There's no biological flip of the switch when you turn 35, but it can sometimes feel that way for people who want to have a baby in their late 30s or beyond.
Being at "advanced maternal age," patients 35 and older are usually cautioned about all types of pregnancy complications that can interfere with family planning — from miscarriage and preterm birth to high blood pressure and diabetes. And that's if you can get pregnant. Fertility starts to decrease by age 30 and gets more problematic just a few years later due to reductions in egg count and a higher risk of developing uterine fibroids, which can make it harder to conceive.
But that's not stopping a generation of people looking to delay pregnancy until later in life. Between 1990 and 2019, birth rates went down for twentysomethings and up for people over 30. The rates of people having babies between the ages of 40 and 44 doubled from 0.5% to 1%.
Fortunately, obstetric care has advanced to the point where patients of all reproductive ages now have tools to help them pursue healthy pregnancies. If you hope to have a baby at any age — but especially after 35 — here's what you need to know.
Different pregnancy complications by age
No matter who you are, pregnancy takes a toll on the body and mind. Complications can mean problems for the baby, problems for the birth-giver or concerns that affect them both. While many variables can contribute to these issues — and complications can affect patients of any age — a mother's age is still very often among the risk factors for common issues that can occur during pregnancy.
At any age
In early pregnancy, miscarriage is common, affecting up to 1 in 2 conceptions. Although people of all ages experience miscarriages, older age can raise the risk.
After 25, your risk for gestational diabetes goes up. This pregnancy-related condition happens when the body has trouble breaking down sugars in the blood. It can create some problems in pregnancy, such as having a big baby or requiring a caesarean section, but it typically resolves after the baby is born.
35 and older
In addition to fertility struggles that may accelerate at this age, being 35 starts the period of reproductive health called advanced maternal age. Notably, babies of mothers over 35 tend to have a higher risk for chromosomal abnormalities like Down syndrome. They're also at greater risk of having a low birth weight or being born prematurely.
At this age, risk also climbs for prenatal depression, although some studies have shown that this mental health concern is rising in younger mothers too.
40 and older
Hypertension happens when blood pressure is too high, and it can lead to a severe complication called preeclampsia that can affect the organs and require emergency delivery. After age 40, the risk for preeclampsia goes up.
Detecting and preventing complications through prenatal care
Whether you're already pregnant or trying to be, the best things you can do for yourself and your baby are to eat healthy, stay active, take a prenatal vitamin, avoid smoking and get routine care. Doing so can help you minimize other risks, such as being overweight, which can combine with age-related risk factors.
Patients struggling with fertility may want to undergo specialized testing to help them conceive, especially after age 35. If you are pregnant at an older age, there's good news: You'll likely get the benefit of added monitoring, which may include more ultrasounds, access to genetic testing and prenatal visits. This type of extra surveillance can help doctors detect possible concerns and further reduce the risk of other complications.
Whether you're expecting or not, don't forget that doctors are happy to answer any questions you may have about pregnancy complications at any age. Reach out to them for more information or if you're ever worried about anything getting in the way of a happy and healthy pregnancy.