While the overall birthrate in the United States is dropping, especially among people in their 20s, there has been a dramatic increase over recent decades in the number of people giving birth at age 35 and older.
“There are many reasons for the trend in delayed childbearing,” says Dr. Robin Kalish, a maternal-fetal medicine specialist at the NewYork-Presbyterian Alexandra Cohen Hospital for Women and Newborns. These include career aspirations, financial security, availability of a wide range of birth control methods, and access to enhanced fertility treatments such as in vitro fertilization (IVF) and egg freezing, she says.
But as people get older, they face an increased risk of medical issues that can potentially complicate their pregnancy. While delivering at age 35 and older is officially considered “advanced maternal age,” Dr. Kalish notes that in reality, there’s no “magic number” for being at-risk for complications.
“A healthy 38-year-old could have an easier pregnancy than a 20-year-old who has multiple medical issues,” Dr. Kalish says. “It’s really a gradual increased risk little by little over age 35, and it’s incredibly individualized.”
Dr. Kalish adds that her over-40 patients usually ask her, “‘Am I too old?’ My answer is almost always, ‘No, you are not too old.’ And then their next question is, ‘Am I high-risk?’ Unfortunately, my answer is usually, ‘Yes.’ But with proper care and monitoring, the majority of women in that age range go on to have a healthy pregnancy.”
Health Matters spoke with Dr. Kalish, who is also a professor of Obstetrics and Gynecology at Weill Cornell Medicine, to understand what to expect during a pregnancy after age 35 and to learn tips to help have a healthy pregnancy for you and your baby.