Patient education: Pregnancy as you get older (The Basics)

Does my age affect my pregnancy? — 

Yes. As you get older, your risk for certain problems related to pregnancy increases.

Doctors sometimes use the term "advanced maternal age." This typically means pregnant people who will be 35 years or older on their due date. But the risks that come with age increase gradually, not suddenly at a certain age.

If you are 35 or older, your doctor or midwife will talk to you about your care during pregnancy. They will probably recommend extra visits and tests. This way, they can monitor you for any problems.

What are the risks of being older during pregnancy and birth? — 

Most people will not have serious problems with pregnancy or birth, even if they are older. But there are some increased risks to know about. These depend not only on your age but on your overall health. Some are related to health problems that are more common as a person gets older, like high blood pressure and diabetes.

As you get older, you have an increased risk of:

●High blood pressure or preeclampsia – Preeclampsia is a serious problem that can happen during pregnancy. It causes high blood pressure and other problems.

●Diabetes – Diabetes causes high blood sugar. During pregnancy, this can cause problems such as the baby being larger than usual.

●Getting pregnant with twins or triplets

●Ectopic pregnancy – This is when the pregnancy grows outside the uterus, usually in 1 of the fallopian tubes.

●Problems with the placenta – The placenta is the organ inside the uterus that brings nutrients and oxygen to the fetus.

●Pregnancy loss (miscarriage) or stillbirth

●The baby being born early ("preterm") or weighing less than normal at birth

●Problems with the fetus – As you get older, the risk of some genetic disorders, like Down syndrome, increases. Certain problems with the fetus's development might also be more likely.

What kind of prenatal care will I need? — 

All pregnant people should see their doctor or midwife for regular "prenatal" care.

If you will be 35 years or older on your due date, your doctor or midwife will probably offer specific tests. These typically include:

●Ultrasound – This uses sound waves to create pictures of the inside of your body and of your fetus. Early in pregnancy, it is done to check your due date and see if you are pregnant with more than 1 fetus (such as twins). Ultrasounds can also help the doctor or midwife see how the fetus is growing.

●Testing for Down syndrome and other genetic disorders – There are different options:

•Blood tests – These can give information about how likely the fetus is to have certain genetic problems.

•Diagnostic tests – These include amniocentesis and chorionic villus sampling ("CVS"). They involve using a needle to get a sample of fluid or cells for testing. These tests can tell for sure if a fetus has certain problems, such as Down syndrome.

●Early diabetes screening – This involves drinking a sugar drink and then having your blood drawn. It is recommended for everyone during pregnancy, but is often done earlier in people who are older.

●More frequent checks toward the end of pregnancy – Your doctor or midwife might do an ultrasound at or after 32 weeks of pregnancy. This is to check how the baby is growing and measure the amount of fluid around it. After that, they will do regular checks of your baby's movement and heart rate.

In some cases, you can choose which tests to have. For example, some people want to know for sure if their fetus could have a genetic problem. Other people choose not to.

What should I expect when giving birth? — 

People older than 35 years are more likely to have problems during labor. For example, labor might not move along as expected, which can lead to needing a cesarean birth (c-section).

Your doctor might recommend "inducing" labor at 39 weeks of pregnancy. Sometimes, this can be safer than waiting for labor to start on its own. They will talk to you about your options, and the risks and benefits of each.

What can I do to lower my risks? — 

You can:

●Talk to your doctor or nurse before you start trying to get pregnant – They can help you take steps to make sure you are as healthy as possible before pregnancy. This includes making sure any other medical conditions are well managed.

●Take low-dose aspirin, if your doctor told you to – In some people, this can lower the risk of preeclampsia. Doctors do not recommend this for everyone.

●Space out your pregnancies, if possible – Getting pregnant again soon after giving birth can increase the risk of problems, especially if you are older. Doctors often recommend waiting for at least 1 year after giving birth before trying to get pregnant again.

There are also things every pregnant person should do, no matter their age. For example, it's important to:

●Take a "prenatal" multivitamin that has folic acid.

●Avoid smoking, drinking alcohol, or using drugs. Talk to your doctor about what medicines are safe to take.

●Try to eat a healthy diet with lots of fruits, vegetables, and whole grains. You should also:

•Avoid eating raw or undercooked meat. Avoid fish that can have high levels of mercury, such as shark, swordfish, king mackerel, or tilefish.

•Limit caffeine to no more than 1 or 2 cups of coffee each day.

•Avoid germs in your food that could make you sick. Wash your hands with soap and water before preparing or touching food. Wash or peel fruits and vegetables before eating them. Avoid deli meats and "unpasteurized" milk or cheese.

●Try to keep a healthy body weight.

When should I call the doctor? — 

Call your doctor, nurse, or midwife right away if you are pregnant and:

●Have a bad headache or vision changes

●Have belly pain

●Feel short of breath

●Have any vaginal bleeding

●Notice your baby moving less than usual

●Think you might be in labor

●Have any other symptoms that worry you

More on this topic

Patient education: How to plan and prepare for a healthy pregnancy (The Basics)
Patient education: Prenatal care (The Basics)
Patient education: Nutrition before and during pregnancy (The Basics)
Patient education: Taking medicines during pregnancy (The Basics)
Patient education: Alcohol and drug use in pregnancy (The Basics)
Patient education: Preeclampsia (The Basics)
Patient education: Gestational diabetes (The Basics)
Patient education: Having twins (The Basics)
Patient education: Ectopic pregnancy (The Basics)
Patient education: Pregnancy loss (The Basics)
Patient education: Stillbirth (The Basics)
Patient education: Preterm labor (The Basics)
Patient education: Prenatal ultrasound (The Basics)
Patient education: Testing for Down syndrome during pregnancy (The Basics)
Patient education: Cesarean birth (The Basics)
Patient education: Labor induction (The Basics)

Patient education: Preeclampsia (Beyond the Basics)
Patient education: Gestational diabetes (Beyond the Basics)
Patient education: Ectopic (tubal) pregnancy (Beyond the Basics)
Patient education: Pregnancy loss (Beyond the Basics)
Patient education: Preterm labor (Beyond the Basics)
Patient education: Should I have a screening test for Down syndrome during pregnancy? (Beyond the Basics)
Patient education: C-section (cesarean birth) (Beyond the Basics)