The reality of pregnancy after 35 (hint: it’s not all risk)
Marketing and Communications Staff Writer
The timeline for starting a family today looks a lot different than it did a generation ago. Many women are having children later in life — once they’ve built a career, felt financially stable and found the right partner.
In fact, birth rates for women in their 30s and early 40s have reached their highest levels in decades. But as women age, the risks of pregnancy increase, too.
“Pregnancy risks increase with a woman’s age, especially after 35,” says Michael Krew, MD, director of Maternal-Fetal Medicine at Akron Children’s. “It’s not a magic number, but starting at age 35 risks start to gradually increase. Egg quality can decline, and women have a higher chance of having underlying health conditions like diabetes or high blood pressure.”
So, yes, the biological clock is a fact of life, but it’s not the whole story. Many women over 35 go on to have healthy pregnancies, especially when paired with good prenatal care and managing existing health conditions.
Learn more about the risks of pregnancy after 35 (and tips for a healthy baby), so you can make informed decisions that feel right for you — on your timeline.
How age affects fertility
You’re born with all the eggs you’re ever going to have. But as you age, both the number and quality of those eggs decrease. Over time, the number of eggs you have drops, so your chances of getting pregnant naturally goes down. And just like humans age, when eggs get older they aren’t as strong and healthy as they once were — increasing the risk of pregnancy problems.
You’re also more likely to have health conditions like diabetes or high blood pressure. If those aren’t well managed, they can affect the health of both you and your baby.
Fertility starts to slowly decline around age 35, with a faster drop closer to age 37. If you’re 35 or older, your pregnancy may be labeled “high risk” because of what doctors call “advanced maternal age.”
But that doesn’t mean pregnancy after 35 is unlikely or impossible — far from it. Many women have healthy pregnancies in their late 30s and even 40s. However, it does mean that it could take longer to get pregnant and there’s a higher chance of pregnancy complications.
Risks of pregnancy after 35
As you get older, the chances of certain pregnancy complications go up. Some of the more common risks of pregnancy after 35 include:
Gestational diabetes
Older moms are more likely to have Type 2 diabetes or develop it (gestational diabetes) during pregnancy. As you age, your body isn’t as good at managing blood sugar, and factors like a higher BMI can add to this risk.
If your diabetes isn’t managed well, it can cause serious health problems. High blood sugar can increase the chances of preterm birth, breathing problems or even miscarriage for your baby.
“There are risks for mom, too,” says Dr. Krew. “High blood sugar can lead to preeclampsia (dangerously high blood pressure) or worsening eye or kidney problems during pregnancy. And a large baby can make delivery more difficult and lead to a C-section.”
Thankfully, planning ahead with a pre-pregnancy plan, getting support and keeping your blood sugar in check with a healthy diet and regular exercise can greatly lower many of these risks.
Preeclampsia
Similar to Type 2 diabetes, older moms are more likely to have high blood pressure or develop it (preeclampsia) during pregnancy. These conditions need careful monitoring because they can greatly affect the health of both you and your baby.
Preeclampsia can spike blood pressure dangerously high and reduce blood flow to your baby, which can slow growth, cause low birth weight or trigger early delivery. It also increases your risk for serious health issues like heart attack, stroke or kidney problems.
Being older can make preterm birth more likely, especially if you have conditions like Type 2 diabetes or high blood pressure. These conditions can cause problems with pregnancy and require an earlier birth than expected.
“These conditions also can affect your baby’s growth by decreasing blood flow and nutrients to the baby,” says Dr. Krew. “This can lead to low birth weight.”
Chromosomal Conditions and Genetic Risks
The chance of chromosomal conditions — such as Down syndrome — increases with mom’s age because the quality of her eggs go down. The likelihood of having a baby affected by Down syndrome rises slowly through your 30s and more noticeably after age 40.
Because of this, your doctor may recommend additional screening or diagnostic genetic testing, so you can learn more about your baby’s health earlier in pregnancy. If there is a problem, you and your partner can make informed decisions about your baby’s prenatal care and plan ahead for care and support once the baby is born.
Cesarean delivery
Research shows women over 35 are more likely to have a C-section. This can happen because of a preexisting condition, pregnancy problems or even if there’s an issue with your baby’s health, such as a chromosomal abnormality.
Sometimes a C-section is planned. Other times, it’s an emergency. But either way, it’s often the safest choice for you and your baby.
Miscarriage and Pregnancy Loss
Most miscarriages are caused by genetic or chromosomal problems. The risk goes up with age because older eggs are more likely to cause these issues. Conditions like gestational diabetes or preeclampsia can also play a role in pregnancy loss.
“Even with all these risks, most pregnancies — even for women in their late 30s and 40s — still lead to healthy babies,” says Dr. Krew. “Knowing the risks and staying on top of your health can make a big difference.”
Age Matters for Men, Too
While much of the conversation about reproductive age focuses on women, men’s age matters, too.
Men produce sperm throughout their lives, but as they age several changes can occur:
Lower sperm count. Sperm count and movement can decrease, which can make it a little harder to conceive.
Reduced sperm quality. Sperm quality can decline and lead to a higher chance of DNA damage. This can affect embryo development and increase the risk of miscarriage.
In fact, research shows that men over 40 have a higher chance of having children with certain conditions, including autism spectrum disorder and some rare genetic conditions.
The good news? These risks are still relatively small. But it’s a helpful reminder that fertility is a shared journey.
“If you’re thinking about having a baby later in life, it’s important to have open conversations together — and with your doctor — about your health, lifestyle and any potential concerns,” says Dr. Krew.
Supporting a healthy pregnancy after 35 — or any age
Doctors usually don’t treat pregnancy after 35 much differently than a typical pregnancy. But because they know risks are slightly higher, they may take extra precautions to keep you and your baby safe.
Thankfully, there are many steps you can take to help improve your chances of a healthy pregnancy — regardless of your age.
One of the most important steps is going to all your prenatal checkups and having open conversations with your doctor about preexisting conditions and other concerns. Eating well, exercising regularly and taking prenatal vitamins are important, too.
If you’re thinking about having a baby — now or down the road — understanding how age can play a role in pregnancy helps you make the best choices for your body and your future.
“In most cases, age is just a number,” says Dr. Krew. “If you maintain good overall health, keep all your prenatal appointments and manage any underlying conditions, chances are you’ll bring home a happy and healthy baby.”
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