The traditional definition of a geriatric pregnancy is one that occurs anytime a woman is over the age of 35—but many experts have been revisiting this definition, claiming that it’s misleading and outdated. Here’s what they’re saying.
Advanced Maternal Age
The minute you turn 35, you’re considered AMA or of advanced maternal age. Doctors used to view this “magic age” as a sharp turning point, at which your likelihood of being able to conceive plummets, and your risk factors for geriatric pregnancy complications skyrocket. Not they’re saying that isn’t how things work at all—it’s not a magic switch that flips at 12:01 on your birthday.
Today’s experts are acknowledging that there is no one-size-fits-all answer to having a healthy pregnancy after the age of 35. Instead, they’re leaning more toward personalized risk assessment. Like in life, age is just a number when it comes to understanding a woman’s risk factors during pregnancy. Doctors are looking more closely at the individual now, not her age, and how her overall health plays a role in her ability to conceive.
So, What Actually Happens After 35?
The number one factor that can affect your ability to have children? Your health. If you’re in perfectly good health at age 35, your ability to conceive is no different than when you were 34—again, there’s no flipping of a magic switch.
The simple biological fact (which is true, but has led to exaggerated claims over the years) is that as you get older, the number of eggs you have decreases. The probability of achieving a pregnancy in one menstrual cycle starts declining significantly in your early 30s, with a steep decline at about 37 years old. In a study on the probability of pregnancy following intercourse, it was found that for women age 27 to 34, their probability was 40%. For women age 35 to 39, it was 30%. In addition to these ages, fertility decreases by as much as 95% between the ages of 40 and 45.
So yes, there is a biological clock—but it doesn’t start ticking for every woman on earth at 35.
Possible Geriatric Pregnancy Complications
The actual reason that the risk of potential pregnancy complications increases as we get older, is because the likelihood of having other medical conditions like hypertension or diabetes goes up as well. Makes sense, right? While pregnancy risks certainly increase, it’s not necessarily because we’re getting older.
The risk for things like spontaneous abortion, ectopic pregnancy, preeclampsia, gestational diabetes, stillbirth, and chromosomal abnormalities like Down Syndrome all increase with age. At 35 years old, your risk of having a baby with chromosomal abnormalities is about 1 in 204. At 37 years old, it’s about 1 in 130. At 39 it’s 1 in 81, and at age 42 your risk is about 1 in 39. Age can also complicate breastfeeding, as some older mothers have issues with their milk supply. This is particularly likely for women who needed medical assistance to either become pregnant, or stay pregnant.
The good news? Health assessment, genetic screening, diagnostic and counseling options are more sophisticated than ever. Women can much better understand their own health and their pregnancies.
The way it used to be is that the risk of a woman at age 35 having a baby with Down Syndrome was equal to the risk of her suffering a miscarriage during amniocentesis. That’s where age 35 became synonymous with “high-risk.” However, with new technologies in ultrasound, the risk of miscarriage during an amnio is around 1 in 500, making that magic age obsolete.
Doctors are continuing to see more pregnancies in women over 40, and more of them that are successful. In fact, women over 40 actually have the second highest unintended-pregnancy rate, after very young women. Many experts are even looking at age as an asset in successful pregnancies now, being that older women are more experienced, and tend to feel more emotionally ready to be a parent.
The bottom line? A woman who maintains a healthy weight, manages her medical conditions, doesn’t smoke, and keeps her vaccinations up to date has a better chance of conceiving a healthy baby—regardless of her age.
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