Pregnancy After 35

Having a baby when you're over 35 can mean more health concerns and extra tests, but it shouldn't be cause for alarm or distress. In fact, nearly 1 in 10 babies are born to women over 35, and the majority are delivered without complications. "Women over 35 are at higher risk for developing high blood pressure and gestational diabetes, but with good prenatal care, they should be off to a healthy start," says Lynn Simpson, M.D., an ob/gyn at Columbia Presbyterian Medical Center in New York City. Here, a look at what older pregnant women should consider:

General health Women this age need to eat properly, exercise, and attend all prenatal appointments. "Since older women tend to be a bit heavier, they should follow a well-balanced diet throughout pregnancy," says Dr. Simpson. Most women need to add about 300 calories to their daily diet.

Testing It's standard for women over 35 to be offered genetic testing, as the risk of chromosomal abnormalities increases at this age. You can usually choose between a chorionic villus sampling (CVS) at 9 to 11 weeks or an amniocentesis at 15 to 16 weeks. (Miscarriage risks are a bit higher with the CVS test.) If the results are positive, further tests or counseling can be arranged, says Maria Hayes, M.D., a reproductive endocrinologist at Oakwood Hospital in Dearborn, Michigan.

Complications Pregnancy in women over 35 can trigger high blood pressure and diabetes, and the risk of preeclampsia (pregnancy-induced hypertension) may also increase. The risk of miscarriage and stillbirth goes up with age as well, possibly due to chromosomal abnormalities or uterine fibroids (benign tumors found in nearly one-quarter of women over 35), which may interfere with fetal development. The incidence of twin births also increases and can cause preterm labor, which occurs in almost half of all multiple pregnancies. Older women have a higher rate of cesarean sections as well, which involve a longer recovery.

Emotions Moms-to-be over 35 are usually ready for the life change that comes with the birth of a baby. Managing the emotions and added strain that may accompany pregnancy, however, is important as high stress levels have been linked to an increased risk of complications. In addition to eating well and exercising, making time to relax should be a priority. Yoga, massage, and leaning on a support network of friends and family will help expectant mothers wind down during this emotionally charged time. 

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Pregnancy at 20, 30, 40

Most experts would say there's no one right time to start a family. But there are both advantages and disadvantages to giving birth at different ages: In your 20s, for instance, you'll have more energy to run after and care for your child but fewer financial resources and less personal life experience on which to draw; in your late 30s and 40s you may be more established financially but have a tougher time getting and staying pregnant and, afterward, keeping up with an active baby and toddler.

What follows is a look at the pros and cons of pregnancy at different ages.

Ages 20 to 24

YOUR BODY

These are your most fertile years. Your periods are probably regular, and most, if not all, of them are ovulatory. Even now, however, you may not conceive exactly when you want to. The average woman between 20 and 24 years old has about a 20 percent chance each month of getting pregnant when she has unprotected intercourse.

Once you do conceive, your blood pressure will probably be checked at each prenatal appointment, even though most women in their 20s have only a small risk of hypertension during pregnancy. New research shows that you have about half the risk of gestational diabetes that women in their 40s do, which is why recent guidelines from the American Diabetes Association suggest eliminating the once routine test for gestational diabetes in women age 25 or under.

YOUR EMOTIONAL SELF

How you feel about your pregnancy may depend, in great part, on other things in your life. Some women who postpone job advancement to have a baby feel ambivalent or resentful at first, says Diane Ross Glazer, Ph.D., a psychotherapist in Woodland Hills, CA. "Another concern is body image, which is a bigger issue for most women in their 20s than for those who are older. Also, a woman at this age is likely to be focused more on her marriage than on other parts of her life, such as her job, and adding a third person into the mix may be difficult," says Glazer.

RISKS TO YOUR BABY

The miscarriage rate during these years is about 9.5 percent, the lowest it will ever be. Because your eggs are still relatively young, your baby is much less likely to be born with a birth defect such as Down syndrome (1 in 1,667 births among women age 20) or other chromosomal abnormalities (1 in 526 among women age 20). Yet more infants with these disorders are born to women in their 20s because those in this age group have more babies and women past 35 are more likely to be offered screening tests and may elect to terminate a pregnancy in which the fetus has a birth defect.

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