October 20, 2021

How to Have a Healthy Pregnancy After 35

What women should know about “advanced maternal age”

Pregnant person standing at desk working, hand on belly

You’re ready to have a baby. How exciting! But you’re also well into your 30s — or beyond. How much does age really matter?


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“While it’s true there are some risks to moms past their mid-30s, there’s no reason to panic about the number of candles on your last cake,” says Ob/Gyn Salena Zanotti, MD. “There’s nothing magical about the number 35,” Dr. Zanotti says. “Your health before and during pregnancy is more important than your age.”

Here’s what you should know about having babies on the far side of 35.

What does pregnancy at 35+ look like?

Lots of women are waiting longer to start families. The number of babies born to first-time moms 35 and older was nine times higher in 2012 than it was in the early 1970s, according to the Centers for Disease Control and Prevention (CDC).

Many of these women have to deal with terms such as “advanced maternal age” or — even worse — “geriatric pregnancy.” What those tactless terms miss is that many, many women in their late 30s and 40s have smooth pregnancies and healthy babies. And there are things you can do to boost the odds you’ll be one of them, notes Dr. Zanotti.

What are the risks of advanced maternal age?

As women get older, the risk of certain complications can increase. That doesn’t mean every older mom-to-be will have problems. But it’s helpful to be aware of the possible risks so you can take steps to reduce them:

Fertility troubles

Talk about irony: You’ve spent all these years trying not to get pregnant. Now that you’re ready, it might be a trickier task. As women get older, their fertility decreases. It’s just not as easy to get pregnant at 40 as it is at 30. That’s something to keep in mind if you’re having the “When should we have a baby?” debate.

Chromosomal abnormalities

Babies of older moms are at increased risk of chromosomal problems, which can cause a variety of birth defects. The most common one is Down syndrome.


At 25, a woman’s chance of having a baby with Down syndrome is 1 in 1,250. By age 40, the risk is approximately 1 in 100 (though that’s still just a 1% chance).

Pregnancy-related complications

Mothers over 35 can have a higher risk of problems such as:

These complications can be harmful to the mother and the baby. They can also increase the chance that a mother will need a C-section.

Smaller babies

Moms in their late 30s or 40s are at risk of having smaller babies, which might lead to future health problems. It’s not entirely clear why that happens, but it might have to do with a deficiency of nutrients from the placenta during pregnancy, Dr. Zanotti says.

7 steps for a healthy pregnancy

Numbers don’t tell the whole story. While older moms may have increased risks overall, age is only one factor in a healthy pregnancy. Women can take actions to boost their health and lower their risks, Dr. Zanotti says:

1. Say no to smoking

Smoking during pregnancy can increase the risk of:

  • Low birth weight.
  • Premature birth.
  • Some birth defects.
  • Sudden infant death syndrome (SIDS).

2. Watch your weight

If you’re planning to become pregnant, now’s a good time to work toward a healthy weight. During pregnancy, do your best to limit weight gain according to your doctor’s recommendations.


3. Eat right

Nutritious, well-balanced meals are important for your health and the health of your developing baby. (That said, morning sickness is no joke. If you can only stomach crackers and toast right now, don’t beat yourself up.)

4. Move around

Try to get regular exercise, before and during pregnancy. Yes, your daily walks might look more like daily waddles in the third trimester, but they still count as healthy activities.

5. Manage medical problems

Unmanaged problems such as high blood pressure, heart disease or diabetes can cause problems for mother and baby. Work with your doctor to review current medications and supplements you’re taking and to get existing medical conditions under control — ideally, before getting pregnant.

6. Learn about screening and diagnostic tests

These tests can identify birth defects and other potential problems during pregnancy. If the tests detect anything concerning, you can work with your doctor on the next steps of your care.

7. Have a preconception visit

Before tossing your birth control, visit your doctor. Make sure any medical conditions are well managed and learn how to boost the odds of a healthy pregnancy.

Taking these steps can make a big difference in having a healthy pregnancy and baby. “It’s your health more than your age that determines the outcome of your pregnancy,” Dr. Zanotti says.

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