Advanced maternal age. It sounds like a disease.
You’re pregnant.
Which means you’re in amazingly good health.
But the doctors tell you you’re of advanced maternal age.
So why are you considered of “advanced maternal age” anyway?
I’ve asked several healthcare providers this question.
Advanced Maternal Age
The official answer is that some studies, including data collected by Parkland Hospital that examined pregnancy complications from 235,329 deliveries between 1988-2007, indicate that after age 35 there is an increased risk of complications, especially pregnancy-induced diabetes and hypertension. (For more information on this, see Williams Obstetrics, 23rd edition, p.181.)
Some research has also found that the maternal mortality rate is higher in women over 35.
However, babies with chromosomal abnormalities, like Down syndrome, are more likely to be born to younger women, since more young women give birth. But the risk of having a baby with Down syndrome increases with age (from about 1 in 1,250 for a woman who is 25, to about 1 in 400 for a woman who is 35).
Over 35 is an Arbitrary Number
But many health care providers I’ve interviewed point out that 35 is an arbitrary number. To their knowledge, there is absolutely nothing scientific about making 35 the cut-off date.
You don’t automatically morph into “high-risk” the day after your 35th birthday.
And we all know women in their late 30s and early 40s who are less sedentary and much, much healthier than women much younger than they are.
When I sat down with two forward-thinking obstetricians and two forward-thinking certified nurse midwives in the Boston area to talk about the current state of obstetric care, I was surprised how forcefully they insisted that 35 is a meaningless number.
Instead of upholding the idea that women over 35 are “high risk” and doctors should treat them accordingly, these medical professionals told me stories of how invasive medical intervention on women over 35 is what causes the problems.
Invasive Medical Intervention on Women of Advance Maternal Age
One of the midwives recalled how when amniocenteses were first performed on “older” moms, there were no ultrasounds to help direct the needle through the abdomen into the mother’s uterus. The doctor would palpitate the belly, pulling the fetus’s head back as best he could with his hands.
In the mid 1970s this test actually carried a greater risk of having a miscarriage than the moms had of having a baby with Down syndrome.
But by the time she was 35, in 1984, amniocentesis had become the standard of care for “older” moms.
Despite pressure from her doctor, she declined the test.
She wasn’t sure what she would do with the information (that is, whether or not she would have an abortion) should the test come back positive for Down syndrome. But she was sure that the anxiety it would produce and the risk to the fetus from the test itself was not worth it.
All four medical professionals agreed that the classification of high-risk for pregnant women over 35 is “absurd.”
Individual health assessments make sense, arbitrary numbers do not.
It would be much more logical for pregnant women to be assessed individually for health risks, they said.
Does it matter how old you are when you get pregnant? Not as much as you may have been led to believe.
Does it matter how healthy you are when you get pregnant and during your pregnancy?
Yes!
Your general health, your eating habits, and your lifestyle choices matter tremendously, more than even your doctor is telling you (because, despite best intentions, your doctor has not been educated about preventive proactive medicine and good nutrition).
You can’t change your age but you can change your eating and lifestyle habits.
You know what to do: exercise daily and be active throughout the day instead of sitting at a desk; cut refined sugar, processed grains, and packaged foods COMPLETELY out of your diet; eat fresh fruits and vegetables, nuts, eggs, healthy meats, healthy fats like olives and avocados, and whole grains; minimize your stress levels; get outside as much as possible so you get enough Vitamin D on your skin; minimize your exposure to harmful chemicals, medications, and pesticides; avoid over-vaccination; stay connected to important people in your life; reduce your stress and anxiety; and work through your psychological issues.
Be Mindful of Your Psychological Health During Pregnancy
Your psychological issues impact your family’s health
What about the psychological impact on your child when you have them later in life? A friend was telling me recently that she always hated it that her mom (who had her at 40 and her youngest sister at 45) and dad were older than her friends’ parents, and acted like fuddy-duddies.
I was saddened to read this essay by Dvora Meyers, “My Mom Was Too Old.” Meyers is a young woman whose mom had her when she was 42. She felt like her mom got old and frail before she was ready to care for an elderly parent.
But if my friend’s mom had had her at 25, maybe my friend would’ve been sorry for a different reason.
And even if she were in middle age with children of her own, maybe Dvora Meyers still wouldn’t be ready to care for her aging mom.
“I am 46 and will be 47 in June,” a mom posted on this MedHelp.org thread about having children over age 45. “I have a beautiful 18 month old that I did not expect to enter my life. My pregnancy was unplanned and unexpected. I had a new business, money was tight and loads of things were going wrong … with that said, I wouldn’t trade a second of it. She is the light of my life. Her father is in his 40’s and never had children. You can imagine the love this baby girl gets. So, sorry to burst the naysayers bubble, but a woman over 45 can get pregnant, can deliver a smart healthy baby and can figure out how to take care of their child just like a 20-something can. And one more side note, I too was the ‘What I am pregnant?’ baby for my mother whom is still living and [whom] I adore.”
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Updated: August 17, 2022
Toni DiLeo says
I had my second child when I was forty-two. A healthy, uncomplicated pregnancy and delivery, a healthy baby boy. Our son is now eighteen and ours is the house that all the friends hang out at. We have even taken in two of his friends who needed a better living situation than they had. I think having a baby a little latter than norm has kept us current and involved with our community and the youth at large.
I would encourage any healthy, secure couple to have a baby in their early forties if they want to. Life and health at any age is not a guarantee. If fact, being an older parents gives you incentive to stay healthy and fit.
Alexandra says
I had my first child three weeks after turning 23. All my friends from college were going for careers. My daughter was 37 when she had her first child. I know it is not always “convenient” to have children young, but there are advantages, like being a young grandmother. Also, you have so much more energy for running after a toddler. (I should also mention that my mom was 37 when I was born, and 40 when my brother was born. I, too, did not like having “older” parents, but now that my daughter is an “older” parent, I see the advantages for my granddaughter.)
Ruth Pennebaker says
I think the conclusion to the second half of your post is the same as the first: It’s all individual, depending on each family’s circumstances. There is no right or perfect time to have a baby.
Jane Boursaw says
I was … trying to think … 34 and 37, I believe, when my kids were born. I didn’t really think much about my age. I was healthy and everything went well, thank goodness.
Jeanine Barone says
One can’t at all make any kind of generalizations as to whether having a baby after 35 is a good idea or not. I had older parents and didn’t like it at all. The didn’t have the energy to keep up with me. And then they both got sick when I was in my early 20s. I have some friends who had babies when they were “older” and had no physical troubles at all. Others did. It all depends.
MyKidsEatSquid says
I’ve also wondered about 35 as the age when you’re automatically lumped into the “high risk” category. My mother had me when she was over 35. But all of my kids were born before I hit that supposedly magical number. As others have pointed out, it’s more about the individual than the age. Advantages to each.
HeatherL says
Great info for those who might be considering pregnancy and want to know the risks.
Roxanne says
I’ve always wondered about this. What if they had chosen 40 or 45 for the studies?
Living Large says
Our daughter was 36 when she gave birth and she has a perfectly happy and healthy baby girl!
Alisa Bowman says
I do think it’s important for women to consider–possibly before becoming pregnant–what they will do if they learn there is something wrong with the baby, whether it be Down or something else. If you will still have the baby (I would), then there’s no need to risk the testing.
Donna Hull says
As the saying goes, “age is just a number.” The health and vitality of the mother are much more important benchmarks than age.
Lauren says
I should look at the study more closely. If it’s the Parkland Hospital that’s down the street in Dallas, it is the city hospital and most of the deliveries there nowadays are to low SES moms. I have noticed that health follows wealth in the US, both in big cities like Dallas and in rural areas. Did they control for SES when they made the “35 is advanced maternal age” determination?
Jessica says
I am having my 5th child at age 37. My older kids are 9, 6, 4, and 2. When the 2-year old was 9 months old, I ran a marathon and qualified for Boston. When he was 18 months old, I did IRONMAN Louisville. Last month, I ran Boston and re-qualified and just found out I was actually pregnant when I ran. Oh by the way, the first four were Clomid babies and this one was an “accident” after having regular periods for a whole year (when I hit ironman training hard core). Seems to me that mid-30s makes me one bad ass, healthy, fertile momma. Not some old fart. So happy to see that 35 is not THE cutoff in everyone’s eyes!
Leslie D says
I was 35 with my 3rd. My others are 13 and 8…
I interviewed a midwife at 10 weeks. There was no check up just chit chat and I decided that I didn’t want any medical assistance this time around.
I went into labor at around noon and had her at 6:40. Mind you I was running a preschool at the time and my last family went home at 5:20. I crawled into the bath with tub to relieve some lower back pain I was having. I had her less than 40 min later.
Delayed her cord clamping and her 13 yr old sister cut it.
I didn’t have an US, either. Felt no need for that exposure to myself or the baby. My mom ever had one done. But all of a sudden we are getting them done with no real research to back up the “benefits”…
Even thought I had midwives with the other two I still felt there were things that were done on fear based medicine. Cervical check for example. I totally noticed my labor slow down every time I got checked with my second. Being told when to push. My chest was black and blue with my first because I was pushing so hard. I also tore with my first 2, But not with my last where she was ejected from my body when she was ready! No tearing!
If I have a fourth I will do the exact same thing. Free birth was the most Empowering thing I could have done, Not only for myself but my two other daughters!
Emily Lewis says
I agree that the health of the mother is far more a better indicator than age alone. However, it is no coincidence that women’s peak fertile years are during her 20’s-30’s. Nature has it’s course. The increase in IVF treatments and learning and behavioral disorders has been linked to older mom’s. If more families were intentional with having children instead of “having it all” I think we’d see far fewer issues in general.
Nicole says
Don’t forget that the chance of twins also increase with age! I had a girl at 38, surprise boy girl twins (really a suprise, I did not have any ultrasounds) at home at 41 and a second surprise (unplanned pregnancy) boy at 45 at home. All easy pregnancies and births without any interventions or complications, and four healthy kiddos. I breastfed the first three until age 2.5-3 years old and will do the same for the last one. God is good, and life is wonderful. Seek out the good and embrace life.
Jennifer Margulis, Ph.D. says
Wow Nicole! So inspiring. Thank you for sharing this story. My friend also had an amazing and empowering home birth at age 42. That baby was a surprise for their family. They had two boys already. And she has been such a gift, and so so loved, ever since.
Recently I met a mom who had her first baby, born at home, at age 41, and her second baby, also born at home, at age 44. She said both births were very intense and not “easy,” but also fun and empowering. She’s a singer and she sang through the contractions!
Mary Lawson says
I just found out I’m pregnant with our second at 38! I had my first at 33. We have been married ten years and tried the whole time but couldn’t get pregnant but once; this is only my second pregnancy. I am happy to read this so I can shut out the negativity I’ll receive. I exercise, eat Whole Foods/organic, get good sleep and work part time so have afternoons to rest. I’m going to try all natural at a birthing center or home! I’m so shocked to be pregnant after all this time but super excited.
Jennifer Margulis, Ph.D. says
Huge congratulations Mary! You are going to have so much fun! And at 38 you are still a spring chicken. I’ve heard about women getting pregnant (without assistance) all the way up to age 52. So, who knows, you may end up with SEVERAL more children…