Bearing Children Later in Life

Question: I’m over 35 and am now ready to start a family. Should I worry that I am too old?

Answer: by Jon S. Matsunaga, M.D.

Today, more and more couples are starting families later in life. Although there is no set age that is unsafe for women to become pregnant, women in their 30’s and 40’s tend to have concerns about whether their age will affect their ability to become pregnant, their health and the health of their babies.

The most common concern is fertility. Although ovulation -- the release of an egg from one of the ovaries -- continues until menopause, the quality of the eggs decreases with age. Since these eggs are older and less viable, they are more difficult to fertilize than those of a younger woman.

According to the American Society for Reproductive Medicine, for a woman under 30, the chance of becoming pregnant in any one month is estimated to be about 20 percent. In women age 30 to 40, that number drops to five percent. After the age of 35, we see a significant decline in fertility in this age group. Once a woman turns 40, her fertility drops even further. It is estimated that only 10 percent of women over the age of 40 will be able to conceive.

Of course, these are statistics. Every woman – and her ability to get pregnant – is different. Many women in their late 30s and early 40’s conceive and bear children either naturally or with the help of fertility treatment.

Once a woman over the age of 35 becomes pregnant (and holds on to the pregnancy past 12 weeks), it should be reassuring to know that she runs about
the same risk as a younger pregnant woman in terms of developing medical/obstetric conditions such as gestational diabetes or high blood pressure. And her chance of needing a Cesarean delivery or having a low birth weight baby is about the same as for a younger woman.

Miscarriage (the loss of pregnancy before 12 weeks), however, is slightly more common in women over the age of 35, where it occurs in 20 to 25 percent of pregnancies as compared to about 15 to 20 percent of all pregnancies.

Being prepared for pregnancy is the best way for couples of all ages to improve their chances of having a healthy baby. Regular and early prenatal care is important as your doctor can closely monitor and treat potential problems early on.

Genetic counseling is advised for women who will be 35 or older when their baby is due as chromosomal abnormalities are more common in this age group. Couples who have already had a child with a birth defect, or couples with a family history of genetic problems or birth defects, should also receive counseling.

A number of tests are offered to pregnant women over the age of 35. The tests, which include amniocentesis and chorionic villus sampling (CVS), can help diagnose genetic disorders or chromosome problems during pregnancy. Your doctor can provide you with more information on these tests.

A woman having her first child in her mid-30’s or older may have other issues to be concerned with as she tries to become pregnant. It may take longer to become pregnant than she had hoped or fertility treatments may be needed, both of which can be stressful. On the other hand, an older woman may feel more emotionally mature and ready to have a child, which can make her feel more relaxed and in control during pregnancy.

If you are over the age of 35 and considering getting pregnant, there is no need to panic. You should, however, make an appointment with your Ob/Gyn to discuss how to maximize your chances of becoming a parent. He or she can best advise you on an individual basis.

Research shows that most women have healthy pregnancies and normal babies, so age in of itself should not be a barrier when considering pregnancy. Generally, most women in their 30’s and 40’s show no greater signs of problems once they are pregnant than their younger counterparts, a fact that should be reassuring to women considering having a child later in life.

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Dr. Jon Matsunaga is an Ob/Gyn in Santa Monica and chair of Saint John’s Health Center’s Department of Obstetrics and Gynecology. For more information on Saint John’s, please contact the health center at (310) 829-5511 or visit the hospital’s website at http://www.stjohns.org