In the past few decades childbearing timing has changed, with late pursue of pregnancy becoming an increasing phenomenon. Whether the reason is the availability of better contraceptive options, wider opportunities for further education and career advancement for women, a late marriage or remarriage, or difficulty achieving pregnancy, more women are crossing the age of 35 or even 40 before thinking of getting pregnant. In fact 14 percent of all births in the United States were to women at 35 years or older.

I would like to divide this common question in two areas of interest.


As women enter their 30’s, fertility starts to decline, fewer eggs will be available and those eggs remaining may not be as healthy as previously. By age 37 this decline usually accelerates. This in turn may bring a prolongation in the average time for achieving conception or the need for assisted reproductive techniques.

Currently we recommend that all couples should be evalueted for infertility if after six months of pursuing pregnancy they are not successful. If problems appear, prompt treatment should be directed to enhance pregnancy chances.


Complications during pregnancy are more common after age 35 for several reasons that I will mention below.

– Medical and surgical illnesses, such as cancer; hypertension, diabetes, renal, autoimmune disease and obesity increase with advancing age.

– Older women experience an increased rate of spontaneous abortion and ectopic pregnancies (pregnancy located outside the uterus).

– There is a steady increase in the risk of birth defects as a woman ages.

– Older women are more likely to deliver a low birth weight baby, have a stillbirth, abnormal location of the placenta and increased likelihood of having premature labor and a cesarean section.

However, the reality is that most healthy women from age 35 into their 40s have healthy pregnancies, and most women over 35 are in good health. Good prenatal care and healthy habits can help you reduce certain risks. Prenatal screening can accurately test for birth defects. The feared amniocentesis, although a very precise and safe option, has now some alternatives with new technology that is ls less invasive. A combination of blood work and ultrasound on the mother is now able to predict the possibility of some birth defects. More recently, a revolutionary new test was developed to detect free DNA of the fetus in the maternal blood to test for this same purpose.

You can’t change your age but can take care of your overall health; to help reduce risks during pregnancy:

• Eat healthy foods; gain a healthy amount of weight.

• Exercise with your health care provider’s guidance.

• Don’t drink alcohol, smoke or take illegal drugs.

• Don’t take any medications or herbal supplements without first checking with your health care provider.

• Get all medical conditions under control before you get pregnant, since it could make a real difference to your baby.

If problems do arise, usually they can be successfully treated. For those of you planning for a new baby, we will be glad to see you in our office for more information.