Geriatric pregnancy: Waiting later in life to have a baby


by Ingrid Kohlmorgen, MD

Apr 30, 2019

As a practicing obstetrician-gynecologist for more than two decades, I think the term “geriatric pregnancy” is a bit of an exaggeration. When I think of the word “geriatric,” I think of older ladies enjoying their retirement years after having spent a large portion of their younger years raising families and working.

But in the world of obstetrics, the term geriatric applies to any woman having a baby at the age of 35 or older. Having my children at the ages of 39 and 41 put me right in the middle of the definition of geriatric pregnancy!

The numbers of women having what is considered a geriatric pregnancy have been steadily rising over about the past four decades.

The numbers of women having what is considered a geriatric pregnancy have been steadily rising over about the past four decades. As women are waiting longer to have children, many worry about the potential risks and dangers of waiting too long. The reality is this: Women are born with a finite number of eggs. With increasing age, both the number and quality of the eggs decline. So, as we age, our ability to get pregnant and carry a successful pregnancy to term decreases, and our risk of some complications increases.

But let me pause here for a moment. I know it can seem overwhelming, as if the clock is just ticking away, but don’t worry. You are not in this alone, and it is fully possible to have a healthy geriatric pregnancy. Like I said, I’ve been there, done that — twice. Here’s what you need to know.

Fertility: Getting pregnant after age 35

Fertility issues do become more common as you age. If you are between the ages of 35 and 40 and have been trying to achieve pregnancy unsuccessfully for six months, seek the help of a reproductive specialist. Help is encouraged even earlier for women aged 40 and older.

A visit with your OB/GYN is the perfect place to start. We can offer evaluation and treatment options for all problems that may impact achieving and maintaining a healthy pregnancy, and refer you to an endocrinologist for more complex issues, if needed.

Related: How to cope with the emotional stress of infertility

What to expect during pregnancy screenings

Once pregnancy is achieved — congrats! — there are options for prenatal screening which can help a couple assess their individual risk for chromosome defects, the most widely known being Down Syndrome (occurs when there are three number 21 chromosomes present). While all patients are offered these screening tests, some tests are reserved for people aged 35 or older, and those with other medical indications because some inherent risk to the fetus is involved with these more invasive procedures. These include chorionic villus sampling and amniocentesis. However, there are also non-invasive prenatal testing methods available if you prefer.

Talk to your OB/GYN about any concerns you have related to screenings or potential abnormalities. I cannot stress the importance of open dialogue throughout your pregnancy journey.

Other important pregnancy considerations

With advancing age, other medical conditions can potentially impact your pregnancy. The older you are, the more likely you are to have existing medical conditions, such as high blood pressure and diabetes.

Additionally, over the age of 35, women are more likely to develop pregnancy complications. Even in patients without pre-existing high blood pressure and diabetes, preeclampsia and gestational diabetes can occur. These conditions require more frequent prenatal care visits and more intense monitoring than pregnancies without these complications. Advanced maternal age or “geriatric pregnancy” is a risk factor for both.

Related: Should you consider a birth plan?

Lean on the support and guidance of your OB/GYN to walk you through any questions or fears on your mind. That’s why we’re here.

Regardless of your age, it is always recommended to meet with your doctor if you are thinking about trying to conceive. Your doctor can evaluate your overall health and review personal and family medical history for any impact it may have on your future pregnancy.

During these visits, you can expect your doctor to discuss several items, including:

  • Immunization and vaccination status
  • Current medications, including any over-the counter supplements
  • General screening tests: Determining blood type, Rh factor and carrier status for certain genetic disorders, as well as checking for immunity to rubella (measles) and vaccinating prior to pregnancy where no immunity exists
  • Staying healthy during pregnancy: Maintaining a healthy weight, eating a healthy diet, exercising regularly and avoiding alcohol, tobacco and drugs

More and more women are delaying childbirth for many different reasons. The really great news is that we are here to help you achieve your pregnancy goals with the hope that every woman will be able to have the family of her dreams.

Find an OB/GYN to guide you through pregnancy and parenthood.

About the Author

Ingrid Kohlmorgen, MD, is an obstetrician-gynecologist on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth.

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