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Dr. Jacquelyn Means, a Texas OB-GYN, recognized the challenges of being pregnant in her late 30s. She had her first child at 37 and her second at 39, noting
that pregnancy at this age can lead to increased fatigue and specific complications. A federal report revealed that 21% of all births in the U.S. in 2023 were to women aged 35 and older, a significant rise from 9% in 1990. This trend, referred to as 'advanced maternal age,' elevates health risks for both mothers and their infants.
Health Risks Associated with Advanced Maternal Age
Women who are older when they become pregnant are more susceptible to health issues such as high blood pressure and obesity, which can lead to complications during pregnancy. These women also face a higher likelihood of requiring cesarean sections and giving birth to twins or infants with genetic abnormalities.Despite these risks, experts indicate that most older mothers experience normal pregnancies. Dr. Michael Warren, chief medical and health officer for the March of Dimes, emphasized that women over 35 can still achieve a healthy pregnancy and deliver a healthy baby.
Pre-Pregnancy Health Optimization
Dr. Ashley Zink, a maternal-fetal specialist, advises that optimizing health before conception is crucial, likening it to 'building your baby’s first home.' This preparation includes maintaining a balanced diet, engaging in regular physical activity, and avoiding harmful behaviors such as smoking.Warren further stressed the importance of managing chronic conditions and receiving regular preventive medical care to enhance overall health before pregnancy.
Prior to attempting to conceive, a medical checkup can be beneficial. This visit allows individuals to discuss any health concerns, receive treatment for existing conditions, and ensure vaccinations are current.
Prenatal Care and Testing During Pregnancy
During pregnancy, it is recommended that women over 35 undergo a first-trimester ultrasound to assess fetal size, confirm due dates, and check for multiple fetuses. Due to hormonal changes, older women may also be more likely to conceive multiples, which can increase the risk of complications such as premature birth.Noninvasive prenatal testing can screen for chromosomal abnormalities, with risks for conditions like Down syndrome increasing with maternal age. Should initial screenings indicate potential risks, more invasive diagnostic tests, such as amniocentesis or chorionic villus sampling, may be recommended.
Additionally, Zink suggests considering a 'growth ultrasound' around 32 to 34 weeks to evaluate placental function and fetal growth, which is critical given the increased risk of birth defects in older pregnancies.
Understanding Risks During Delivery
Research indicates that the rate of cesarean deliveries increases with maternal age, with approximately 48% of live births for women aged 40 and older resulting in C-sections. Such deliveries carry a higher risk of complications, including infections and bleeding.Medical indications for C-sections often include chronic health conditions that complicate vaginal births, such as diabetes or high blood pressure. Other factors may involve labor complications, such as delivering a larger baby due to gestational diabetes.
Older women also face a higher likelihood of placental complications, which can lead to serious bleeding before or during labor. Means, who experienced placenta-related issues and gestational diabetes, shared her experiences of postpartum complications but expressed gratitude for her children's health.
