Tips to have a healthy pregnancy after 35
May 13, 2025
Over the past few decades, there has been a noticeable trend in pregnancy: Women are having babies later in life. In the U.S., the average age of a mother at her first birth jumped from around 21 in 1970 to 27 in 2020. And in 2020, women 35 and older accounted for nearly 19% of all pregnancies and 11% of first-time pregnancies.
There are certainly several advantages to having children later, such as completion of desired educational or career goals or achieving a more stable financial situation for the family. But delaying can also make having the babies you want a little more challenging.
While giving birth at age 35 or older is becoming more common – and thankfully it’s no longer called a geriatric pregnancy! – there are some special considerations for patients who become pregnant at an advanced maternal age.
The older we get, the less our bodies compensate for changes. That means all the body changes that happen during pregnancy have a more pronounced effect in older patients and their babies. Older women are more likely to start pregnancy with existing health conditions such as a higher weight, high blood pressure, or diabetes.
Despite these challenges, most women who become pregnant later in life will have healthy pregnancies. Let’s take a closer look at what you expect when you’re expecting at age 35 or older.
Potential pregnancy risks for mom and baby
During your early prenatal checkups, your provider will talk with you about conditions that are associated with advanced maternal age in pregnancy, such as:
- Gestational diabetes
- Pre-eclampsia or eclampsia (seizure-associated with preeclampsia)
- Heart attack or stroke
- Fetal growth restriction or low fetal birthweight
- Chromosomal abnormalities of the baby
- Preterm birth
- Pregnancy loss (with risk in the first trimester largely related to the increased odds of chromosomal abnormalities)
Older moms are also more likely to have complications during labor. Talk with your health care provider about whether there is a need to plan for a specifically timed delivery. Women who have had fertility treatments are also more likely to carry multiples (twins or more), and multiples are often born prematurely.
If you have concerns about becoming pregnant in your 30s or 40s, talk with your provider about preconception counseling. In this visit, we’ll discuss:
- Personal health history
- Family health history, including genetic conditions
- Reproductive history, such as past pregnancies and menstrual cycles
- Healthy habits and lifestyle choices
- Home and workplace environment
Together, you and your care team can talk through strategies to optimize your health before pregnancy. If you have particular health conditions, such as a heart condition or a history of pregnancy complications, we can connect you with our maternal-fetal medicine team for specialized care.
Related reading: What noninvasive prenatal testing can (and can’t) tell you about your baby
Age, gender, and fertility
Around age 35, infertility rates in women rise – the body has fewer healthy eggs and is less able to release them. Women in their 30s are about half as fertile as they are in their 20s.
Men are considered to be at an advanced paternal age around 40 years old, though the defined age is not as specific as it is for women. Reduced fertility can be due to factors such as lower testosterone, reduced sperm motility, and lower total sperm count. There is an increased risk for new onset of some genetic conditions (autosomal dominant mutations) and chromosomal anomalies in the sperm as well as increased prevalence of some birth defects, cancers, and schizophrenia in the offspring with the change starting around paternal age of 35.
Prenatal screening and testing
During pregnancy, you’ll see your provider for checkups on the same schedule as you would at any age – once a month until 28 weeks, then every two weeks until 36 weeks, then weekly until delivery.
If you are 35 or older, your provider will perform an ultrasound to check fetal growth during the third trimester, around 32-34 weeks of pregnancy even if there are no other complications of pregnancy. We check to make sure that the baby’s growth, fluid levels, and organ systems are as expected for the gestational age.
For patients 40 and older, we recommend additional fetal surveillance as your due date approaches due to the further increased risk for adverse outcomes such as stillbirth. It is recommended to start this weekly beginning in the 34th week. This is essentially a “baby report card” to ensure your little one is still thriving and the amniotic fluid levels remain normal.
While it was originally only offered to women over 35, we now offer noninvasive prenatal testing for all patients who desire this. This is done after 10 weeks of gestation and requires only a blood sample from the mother.
If the results show a chance that a chromosomal condition exists, we can refer you to a genetic counselor and do additional testing. Our maternal-fetal medicine physicians in Plano and Dallas can perform chorionic villus sampling (CVS) as well as amniocentesis to help determine whether a fetus has a specific chromosomal or genetic condition.
Healthy choices for healthy pregnancies
While you can’t turn back the clock on aging, there are healthy choices you can make now to increase your chance of having a healthy pregnancy.
- Eat a healthy diet with plenty of fruits, vegetables, and lean protein.
- Exercise at least 30 minutes a day most days.
- Take 0.4 milligrams of folic acid per day starting two to three months before becoming pregnant to reduce the risk of neural tube abnormalities in your baby.
- Stay away from drugs, alcohol, and tobacco products.
- Talk with your doctor before starting any new medications.
- Schedule a preconception counseling visit to discuss any health problems or concerns.
By committing to a healthy lifestyle, you can set yourself up for a healthier pregnancy and delivery. If you want to have a baby at 35 or older, our maternal health specialists can help create a pregnancy plan that’s right for you.
To talk with an expert about pregnancy care, make an appointment by calling 214-645-8300 or request an appointment online.
