Waiting until later in life to have a baby is a growing trend in the United States. According to the Centers for Disease Control and Prevention (CDC), birth rates for women ages 35-44 have been increasing regularly since 1985. So if you’ve been waiting to have a baby, know that you aren’t the only one.

You may have heard that having a baby after age 35 is “risky.” And the terms that get used for this topic, like “advanced maternal age” and “geriatric pregnancy,” aren’t reassuring either. However, pregnancy has risks regardless of your age. And while some risks do increase with pregnancy after 35, many of those risks are small. In fact, many people of advanced maternal age have healthy pregnancies.

But we know you have questions. So, it can be helpful to understand how age may impact your fertility, pregnancy and labor, as well as what you can do to have a healthy pregnancy after 35.

How does age affect fertility?

Everyone’s fertility decreases as they get older, which is a totally normal part of the aging process.

Women are born with a fixed number of eggs, which naturally decrease in quality and quantity with age. Men’s sperm also tends to see an age-related decrease in quality, though it’s usually more gradual.

As women reach their mid to late 30s, changes in fertility can mean that eggs with extra, missing or damaged chromosomes become more common. So, if one of these eggs is fertilized, there’s a higher chance that it may not result in a pregnancy at all, or not be a viable pregnancy and result in a miscarriage.

This means that age can make it harder to get pregnant (even when you know your fertile window), and it increases the risks of a baby having a chromosomal condition.

As women age, their risk of developing conditions like endometriosis, which can affect fertility, also increases. This is one of the reasons why it’s important to have a preconception appointment – your doctor or midwife will address these kinds of conditions as they help you prepare for pregnancy.

It’s also important to note that fertility problems can happen at any age, and for a variety of reasons. If you’re noticing signs of infertility in yourself or your partner, they aren’t necessarily being caused by your age.

How does age affect pregnancy?

No matter your age, getting pregnant is a matter of chance. While it could be more difficult to conceive after the age of 35, there’s still plenty you can do to increase your chances of getting pregnant.

Also keep in mind that there are age-related factors to be aware of that might affect you once you become pregnant, including:

Increased risk of complications

Older women are at a higher risk of developing certain complications during pregnancy, including:

  • High blood pressure, which can put stress on your organs and lead to other pregnancy complications.
  • Gestational diabetes, which is when you have too much sugar in your blood.
  • Preeclampsia, a kind of high blood pressure that can cause problems in organs like your liver and kidneys.

These complications can lead to others if they go untreated, including premature birth, low birth weight and pregnancy loss. But they are all manageable or treatable, and your care team will test for them regularly throughout your pregnancy to minimize your risk.

Increased risk of chromosomal conditions

As mentioned above, your chances of having a baby with a chromosomal condition increase as you get older, but it’s still rather rare. Down syndrome is the most common chromosomal condition among babies born to older mothers, and affects about one in 85 babies born to 40-year-old mothers.

If you want to know about the likelihood of chromosomal conditions and other issues before or during your pregnancy, ask your care provider about genetic testing. Screenings and diagnostic tests are usually offered as a part of prenatal care and can be used to check for the presence of various conditions, or their odds of developing.

A common example is noninvasive prenatal testing (NIPT). NIPT screens a regular blood sample for pieces of DNA shed by the placenta, which is usually the same as the fetus’ DNA. Analyzing these pieces can determine the fetus’ risk for certain chromosomal conditions.

Increased chance of multiples

Around age 35 and older, your ovaries are more likely to release more than one egg per month, which means your chance of having multiples increases.

How does age affect labor?

Older mothers have a higher risk of abnormal labor patterns, including a lack of progress during labor. This, along with a higher risk of complications, increases the chance that your labor will need to be induced, or that you’ll need a cesarean section.

How to prepare for a healthy pregnancy after age 35

Remember, most women over age 35 have healthy pregnancies. But to increase your chances of getting pregnant and minimize risks for both you and your baby once you do, here are some tips:

Make a preconception appointment

A preconception appointment helps you prepare for pregnancy. At a preconception appointment, your care provider gives you personalized care and counseling based on all the factors that could affect your pregnancy, such as your medical history and lifestyle. It’s also an opportunity to voice any questions or concerns you have. It’s recommended that you and your partner each make your own preconception appointments.

Maintain a healthy lifestyle

Many of the recommendations you’re likely to get during a preconception appointment have to do with managing your overall health leading up to and during pregnancy. This breaks down into a few parts:

  • Avoid toxins. Tobacco, alcohol and marijuana all have negative effects on fertility, which can make it harder to get pregnant. And once you get pregnant, no amount of smoke or alcohol is safe for your growing baby. Ideally, it’s best to quit a couple of months before you get pregnant.
  • Eat healthy. Focus on whole foods rich in folate (or folic acid), iron, calcium, vitamin D and protein. These are the key nutrients a pregnancy diet is based on – for example, folic acid helps prevent birth defects. You may also be prescribed supplements to round out your nutrition.
  • Exercise regularly. Exercise can help manage health conditions and strengthen your body for the demands of pregnancy. If your care provider recommends losing weight before getting pregnant, exercise is a good way to help. But be sure to ask your care provider about what exercises are safe once you’re pregnant.
  • Manage health conditions. Getting or continuing treatment for any existing physical or mental health conditions will help minimize their effect on your pregnancy. Make sure that your care provider is aware of these conditions, especially if you take medication for them, as you may need to change medicines during pregnancy.

Get more tips for living a healthy lifestyle.

Follow your prenatal appointment schedule

Once you get pregnant, your care team will give you a prenatal appointment schedule. Prenatal appointments happen regularly throughout pregnancy. They allow your care team to track your progress, and monitor you and your baby’s health. Following your schedule ensures that you’re both getting all the care you need, when you need it.

Don’t let age stop you

While there are additional factors to consider when getting pregnant later in life, it’s very possible to have a healthy pregnancy (and baby). You have knowledge on your side, and your care team will do everything they can to make your pregnancy safe, every step of the way.