If you’re planning to delay motherhood–or aren’t even sure you want children at all–the number 35 is probably on your mind a lot. That’s the average age when fertility starts to decrease, according to the American Congress of Obstetricians and Gynecologists (ACOG), and it’s unofficially the age when many women think they need to make their final childbearing decisions.
But there’s nothing magical about a woman’s 35th birthday when it comes to pregnancy. The vast majority of pregnancies in 35-plus women are uncomplicated and result in the birth of a healthy child. Having a baby when you’re 35 or older just means that both the mother-to-be and her care provider have to be ultra-vigilant to avoid some of the issues that may come with older motherhood.
Getting pregnant after 35
Although fertility can start decreasing any time between ages 32 and 37, that doesn’t mean you can’t optimize your chances of conceiving and having a healthy child. The first step is scheduling a preconception visit and asking your doctor:
- What are my chances of getting pregnant?
- What do I need to do before the pregnancy to ensure an optimal outcome?
- How are you going to watch my pregnancy differently?
- What screening exams do I need during this pregnancy?
The visit should also include a thorough exam, with a pelvic exam and full history. It’s also important to identify existing conditions that may cause problems with the pregnancy such as high blood pressure, obesity and high blood sugar.
In addition, begin taking a folic acid supplement at least six months before you plan to try conceiving, to help prevent neural tube defects. It’s also recommended that older moms-to-be use an ovulation predictor kit right from the start. A couple should be counseled on how to best use their kit. If there’s no pregnancy after 6 months, talk to your doctor again.
Both before and during your pregnancy, it’s important to maintain a healthy lifestyle overall including a normal BMI (body mass index), regular exercise, a healthy diet and no drugs or alcohol. One should also be cautions against taking supplements, even those generally perceived as safe, such as vitamin D or fish oil supplements.
In addition to the standard tests associated with pregnancy in the first trimester, a pregnant woman over age 35 may need more frequent prenatal visits or more screenings to rule out fetal abnormalities. Your physician may begin with a nuchal scan, a special ultrasound that can help identify some chromosomal conditions. There are also a number of noninvasive maternal blood tests that have greater than 99 percent accuracy in detecting chromosomal abnormalities.
These tests are recommended because pregnant women over age 35 have a higher risk of having a child with a chromosomal disorder, such as Down syndrome. Doctors will also watch the mother’s health carefully because her risk of complications–such as preeclampsia, gestational diabetes and placenta previa–are higher.
The best preparation for an easier delivery? Get moving! Cardio can make labor and delivery a lot easier, plus staying fit can help older mothers avoid C-sections.
Talk to your doctor about how much exercise is appropriate when pregnant. Women who are new to exercising may have different restrictions than those who are not.
35+ pre-conception checklist
- Preconception exam with your healthcare provider
- Existing medical conditions under control
- Folic acid supplements for at least six months
- Healthy diet and regular exercise
- Ovulation predictor kit