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Pregnancy After Age 35

What You Need to Know

You're not alone. More than 1 in 5 babies in the U.S. are born to mothers age 35 and older.

What Does "Advanced Maternal Age" Mean?

Advanced maternal age means you are 35 years or older when your baby is born.

This is just a medical term. It doesn't mean your pregnancy will have problems.

It means your care team will offer you extra monitoring and testing options.

Why Does Age 35 Matter?

Age 35 is when certain risks begin to increase more noticeably.

Chromosomal Changes

The chance of chromosomal differences (like Down syndrome) increases with age.

Pregnancy Conditions

Conditions like diabetes and high blood pressure become more common.

Important: Increased risk doesn't mean certainty. Most pregnancies after 35 are healthy.

Understanding Chromosomal Risk

The chance of Down syndrome (trisomy 21) increases gradually with age.

Your Age at Delivery Chance of Down Syndrome
25 years 1 in 1,250
30 years 1 in 952
35 years 1 in 378
40 years 1 in 106
45 years 1 in 30

Source: ACOG Practice Bulletin

What Do These Numbers Mean?

"If my risk is 1 in 100, what does that really mean?"

It means that out of 100 pregnancies at your age, 1 would have this condition and 99 would not.

Remember: Even at age 40, your chance of NOT having a chromosomal condition is about 99 in 100.

Other Conditions We Watch For

Advanced maternal age is associated with higher rates of:

These risks are manageable with good prenatal care and monitoring.

Screening Tests: What's Available?

You have several options to check your baby's health.

Non-Invasive Tests

  • First trimester screening (blood + ultrasound)
  • Cell-free DNA test (blood test after 10 weeks)
  • Quad screen (blood test at 15-20 weeks)

Diagnostic Tests

  • Chorionic villus sampling (CVS) at 10-13 weeks
  • Amniocentesis at 15-20 weeks

We'll discuss which tests are right for you.

Screening vs. Diagnostic Tests

Screening Tests

Purpose: Estimate your risk

Method: Blood tests and ultrasound

Risk: No risk to pregnancy

Results: "High risk" or "low risk"

Diagnostic Tests

Purpose: Give definite answers

Method: Testing placenta or fluid

Risk: Small miscarriage risk (~0.1-0.3%)

Results: "Yes" or "no"

All tests are optional. We'll help you decide what's right for you.

Cell-Free DNA (cfDNA) Testing

This is a blood test you can have after 10 weeks of pregnancy.

How It Works

Your blood contains tiny pieces of placental DNA. We test this DNA to screen for chromosomal conditions.

Benefits

  • Very accurate screening test
  • No risk to pregnancy
  • Results in 1-2 weeks

What It Screens For

  • Down syndrome (trisomy 21)
  • Trisomy 18
  • Trisomy 13
  • Sex chromosome conditions

Understanding Your Test Results

"What does 'high risk' really mean?"

A "high risk" screening result means more testing is recommended. It does NOT mean your baby definitely has a condition.

If screening shows high risk, we may recommend amniocentesis or CVS for a definite answer.

You're in control: You can choose which tests to have and which to decline.

Your Pregnancy Timeline

1st
First Trimester
Screening options
CVS if chosen
2nd
Second Trimester
Anatomy ultrasound
Amniocentesis if chosen
3rd
Third Trimester
Growth monitoring
Closer visit schedule

We'll monitor your pregnancy more closely, but most visits are routine.

Extra Monitoring During Pregnancy

You may have additional tests to check your health and your baby's growth.

These appointments help us catch any problems early and keep you and your baby safe.

Gestational Diabetes

What it is: High blood sugar that starts during pregnancy.

Why it matters: It can affect your baby's growth and delivery.

What we do: Test you between 24-28 weeks. If present, we manage it with diet changes, monitoring, and sometimes medication.

Good news: Most women with gestational diabetes have healthy pregnancies and healthy babies with proper management.

Preeclampsia

What it is: High blood pressure with protein in your urine, usually after 20 weeks.

Warning signs to watch for:

What to do: Call your doctor right away if you have these symptoms. We monitor closely and can treat this condition.

Third Trimester: Closer Monitoring

In the last few months, we may recommend:

Antenatal Testing

  • Non-stress tests (monitoring baby's heart rate)
  • Biophysical profiles (ultrasound + heart rate)

When We Start

Usually around 36-37 weeks, or earlier if there are concerns.

These tests help ensure your baby is doing well and getting enough oxygen and nutrients.

Planning for Delivery

Advanced maternal age alone is not a reason for cesarean delivery.

Many women over 35 have vaginal deliveries. Your delivery method depends on your health, your baby's health, and your pregnancy course.

We may recommend delivery by:

We'll make a plan together based on your individual situation.

What You Can Do

You have more control than you might think.

Healthy Habits During Pregnancy

Nutrition

  • Eat a balanced diet with plenty of fruits and vegetables
  • Choose whole grains and lean protein
  • Stay hydrated
  • Limit caffeine to 200mg/day

Physical Activity

  • Aim for 30 minutes of moderate activity most days
  • Walking, swimming, and prenatal yoga are great options
  • Listen to your body

Talk to your doctor before starting any new exercise program.

When to Call Your Doctor

Call right away if you have:

Never hesitate to call. We would rather check and reassure you than miss something important.

Your Mental Health Matters Too

Pregnancy can bring up many emotions, especially if you're worried about risks.

It's normal to feel anxious, excited, worried, and happy all at once.

Tell your doctor if you experience:

Mental health is part of your overall health. We can connect you with support and resources.

Building Your Support Team

You don't have to go through this alone.

Your Medical Team

  • Obstetrician or midwife
  • Maternal-fetal medicine specialist (if needed)
  • Genetic counselor

Personal Support

  • Partner, family, friends
  • Support groups
  • Mental health professionals

Don't hesitate to ask questions or seek extra support. That's what we're here for.

Genetic Counseling

What is it? A genetic counselor helps you understand your risks and testing options.

When it's helpful:

We can refer you to a genetic counselor at any point in your pregnancy.

Questions to Ask Your Doctor

Here are some questions you might want to discuss:

Write down your questions before appointments. No question is too small.

The Reality: Success Stories

85-90% of pregnancies in women over 35 result in healthy babies

Millions of women over 35 have healthy pregnancies and healthy babies every year.

With good prenatal care, close monitoring, and your active participation, your chances of a successful pregnancy are excellent.

Common Misconceptions

❌ Myth

"I'll definitely need a C-section because of my age."

✓ Reality

Many women over 35 have vaginal deliveries. Your delivery method is based on individual factors.

❌ Myth

"Something will definitely go wrong with my pregnancy."

✓ Reality

Most pregnancies after 35 are healthy. Increased risk means more monitoring, not guaranteed problems.

Your Strengths as an Older Parent

Being older when you have a baby comes with advantages:

You bring wisdom, stability, and readiness to parenthood. These are valuable gifts for your baby.

We're Partners in Your Care

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This is a journey we take together.

You provide: Information about your body, questions, concerns, and your values and preferences.

We provide: Medical expertise, monitoring, testing options, and recommendations based on evidence.

Together we make: Informed decisions that are right for you and your baby.

Taking It One Step at a Time

Pregnancy can feel overwhelming. Here's how to approach it:

Key Takeaways

  • 1. Advanced maternal age means more monitoring, not guaranteed problems
  • 2. You have excellent options for screening and testing
  • 3. Most pregnancies after 35 result in healthy babies
  • 4. You're an active partner in your prenatal care
  • 5. Your medical team is here to support you every step
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You've Got This

Your age is just one factor in your pregnancy story.

With good care, close monitoring, and your active participation, you have every reason to be optimistic.

Remember: We're here to answer questions, address concerns, and support you throughout this journey.

Thank you for trusting us with your care.