Though older women do have an increased risk of complications, generally speaking, it is not dangerous to have a baby after age 35 either for women who become pregnant naturally or for those who have assisted pregnancies. Though the risk for miscarriages and chromosomal abnormalities does increase at this age, the overall rate of these conditions happening is still extremely low, and most older women have healthy babies. Age appears to be less important than a woman's health before she becomes pregnant and the type of prenatal care she receives. Most of the complications that may happen during an older woman's pregnancy are manageable, and prenatal counseling can prepare a mother for potential problems, or help her decide whether she wants to terminate the pregnancy.
Risks to the Mother
The main risks that come with pregnancy in women over 35 stem from physical changes that happen with aging. As a woman ages, her body becomes less fit for pregnancy, making it more difficult to conceive and increasing the risks of complications. Older women are more likely to develop gestational diabetes, hypertension, pre-eclampsia, an ectopic pregnancy, placental abruption, and placenta previa, in which part of the placenta grows over the cervix. They are also more likely to have problems during labor and delivery, and are given more Caesarean sections (C-sections), though this could be due in part to the fact that healthcare providers are quicker to intervene. Additionally, these women may feel the physical stresses of pregnancy more, meaning that they may be more tired and have more morning sickness than younger women.
Risks to the Fetus
Women in their late 30s tend to produce fetuses with more chromosomal abnormalities than younger women, which can lead to birth defects and genetic disorders, notably Down Syndrome. Those between 35 and 39 who have live births have about a 2 in 1,000 chance of having a baby with Down Syndrome, while those over 45 have about a 14 in 1,000 chance. Women who get pregnant later in life are also significantly more likely to miscarry or have a stillbirth than those who do so earlier, but the overall rate of either is still very low in developed countries. Also, babies born to older women are more likely to be premature and underweight, though this risk can be reduced with proper prenatal care.
Natural Pregnancy vs. Assisted Pregnancy
The risks of pregnancy in women over 35 appear to be similar for both women with natural and assisted pregnancies. Studies show that age may not play as much of a role in women who get pregnant via egg donation, though; a 2012 study from Columbia University Medical Center found that women who conceive in this way face the same level of risk, regardless of age. Pregnant women over age 35 are more likely in general to have a multiple pregnancy, especially those who use fertility medications or in vitro fertilization (IVF).
Preparing for Pregnancy after 35
There are many things that women can do to lower their risk of complications, including treating any health conditions they have, getting proper nutrition and exercise, and meeting with a prenatal care provider regularly. Since older women are more prone to hypertension and gestational diabetes during pregnancy, those who have these conditions before they become pregnant should be sure to tell their healthcare providers and take steps to control them. They should also tell their obstetrician or midwife about any other health conditions they have and medications they take, so that he or she can be aware of any potential problems.
Nutrition is also extremely important, especially in the first weeks of pregnancy, so women trying to conceive should take prenatal vitamins and make sure to get at least 400 micrograms of folic acid a day. Being overweight can also increase the risk of pregnancy complications, so exercising regularly and eating a healthy diet can help both with conception and during the pregnancy. Quitting smoking and drinking can also greatly decrease the risk of problems, as can getting regular dental care.
Additionally, women should be sure to get regular prenatal care from a medical professional. He or she can do tests to monitor any conditions a woman has and can also educate her to prepare her for any complications. Many women over 35 choose to have optional genetic tests to see if their fetus has any abnormalities that would cause birth defects. If the tests do show that a fetus will have birth defects, her healthcare provider can counsel her to prepare her for the birth, or help her if she decides to terminate the pregnancy.
