the average woman begins menopause at 51.
While there are always inherent risks to getting pregnant, older women may face more complications. These include difficulty in getting pregnant, as well as an increased chance of multiple births due to the body’s releasing more than one egg as it goes through hormonal changes. The risk of multiple births also rises if you are undergoing in vitro fertilization (IVF) treatments – one of the many options for couples having difficulty conceiving.
Once pregnant, your chance of developing gestational diabetes is also more common. Your physician will check you for gestational diabetes, but remaining physically active can be very important. Following as much of your regular workout routine can also keep you feeling calm and comfortable and may help during labor and recovery.
Risk Factors & Recommendations
While women over the age of 35 often have great outcomes and healthy babies, there are some other risk factors to keep in mind. As we age, there is the potential for:
- A higher risk of pregnancy loss, often due to pre-existing medical conditions or the baby’s chromosomal conditions. It is important to talk with your provider about genetic screenings and the optimal time for getting screened
- A greater risk of premature birth
- An increased risk of a baby born much larger or much smaller than average
- A higher chance of a C-section delivery
I recommend the following measures to make your pregnancy and birth as smooth as possible:
- Take prenatal vitamins with folic acid and docosahexaenoic acid (DHA), an omega-3 fatty acid that can be vital for a fetus’ and infant’s brain and eye development
- Keep up with your appointments, as you will be monitored for signs of preeclampsia or gestational diabetes
- After delivery, try to be up and mobile as soon as you can; this helps with your recovery either from vaginal or C-section delivery
Having a baby at any age is one of life’s great joys, but being aware of the risk factors involved – especially if you are 35 or older – is essential to ensuring you are prepared for what is ahead. Your physician is always your greatest resource, so be sure to let us know your plans so we can help you every step of the way.
Learn more about White Plains Hospital's Maternity services.
Dr. Karimah Smith is a board-certified obstetrics and gynecology physician at White Plains Hospital Physician Associates in White Plains. To make an appointment, call 914-328-8444.