5 things to know about pregnancy after 35 :: WRAL.com

Wondering if you’re too old to have a baby?

More women are waiting to start a family, according to the US Census Bureau. The median age of mothers giving birth in the United States is now 30. The number of women aged 35-39 giving birth increased by 67% between 1990 and 2019, and by 132% for those aged 40-44.

Although some pregnancy risks increase as the mother ages, your family history and general health are important factors in your ability to conceive, carry and deliver a healthy baby, says Omar Young, MD, maternal-fetal medicine specialist at UNC.

“Advanced maternal age is generally considered to begin at age 35,” says Dr. Young. “But I tell patients, ‘Nothing magical happens when you hit 35.’ Women over this age account for 15% of all pregnancies Women over 40 account for 3% of pregnancies.

So what are your options if you wait until you’re older to start a family?

1. Make sure your general health is under control.

“As we age, we all have more health complications,” says Dr. Young.

Women hoping to conceive should ensure that their blood pressure, blood sugar and weight are under control. Keep up to date on vaccinations, especially against varicella (chickenpox) and rubella (German measles).

“If you’re overweight, losing even 5 or 10 percent of your body weight can reduce your risk of high blood pressure and diabetes,” says Dr. Young. “Work with your GP or OB-GYN to make sure you’re as healthy as possible.”

He also recommends that all women planning pregnancy start taking prenatal vitamins containing folic acid and exercise regularly.

2. Understand your family history.

“The risk of chromosomal abnormalities, such as Down syndrome, increases with the age of your eggs,” says Dr. Young. “But it’s a common misconception that if you’re a certain age, you’re going to have a complicated pregnancy.”

What is true is that the risk of chromosomal abnormalities is greater if you have a close relative with a genetic condition. This includes parents, siblings and your other children. You and your partner may want to consider getting tested for certain genetic conditions. More on that later.

Dr. Young also notes that some women who wish to delay parenthood until they are older may choose to freeze their eggs, which prevents the eggs from aging. Then, when a woman is ready for pregnancy, the eggs can be fertilized in the laboratory and implanted in the mother’s uterus through in vitro fertilization.

3. Talk to your doctor or midwife about any problems with conception, pregnancy and childbirth.

Even healthy women may have more difficulty getting pregnant when they are older.

“As you get older, the number of eggs you have decreases,” says Dr. Young. “It can make conception more difficult. It is not uncommon for women to be seen by an endocrinologist (hormone specialist) or fertility specialist.

You are more likely to have multiple babies (twins or more), miscarriages, preeclampsia (high blood pressure during pregnancy), premature delivery, low birth weight babies, caesarean section and postpartum hemorrhage , he said.

“If you’re 40, you’re at high risk,” says Dr. Young. “But just because you’re a certain age doesn’t necessarily mean disaster is going to happen. If you are 25 and have high blood pressure or diabetes, you are also at risk.

4. Consider genetic counseling and testing.

If you want to know more about the risks of genetic diseases and birth defects, talk to your doctor or a genetic counselor before you get pregnant, during your pregnancy, or both.

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You and your partner may want to be screened for genetic conditions, especially those that run in your family. If you are found to be a carrier, it means that you are not affected by the disease yourself, but that you could transmit a genetic mutation to your child. If you and your partner are both carriers, your child is more likely to have the disease or be a carrier. Examples of these conditions are sickle cell disease and cystic fibrosis.

“Before doing any tests, however, you need to decide what you would do with the results,” says Dr. Young. “Ask yourself, ‘Am I capable of raising a child with significant disabilities?'”

When you are pregnant, you can take prenatal tests to see if you and your baby are healthy. These include ultrasound, maternal blood screening, and cell-free DNA screening. These tests do not tell you for sure if your baby has a birth defect; only if your baby may be at risk.

Diagnostic tests, including chorionic villus sampling and amniocentesis, can tell you with more certainty if your baby has birth defects.

Knowing if your baby has any chromosomal abnormalities or birth defects can help you prepare physically and emotionally for the birth of your baby. It can also help your doctor know if you will need any special treatment to stay healthy during pregnancy and childbirth.

5. Eat well and exercise.

Make sure you’re getting enough of the right nutrients for you and your baby during your pregnancy. This includes protein, carbohydrates, fiber, calcium, folic acid, vitamin D, iron, omega-3 fatty acids, and iodine.

“Exercise is awesome,” adds Dr. Young. “Exercising before pregnancy helps optimize your health, and exercising during pregnancy can help you stay healthy.”

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He recommends 30 minutes of aerobic exercise five days a week, such as walking around your neighborhood or on a treadmill, doing Zumba or Pilates, swimming, or riding a stationary bike. Bodybuilding is good too. Just make sure you’re doing exercises that won’t compromise your center of gravity and throw you off balance. Some exercises can be modified as your pregnancy progresses.

Fitness experts like those at UNC Wellness Centers, as well as your OB-GYN, can help you determine which workouts are safe and which to avoid while you wait.

“Pregnancy is not a reason to stop doing your exercise routine,” says Dr. Young. “It is not an illness.”


Omar Young, MD, is a subspecialist in maternal-fetal medicine at UNC/NC Women’s Hospital and a member of the Rex Women’s Health and Heart Clinic. He is also an associate professor in the Department of Obstetrics and Gynecology at the UNC School of Medicine and serves as vice president of education and associate director of the residency program.

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