The Older Mom
As women become older, certain medical and obstetric problems can occur with pregnancy. Most women over the age of thirty-five have healthy pregnancies and healthy babies. However, they do face some special risks. In recent years, the birth rates for women in their late thirties to early forties has drastically increased. According to the National Center for Health Statistics, the birth rates for women aged thirty-five to thirty-nine and forty to forty-four years more than doubled between 1978 and 2000.
With recent advances in medical care, women who have babies later in life have a better chance for a healthier and safer pregnancy than in the past. All women should consult with their doctors before becoming pregnant, but this is especially important for older women who are planning to conceive and even more important if there are any preexisting health problems, such as diabetes or high blood pressure. Some of these conditions are more prevalent in women in their late thirties and forties than in younger women and can be risky to both the mother and baby. Proper medical monitoring and treatment before conception and throughout pregnancy can lower the risks and complications associated with these conditions and result in a healthy pregnancy and outcome.
Fertility rates tend to drop slightly for women over age thirty-five. However, in general, many cases of infertility can be treated successfully.
Weighing the Risks
Studies do suggest that women over the age of thirty-five are at higher risk than younger women for complications such as high blood pressure, diabetes, and placental problems during pregnancy. They are also at a higher risk for miscarriages, stillbirth, and cesarean deliveries. As women become older, their chances also increase for having a baby with a birth defect or for chromosomal disorders such as Down syndrome, trisomy 18, and neural tube defects.
Fortunately, screening procedures are now available that indicate those babies who may be at an increased risk for these birth defects. Some of these screening tests include the Quad test, or maternal serum screen. Not all screening tests will screen for every birth defect. Keep in mind that these are only screenings. They do not provide a yes-or-no answer to the question of whether a baby definitely has a specific disorder. Instead, screenings will tell you the rate of your personal risk and whether you need further testing through a specialist. Remember also that just as a positive screen indicates a need for additional testing, a negative screen does not guarantee your baby will not be born with a birth defect. Additional diagnostic testing may include an ultrasound, amniocenteses, and/or chorionic villus sampling. There are pros and cons to these tests, and you should discuss them in detail with your doctor before making a decision.
The American College of Obstetricians and Gynecologists recommends that women over thirty-five be offered specialized prenatal testing to diagnose or rule out chromosomal disorders such as Down syndrome.
Reducing Your Risks
You may not be able to decrease some of the risks that come with age and pregnancy, but by following the basic lifestyle rules for a healthy pregnancy, you can optimize the chance for a safer and healthier outcome. This includes visiting with a doctor before conceiving and addressing any preexisting medical problems as well as medications and immunizations. Taking a prenatal vitamin supplement prescribed by your doctor before conceiving is important to ensure you are getting all of the nutrients you need in proper amounts.

