What to Expect When You’re Expecting (After 35)

It’s no longer unusual for a woman to pop out a baby in her late 30s or early 40s (see trendsetting new moms like Uma, Halle, Salma, and Tina). And while most of these pregnancies go smoothly, the fact is, maternal medicine experts classify them as “high risk” because older mothers are more likely to face complications that can affect their health as well as the health of their baby. If you’re planning on welcoming a bambino after age 35, congratulations! Just keep the following considerations in mind.

Conceiving can take longer
Unfair but true: female fertility dips slightly when a woman is in her early 30s, and after 35, it nosedives. A 30-year-old has a 20 percent chance of getting pregnant per cycle, but by the time she’s 40, her odds sink to 5 percent per cycle, according to the American Society for Reproductive Medicine. If you’ve been going at it for six months with no luck, check in with a fertility specialist, who may be able to diagnose the roadblock, suggests Alyssa Dweck, ob-gyn and coauthor of V Is for Vagina. Many of the things that make it tougher for older moms to conceive can be treated, such as uterine fibroids or irregular periods.

Genetic defects are more common
Sure, you look young and fit on the outside, but by your late 30s, your eggs are senior citizens, and they don’t divide as well upon conception. That increases the odds of an embryo with chromosomal problems, which in turn may result in miscarriage or birth defects, experts say. Seeing your obstetrician for a blood test at 10 weeks and then an early ultrasound at 12 weeks (along with the full anatomy ultrasound at 20 weeks) can pick up the majority of genetic abnormalities and let you know if the baby is developing properly, says Dweck says.

You’re at greater risk of pregnancy-threatening conditions
Gestational diabetes and high blood pressure are just some of the medical issues more likely to strike pregnant moms over 35. If left untreated, they can trigger serious health snags for them or their babies. Make sure your doctor is aware of any family history of these or other chronic conditions; the right time to inform her is during a preconception exam, when your ob-gyn evaluates your health before you start baby-making to suss out potential obstacles. And go to all your scheduled prenatal appointments, so if one of these conditions does develop, your doctor can catch it early and monitor you closely, advises Dweck.

You may have a tougher delivery
Complications that develop around the time of delivery, such as placenta previa (when the placenta blocks the cervix), are more common in older moms. Women over age 35 are also more likely to have prolonged labor lasting more than 20 hours and excessive bleeding during delivery, and end up needing a C-section more often than younger moms do. You may want to speak with a doula or birthing coach about how to emotionally prepare for such an event well before the due date.

Twins and triplets are more likely
The chances of having multiples increases in your late 30s, even if you don’t use fertility treatments, according to a 2012 CDC report. What’s the drawback to rolling out more than one bundle of joy? The more babies a woman carries per pregnancy, the greater her risk of delivering early and/or having low birth-weight preemies, who may end up with lingering health issues.

photo: iStockPhoto/Thinkstock

More from Women’s Health:
Should You Freeze Your Eggs?
How to Protect Your Fertility
When You’re Not Sure You Want a Baby

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