Planning a pregnancy after 35 – Do’s & Don’ts

Age is just a number. But with your biological clock ticking, does its significance change?

Can you be too old to get pregnant once you’ve crossed 35 age? Is there a deadline to get pregnant? 
Women these days often plan to start a family once they have reached 30. (Check out our article on what is the right age to plan a pregnancy

The reasons for this delay in pregnancy planning are many-  With age comes financial stability, emotional and mental maturity. They seem to be more prepared to raise a child in their 30s. 

The availability of better medical facilities & technology is also the cause for the shift leading to women planning motherhood at a later stage. 

Then there are some who wait for the right partners to start a family. 

All these factors have made 30’s the new 20’s, to start a family. 

Though pregnancy after 35 is common, should you be concerned about getting pregnant after 35? What are the risks involved and what precautions need to be taken? Keep reading to find out more. 

Does every pregnancy after 35 ( advanced maternal age) become a high risk?

“Elderly primigravida” is the term used for women who are 35 and above. Primigravida means that this is your first pregnancy (multigravida indicates one or more previous pregnancies). 

The American College of Obstetricians and Gynecologists (ACOG) states that after the age of 35, your chances of getting certain diseases or issues that can affect either you or the fetus, (or both,) increase. However, this does not mean that every pregnancy will have a problem. You may also be able to progress with this pregnancy without any complications.

“Advanced maternal age” pregnancy risk

• Risk of gestational diabetes: The type of diabetes that develops during pregnancy is called gestational diabetes. Pregnancy after 35 is associated with an increased risk of gestational diabetes. Women who develop gestational diabetes are more likely to develop diabetes later on in their lives.
  Gestational diabetes increases the risk of premature birth, pregnancy losses, injuries during delivery, need for operative /caesarean section for delivery and also various complications to your baby including large/small for date baby, birth defects in baby, seizures & sudden hypoglycemia in newborn babies.
  You can control your blood sugar levels through diet, physical activity and sometimes medications may be prescribed by the doctor to control the blood sugar values. 
• Risk of high blood pressure: The risk of developing high pressure is more in older women. This can pose a threat to you & your baby.
  Raised blood pressure is associated with many complications including miscarriage, pre-eclampsia / Eclampsia or seizure disorder, adverse effect on the liver, kidneys, circulatory & blood clotting system. It can lead to life-threatening complications in the mother as well as the baby. There are also chances of preterm delivery, small for dates baby and even pregnancy losses. 
• Longer to get pregnant: Just like a gumball machine has a set number of balls which reduces with every turn, a woman is born with a limited number of eggs and as you age the quality and quantity of your eggs reduce. Fertilization of the eggs is another issue that complicates with older age.
  The chances of various infections or gynaecological diseases causing problems with the genital tract also increase with age. As time passes, increased exposure to sexual activity & disease-causing organisms may lead to Pelvic infections which may damage the lining of the uterus or the fallopian tubes.
  All this makes conceiving after 35 a difficult task to achieve.
• You may have multiple pregnancies: When it gets difficult to conceive naturally, people obviously resort to assisted reproductive techniques which use medications to promote the growth & release of eggs from the ovaries. As a result, often multiple eggs are released from the ovaries. Thus, you make an increased probability of having twins as multiple eggs may be released & fertilized. This also can occur within vitro fertilization as more than one egg may be fertilized & implanted. 
• Risk of birth defects and chromosomal abnormalities and low birth weight in your child: As there is a risk of preterm birth, your baby may have low birth weight. The quality of your eggs & partner’s sperms also reduces with age, due to which there is an increased probability of birth defects and chromosomal abnormalities like Down’s syndrome increases. 
• Risk of miscarriage: All of the reasons mentioned above adds to the risk of miscarriage. 
• Risk of Pelvic problems like Uterine fibroids, Endometriosis, Adenomysosis etc increase the chances of pregnancy complications & miscarriages. The incidence of all these ailments increases with advancing age. 

Precautions you can take to minimize complications

• Be prepared: Preparing for a child to be born begins even before pregnancy. Consult your doctor for preconception counseling. Your doctor may assess your pre-existing medical conditions and suggest alterations in medications, diet &/or lifestyle to optimize your pregnancy outcome.
  Your doctor may look for any existing fibroids/endometriosis/cysts or any other pathology that needs to be treated in order to improve your chances of having a healthy & safe pregnancy.
• Follow-ups: Regular check-ups will help your doctor to detect any abnormalities at an early stage and timely interventions can be made.
• Exercise is the way: Physical activity will keep you in good health. It will help you manage your blood sugar level and blood pressure. It also prepares you for labor by giving you stamina and strengthening your muscles.
  Ideally, it is best to indulge in moderate-intensity exercise for at least 120-150 minutes a week i.e about 30 minutes for at least 5 days a week.
  Always consult your gynecologist before you start with a workout routine and get their green signal because safety comes first. Maintain a healthy weight.
  Read here to check for the exercises when planning to get pregnant.
• Healthy food, healthy you: Good and healthy food is crucial for a healthy pregnancy. The requirement for nutrients increases during your pregnancy because it is required for the growth of your baby also. You will also be started on nutritional supplements like calcium, iron and folic acid. 
• Put a hold on the alcohol & smoking while your womb holds the baby: Like all warning signs say-  Smoking is injurious to your health.  And when you are planning to conceive or are pregnant it is also injurious to the health of your baby. Similarly with alcohol and other illicit drugs. It is wise to completely avoid the use of these during your pregnancy period. 
• Heard about DNA screening? This involves prenatal cell-free DNA screening of your baby to detect any chromosomal abnormalities. The maternal DNA and the DNA of your child are taken from the mother’s blood and screened for Down syndrome, trisomy 13, trisomy 18. Other diagnostic tests like chorionic villus sampling and amniocentesis can help with chromosome abnormality testing but these are associated with the risk of miscarriage. Talk with your doctor about the benefits and risks of each process if you would like to get one done. 

Finally, it is best to have your baby when you are prepared for it. Let not these risks scare you but rather encourage you to take help and the right steps to prepare for a safe and healthy baby. Make your choice wisely and we are here to help you.

For more information on Fertility, please check our other videos