You only need to look at your mother and grandmother's generation to realise that they probably had children when they were younger than you are, and although there are many mums who have children in their twenties or early thirties, an increasing number of us are choosing to wait until we're a bit older to start a family.
It's easy to see why women might want to wait a little longer before getting pregnant, including these 13 celebs who gave birth after 40. Not only does our generation have much better access to contraception, we're also living a lot longer than generations before us. Women are also able to prioritise their education and career now before starting a family, not to mention the fact that this can boost your finances before having a baby.
As with most things, the older you are, the more likely it is that risks are involved. And if you're having a baby after the age of 35, you may have heard the rather outdated term, 'geriatric pregnancy'. This term is now rarely used in the world of medicine for obvious reasons, and the correct term that most medical professionals will now use to refer to mums over 35 is 'advanced maternal age'.
What is a Geriatric Pregnancy?
A 'geriatric pregnancy' is an outdated term that used to refer to pregnant women over the age of 35. The term you might hear your doctors and midwife use instead is 'advanced maternal age'. As we know, most women who have children over this age have healthy pregnancies and babies.
However, because pregnancy at this age can come with added risk, you might be offered an increased number of scans and tests to make sure everything is going to plan.
What are the risks of pregnancy after 35?
Risks can come with any pregnancy at any age, but there's an added risk after 35 and this increases after the age of 40. Firstly, as our expert, Rachel Fitz-D notes, it can be harder to fall pregnant in the first place over the age of 39. "Getting pregnant is far easier to achieve the younger we are - that’s simple biology. Among those actually trying to conceive (so couples having unprotected sex at least twice a week), over 90% of those in their twenties will fall pregnant within the year." As she notes, this does drop as you get older but still remains relatively high in your late 30s. "Whilst fertility drops steadily through our thirties, the good news is that women trying to conceive at 39 still have a 70% chance of getting pregnant within a year. After that, however, the ease in getting pregnant declines far more rapidly and the rate of natural pregnancy within a year stands at a bit over 30% at age forty and down to 20% just four years later."
If you're pregnant and over the age of 35, or 40, there are some risks you'll be monitored for more closely:
• High blood pressure - this can lead to pre-eclampsia. For this reason, the NCT suggests that if you're over 40 and have other risk factors for pre-eclampsia, you might be offered daily aspirin from week 12 of pregnancy.
• Miscarriage - As the NCT notes, the risk of miscarriage does unfortunately increase as you get older. They state, "The risk of a pregnancy ending in miscarriage for women aged 30 is 18%. That rises for women aged 35 to 22%. For women aged 40, this increases to 38% of pregnancies, and 70% for women aged 45."
• Gestational diabetes - The NHS notes that women over 40 have an increased risk of gestational diabetes, which is "high blood sugar (glucose) that develops during pregnancy and usually disappears after giving birth. It happens when your body cannot produce enough insulin – a hormone that helps control blood sugar levels – to meet your extra needs in pregnancy."
• Premature birth or stillbirth - while your chances of stillbirth do rise after 35, they remain low. But it's important to monitor your baby's movements and contact your midwife if you're worried. If you're over 40 you may be offered an induction around your due date.
• Complications when giving birth - this may lead to a c-section
• Low birthweight
• Chromosome disorders such as Down's Syndrome - as Rachel notes "Whilst a pregnant woman at any age may have a baby with a chromosomal abnormality, the chances increases with age. The risk of having a baby with Down’s Syndrome is 1 in 1,250 if a woman conceives at the age of 25, 1 in 400 at the age of 35 and 1 in 100 once a woman reaches the age of 40."
How can I increase my chances of a healthy pregnancy and baby?
Talk to your doctor
Before you start trying for a baby, it might be a good idea to speak to your doctor to check if you're physically ready to carry a baby. When you're pregnant, make sure you attend all of your tests and check-ups, and if anything ever doesn't feel quite right, speak to your midwife or doctor. You may also want to consider the optional tests for pregnant women over 35, to check for any birth defects associated with advanced maternal age.
Take prenatal and pregnancy vitamins
As with all mothers-to-be, it's important to take your vitamins - pre-natal and pregnancy vitamins are essential to boosting your chances of a healthy pregnancy and baby, especiallyfolic acid. As well as taking your vitamins, you'll want to make sure you're eating a healthy, well-balanced diet and have stopped drinking alcohol and smoking. It's also a good idea to cut down on caffeine and brush up on the foods you're advised to avoid while pregnant.
"For those wanting to get pregnant whilst avoiding the increased risks it will not surprise you to hear that staying fit and well is paramount as smoking, alcohol and being overweight increases the chances of miscarriage and other pregnancy problems" says Rachel. "Get fit and stay fit - swimming and walking are ideal forms of exercise in pregnancy - and eat a healthy, varied diet with plenty of fresh fruit, veg and grains. Take a daily folic acid supplement (400 micrograms) whilst trying to conceive and for the first 12 weeks of pregnancy and cut out smoking, alcohol and social drugs."
Additional tests for pregnancies after 35
If you're pregnant and over the age of 35 you might be offered additional genetic tests alongside the regular tests. Rachel Fitz-D explains, "You will be offered a routine scan and blood test to check for chromosomal abnormalities at about 12 weeks of pregnancy and if your result shows that you have an increased risk of your baby being affected, you may be offered more detailed chromosomal testing such as amniocentesis. As this test carries a risk of miscarriage, it is not offered routinely, and so you should discuss this carefully with your GP or midwife before making a decision."
She notes that in addition to the regular tests, your GP or midwife will assess you for potential risks and offer further testing if required. "Alongside the regular blood, urine and blood pressure checks that are done for all pregnant women, if your midwife or GP thinks that you are at an increased risk of diabetes, you will be offered a blood test to check, and if your risk of pre-eclampsia is considered to be greater then your blood pressure will be checked more often."
Rachel also notes that it's important to stay in regular contact with your medical team. "Your midwife will refer you to the obstetric team at any point in your pregnancy if there are any concerns so do make sure to attend every antenatal appointment and tell them if you have any concerns or worries at all."
Geriatric Pregnancy - the benefits
As we mentioned at the start, while there are some risks associated with giving birth over the age of 35, and these increase over 40, there are also benefits. Research has shown that older mothers tend to be better-educated with higher incomes and a number of studies, including one in the British Medical Journal, found that increasing maternal age was associated with improved health and development for children up to 5 years of age. Rachel points out, "it may be easier and less risky to get pregnant in our twenties but more emotionally and financially safe to wait another couple of decades. Whilst science has not yet been able to stop that biological clock ticking, it has helped doctors to overcome some of the age-associated risks, and enabled women to make safer and more informed choices about the timings of when to start their family."
About the expert
Rachel Fitz-D is a retired midwife, baby expert, and author of Baby Skin To Skin, with over 30 years working as a midwife and as a parenting consultant. Based in Berkshire, near London, she has appeared on numerous radio programmes, talking about various issues from infant feeding to smacking to humanist parenting. She co-created Henley Birthcare, a unique freelance midwifery and doula service offering bespoke care.
Lorna White is the Products Editor for Mother&Baby. After running the Yours magazine website, specialising in content about caring for kids and grandchildren, Lorna brought her expertise to Mother&Baby in 2020. She has a keen interest in a range of topics from potty training and nutrition to baby names and early development and has a wide range of experienced medical experts and professionals at her fingertips. In her spare time, she enjoys spending time with her two young sisters, dog walking and enjoying the outdoors with her family.