Are you wondering if you’re too old to have a baby?
More women are waiting to start a family, according to the U.S. Census Bureau. The median age of mothers giving birth in the U.S. now is 30. The number of women ages 35 to 39 giving birth increased by 67 percent from 1990 to 2019, and by 132 percent for those ages 40 to 44.
While some pregnancy risks do increase as the mother gets older, your family history and overall health are huge factors in your ability to conceive, carry and deliver a healthy baby, says Omar Young, MD, a UNC Maternal-Fetal Medicine specialist.
“Advanced maternal age generally is considered to start at 35,” Dr. Young says. “But I tell patients, ‘Nothing magical happens when you turn 35.’ Women over that age account for 15 percent of all pregnancies. Women over 40 account for 3 percent of pregnancies.”
So, what are your options if you wait until you’re older to start a family?
1. Make sure your overall health is under control.
“As we all get older, we all have more health complications,” Dr. Young says.
Women hoping to conceive should make sure their blood pressure, blood sugar and weight are under control. Keep up to date on vaccinations, especially against varicella (chickenpox) and rubella (German measles).
“If you are overweight, losing even 5 or 10 percent of your body weight can reduce your risk of high blood pressure and diabetes,” Dr. Young says. “Work with your general practitioner or OB-GYN to make sure you’re as healthy as possible.”
He also recommends that all women considering pregnancy start taking prenatal vitamins containing folic acid and get regular exercise.
2. Understand your family history.
“The risk of chromosomal abnormalities, like Down syndrome, increases with the age of your eggs,” Dr. Young says. “But it’s a common misconception that if you’re of a certain age, you’re going to have a complicated pregnancy.”
What is true is that the risk of chromosomal abnormalities is greater if you have a close relative with a genetic disorder. This includes parents, siblings and your other children. You and your partner may want to think about getting screened for certain genetic conditions. More on that later.
Dr. Young also notes that some women who want to delay parenthood until they are older may opt to freeze their eggs, which stops the eggs from aging. Then, when a woman is ready for pregnancy, the eggs may be fertilized in a lab and implanted in the mother’s uterus through in vitro fertilization.
3. Talk to your doctor or midwife about all conception, pregnancy and delivery concerns.
Even women in good health may have more difficulty getting pregnant when they are older.
“As you age, the number of eggs you have decreases,” Dr. Young says. “That can make conception more difficult. It’s not uncommon for women to be seen by an endocrinologist (hormone specialist) or a fertility specialist.”
You are more likely to have multiple babies (twins or more), miscarriages, preeclampsia (high blood pressure during pregnancy), premature delivery, low-birth-weight babies, a cesarean birth and postpartum hemorrhaging, he says.
“If you are 40, you have elevated risks,” Dr. Young says. “But just because you are of a certain age, it doesn’t necessarily mean a disaster is going to happen. If you’re 25 and have hypertension or diabetes, you are at risk, too.”
4. Consider genetic counseling and testing.
If you want to know more about the risks of genetic conditions and birth defects, talk with your doctor or a genetic counselor either before you get pregnant, during your pregnancy or both.
You and your partner may want to be screened for genetic conditions, especially those that run in your family. If you are found to be a carrier, that means you don’t have the condition yourself but could pass a gene mutation on to your child. If both you and your partner are carriers, the likelihood that your child will have the condition or be a carrier is greater. Examples of these conditions are sickle cell disease and cystic fibrosis.
“Before you do any testing, though, you should decide what you would do with the results,” Dr. Young says. “Ask yourself, ‘Am I capable of raising a child with significant disabilities?’”
When you are pregnant, you may have prenatal tests to assess whether you and your baby are healthy. These include ultrasounds, maternal blood screening and cell-free DNA screening. These tests don’t tell you with certainty if your baby has a birth defect; only whether your baby may be at risk.
Diagnostic tests, including chorionic villus sampling and amniocentesis, can tell you with greater certainty if your baby has birth defects.
Knowing whether your baby has chromosomal abnormalities or birth defects can help you be prepared physically and emotionally for your baby’s birth. It also can help your doctor know if you will need any special treatment to stay healthy during pregnancy and delivery.
5. Eat right and exercise.
Make sure you are getting enough of the right nutrients for you and your baby while you are pregnant. This includes protein, carbohydrates, fiber, calcium, folic acid, vitamin D, iron, omega-3 fatty acids and iodine.
“Exercise is great,” Dr. Young adds. “Exercising before pregnancy helps optimize your health, and exercising during pregnancy can help you stay healthy.”
He recommends 30 minutes of aerobic exercise five days a week—for example, walking in your neighborhood or on a treadmill, doing Zumba or Pilates, swimming or riding a stationary bike. Weight training also is fine. Just make sure you are doing exercises that will not compromise your center of gravity and cause you to lose your balance. Some exercises can be modified as your pregnancy progresses.
Fitness experts like those at the UNC Wellness Centers, along with your OB-GYN, can help you determine which workouts are safe and which to avoid while you’re expecting.
“Pregnancy is not a reason to stop doing your exercise routine,” Dr. Young says. “It’s not an illness.”
If you are pregnant or considering pregnancy, especially if you are over age 35, talk to your doctor, or find one near you.