Planning for a healthy pregnancy after age 35

There's no biological flip of the switch when you turn 35 years old, but it can sometimes feel that way for people who want to have a baby in their late 30s or beyond.

Being at "advanced maternal age," patients 35 and older are usually cautioned about all types of pregnancy complications that can interfere with family planning — from miscarriage and preterm birth to high blood pressure and diabetes.

But that's not stopping a generation of people looking to delay pregnancy until later in life. Between 1990 and 2019, birth rates went down for twentysomethings and up for people over 30. The rates of people having babies between the ages of 40 and 44 doubled from 0.5% to 1%.

Fortunately, obstetric care has advanced to the point where patients of all reproductive ages now have tools to help them pursue healthy pregnancies. If you hope to have a baby at any age, especially after 35, here's what you need to know.

Improve your fertility after age 35

Fertility starts to decrease by age 30 and gets more problematic just a few years later due to reductions in egg count and a higher risk of developing uterine fibroids, which can make it harder to conceive.

• Eat a healthy diet, including lean protein, vegetables and fruit.
• Stop smoking: Smoking is damaging to your health in a number of ways and will not help increase your fertility.
• Avoid drinking alcoholic beverages, especially during your fertile window and two weeks after.
• Stay fit and active: Maintaining a healthy weight and keeping your body moving will help it function properly and may increase your fertility.
• Track ovulation: Ask your doctor about methods to track your ovulation, such as over-the-counter strips and phone apps.
• Take a supplement, such as a prenatal vitamin containing folic acid and other essential nutrients.
• Speak to your doctor: Let your physician know that you’re trying to conceive, so that they can offer personalized tips and track your progress. They may also recommend:
  • Genetic testing to learn more about the risk of passing along conditions to your baby.
  • Additional vaccinations to protect yourself and your baby from illness.

Know your risk of pregnancy complications by age

No matter your age, pregnancy takes a toll on the body and mind. Complications can mean issues for mom, baby and both. While many variables can contribute to these complications, a mother's age is still very often among the risk factors for common issues that can occur during pregnancy.

At any age

In early pregnancy, miscarriage is common, affecting up to 1 in 2 conceptions. Although people of all ages experience miscarriages, older age can raise the risk.

Over 25

After 25, your risk for gestational diabetes goes up. This pregnancy-related condition happens when the body has trouble breaking down sugars in the blood. It can create some problems in pregnancy, such as having a big baby or requiring a cesarean section, but it typically resolves after the baby is born.

35 and older

In addition to fertility struggles that may accelerate at this age, being 35 starts the period of reproductive health called advanced maternal age. Notably, babies of mothers over 35 tend to have a higher risk for chromosomal abnormalities like Down syndrome. They're also at greater risk of having a low birth weight or being born prematurely. At this age, the risk also climbs for prenatal depression, although some studies have shown that this mental health concern is rising in younger mothers, too.

40 and older

Hypertension happens when blood pressure is too high, and it can lead to a severe complication called preeclampsia that can affect the organs and require emergency delivery. After age 40, the risk for preeclampsia goes up.

Detect and prevent complications through prenatal care

Whether you're already pregnant or trying to conceive, the best things you can do for yourself and your baby are to eat healthy, stay active, take a prenatal vitamin, avoid smoking and get routine care. Doing so can help you minimize other risks, such as being overweight, which can combine with age-related risk factors.

Patients struggling with fertility may want to undergo specialized testing to help them conceive, especially after age 35. If you are pregnant at an older age, there's good news: You'll likely get the benefit of added monitoring, which may include more ultrasounds, access to genetic testing and prenatal visits. This type of extra surveillance can help doctors detect possible concerns and further reduce the risk of other complications.

Whether you're expecting or not, don't forget that doctors are happy to answer any questions you may have about pregnancy complications at any age. Reach out to them for more information or if you're ever worried about anything getting in the way of a happy and healthy pregnancy.

HCA Virginia Health System offers a wide range of women’s health services at our hospitals across the state, including gynecologic services, high-risk pregnancy care, prenatal care, midwifery and labor and delivery services. We also offer classes, events and maternity unit tours for new parents and expectant moms.

This blog was originally published on Mission Health’s Healthy Living blog in 2022. It has been updated and repurposed for HCA Virginia Health System in 2024.