Early into my pregnancy with my fourth child, my doctor caught me by surprise.
“We’ll be doing some early testing this time around,” she said nonchalantly.
Alarmed, I asked if anything was the matter. She reassured me everything was fine, but because I was 35, I was considered to be having a geriatric pregnancy. Or, as she put it in a gentler and less offensive way: I was of “advanced maternal age.”
Advanced maternal age.
Having a geriatric pregnancy wasn’t a term I was thrilled to be connected to. More importantly, it left me with a lot of questions: What would be different this go round? Would my body change on me? Would I be allowed to go to 40 weeks? Would I have to have a C-section? Was the baby going to be okay?
It felt like, all of a sudden, I was in a new club but I didn’t know the rules. Here’s what I discovered about a geriatric pregnancy along the way (spoiler: it all worked out just fine!).
In this article:
Who You Callin’ Geriatric Pregnancy?
A geriatric pregnancy is any pregnancy that occurs in a woman age 35 or older. Data shows that the percentage of women giving birth at age 35 and older is actually increasing every year, particularly in high-income countries where many women delay childbearing for a number of reasons, such as:
- Having career
- Finishing their education
- Gaining financial stability
- Finding the right partner
So if more and more women are giving birth over the age of 35, why the need to monitor them? The answer comes down to biology.
Because women are born with all of their eggs, as we get older, our eggs do too. As the American College of Obstetricians and Gynecologists explains, the older the egg, the more likely it could have some abnormalities.
In addition to problems with older eggs, studies have shown that pregnancies over 35 – and particularly those over 40 – are associated with increased complications, including stillbirth.
"Studies have shown that pregnancies over 35 – and particularly those over 40 – are associated with increased complications, including stillbirth."
Pregnancy After 35: The Real Story
While that data might sound frightening, it’s not as scary as it sounds. It’s actually pretty common for women to give birth over the age of 35 or later.
For instance, according to the most recent data by the CDC, birth rates fell for women in their teens and 20s but rose for women in their 30s and late 40s. In fact, according to the CDC data the birth rate for women between 35 and 39 is the highest it’s ever been since the 1960s.
Having a baby after 35 has also been highlighted by women in the spotlight who are rocking their AMA pregnancies. Rachel McAdams gave birth at 39. Mindy Kaling had her second son at 41. And, the Duchess of Sussex, who is currently expecting a daughter, put AMA in the news by having son Archie at 37. All of these women and more safely delivered their babies post 35.
What to Expect with a Geriatric Pregnancy
If you join me in the ranks of geriatric pregnancy, here’s what you can expect:
- Prenatal screening. Prenatal screening can detect a number of issues that can prepare parents for potential issues their baby may have. A prenatal screening is a screen for the possibility of abnormality or disease—it will not tell you for certain if your baby has a genetic disorder but rather the chances that s/he might. These include blood tests and ultrasounds done between 11-14 weeks that can detect chromosomal anomalies such as trisomy 21 (Down syndrome).
- Genetic testing. Genetic testing is more invasive. For example, chorionic villis sampling (CVS) takes cells from the placenta wall in order to diagnose a disorder. These will confirm a suspected issue or abnormality.
- Additional tests if needed. If an abnormality is seen in your early tests, your doctor may order more invasive testing such as amniocentesis, in which a needle is sent through the abdominal wall to retrieve amniotic fluid.
- Cord blood banking. This doesn’t really have anything to do with being older–it’s just an option parents may be interested in. You can donate your baby’s cord blood for research or to a bank that can use it, or you can pay a private cord blood bank if you’d like to store your baby’s blood.
- Absolutely nothing at all. However, if the results from the 12-week ultrasound don’t indicate any issues, chances are your doctor will proceed with your prenatal visits as normal.
This obviously is different with each individual pregnancy and depends heavily on the initial health of the mother. In fact, preexisting conditions, no matter what your age, will determine the kind of monitoring your OB deems appropriate.
This is why it is so important to sit down with your doctor and discuss your personal health one-on-one. Every pregnancy is different and age is just one factor.
“Age is just one factor in pregnancy and so much more depends on the mother's health at conception instead of how old she is."
Pregnancy Risks After 35
Of course, every pregnancy comes with possible risks. And studies indicate that these risks can increase as you age. This is why prenatal care is so important.
Since older people are inclined to have higher blood pressure, which can result in a higher risk for preeclampsia, your doctor may want to closely monitor your blood pressure. Gestational diabetes is another risk that may increase as you age.
The most important step in avoiding risk in pregnancy is to try to be as healthy as you can by managing what you can control:
- Avoid tobacco, marijuana, and alcohol use
- Exercise and achieve a healthy weight as much as possible
- Take a prenatal vitamin
- Make a preconceptions health plan if you’re planning to conceive in the future
My Geriatric Pregnancy Story
So how did my own geriatric pregnancy turn out? Spoiler alert: it turns out, not a lot changed.
At my advanced maternal age, I delivered my fourth child the same way I did the other three.
For me, pregnancy after 35 felt a lot like “regular” pregnancy. For a lot of women, the same holds true. A healthy pregnancy is a healthy pregnancy.
Sure, I may have been a bit more tired and not as youthful. I was a couple years older and I had three young kids under foot. But my uncomplicated geriatric pregnancy was pretty much identical to my uncomplicated non-geriatric pregnancies.
“At my advanced maternal age, I delivered my fourth child the same way I did the other three.”
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