If you’re thinking about starting or growing a family, age 35 has special — possibly even dreaded — significance to you. It’s when you’re suddenly considered of “advanced maternal age” and your pregnancy may even be referred to as “geriatric” — even if you don’t have a single strand of gray hair.
Although “geriatric” is often used to describe pregnancy in women aged 35 and older, it’s not recognized as an official medical term, according to the American College of Obstetricians and Gynecologists (ACOG). “Advanced maternal age” is the accepted language, and comes with warnings of decreased fertility, increased miscarriage rates, and higher risks for developing serious complications during pregnancy, like preeclampsia (high blood pressure) and gestational diabetes.
Neither term sits well with most women who fall into this category and don’t consider themselves old at all.
At 38, Lauren Wellbank, who’s expecting her third child and going through her second pregnancy, is considered an “older” mom. “I laughed when my OB used the phrase ‘advanced maternal age’ for the first time,” Wellbank tells Parentology. “Even (my doctor) said she hated the term.”
But when Wellbank started noticing words like “geriatric pregnancy” and even “elderly multigravida” on pamphlets and paperwork she received at her doctor’s office, she was no longer as amused. “I was blown away by the use of words like ‘geriatric’ and ‘elderly’ because when you hear those words you think of nursing homes and frail old people. Neither of those things were on my mind at 35.”
Her feelings on the matter? “I wish they would change the term (advanced maternal age). Not because I don’t understand that risks increase after 35, but because it’s still a young age.”
By most measures, 35 is young. After all, Americans are living longer, thriving in middle and older age, and starting families later. More women than ever are having children into their 40s. The birth rate for women in their early 40s has risen almost continuously since 1985, according to the Centers for Disease Control and Prevention (CDC). In 2018, the number of births for women aged 40-44 was 11.8 per 1,000, up 2% from 2017. The number of births to women aged 35-39 increased, as well.
But yes, 35 does matter (and 40 matters even more), especially when it comes to getting pregnant.
“Fertility is a little lower at 35 and a lot lower by 40,” Dr. Rosemary Reiss, a maternal-fetal medicine specialist at Brigham and Women’s Hospital in Boston tells Parentology. “Miscarriage rates also rise between 35 and 40 because it becomes more common for an embryo to have an extra chromosome, and most embryos with abnormal numbers of chromosomes miscarry.”
Reiss explains, “When a girl is born, she has all the eggs she will ever have. We start to use them up, and the eggs age. Overall fertility starts to decline as a woman gets closer to whatever her destined menopause age is. It’s about the biology. We can’t change this.”
The good news: at 35, it’s your overall health, lifestyle, and well-being that make the greatest difference — not your age — when it comes to having a healthy pregnancy.
According to Reiss, medical history and patient weight and overall health play more of a role. “Adults accumulate increasing numbers of medical problems as they live, and this contributes to the ‘age-related’ risk. Personal health and habits like smoking and alcohol use can have bigger effects than numerical age.”
For example, a woman who is 22 with high blood pressure, Reiss explains, is at greater risk for developing preeclampsia during pregnancy than a woman with normal pre-pregnancy blood pressure who is 35.
The bottom line: if you’re approaching “advanced maternal age,” or are already there, don’t panic. There’s nothing magical about age 35. Women can have healthy pregnancies into their early forties. But, Reiss recommends, “If you are intending to delay past 35, you should talk to your ob-gyn before you delay to learn your specific risks.”
Geriatric Pregnancy: Sources
American College of Obstetricians and Gynecologists
Centers for Disease Control and Prevention
Rosemary Reiss, M.D., Brigham and Women’s Hospital