Health

High-Risk Pregnancy: What Women 35 and Over Need to Know

I know a thing or two about having a so-called high-risk pregnancy. I’ll never forget when I first saw the term “elderly multigravida” on my medical record. There it was, confirming all my worst fears: Apparently, I was old, and of course dying of something very, very grave. Except that definitely wasn’t the case.

I was, in fact, simply 35 and enjoying a healthy pregnancy with my second child.

“Elderly,” in the language of obstetrics, refers to pregnant people who are 35 or over. (Multigravida means I had been pregnant more than once. If it were my first pregnancy, my code would have read “elderly primagravida.” Elderly multigravida, elderly primagravida—just as bad!) These are just a couple of the foreboding terms people who are pregnant over 35 must contend with. There’s also “advanced maternal age,” “geriatric pregnancy,” and, of course, the fact that I was considered “high-risk.”

Am I being overly sensitive? As a health editor, I should be used to this, right? Or is age 35 really when your chances of having a healthy pregnancy start to drop?

Pregnancy over 35 is actually quite common.

I had my first child at 33, my second at 36, and recently delivered my third at age 39. When I got pregnant at 32, I was one of the first of my friends to have kids. The rest joined the club after age 35, echoing a national trend of waiting longer to start having children.

“People might want to get their career going and wait a little while, or wait until they meet the right person,” Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells SELF. Whatever the reason may be, times are changing when it comes to how long people are holding off before having children. (And advances in assisted reproductive technology, like in vitro fertilization, have made it easier for some people 35 and older to get pregnant than they could have in the past.)

The average age at first childbirth rose to 26.9 years old in 2018, according to the Centers for Disease Control and Prevention (CDC), a marked increase from 24.9 years old in 2000. For context’s sake, in 1970, people first gave birth when they were 21.4 years old on average, so there’s a clear upward trend happening here.

Experts are seeing national shifts when it comes to having children at age 35 and over, too. From 2000 to 2014, the number of women 35 and over giving birth for the first time climbed from 7.4 percent to 9.1 percent, the CDC notes. Since then, it has generally continued to rise. In 2010, 45.9 out of every 1,000 women aged 35 to 39 gave birth, and in 2018, that number was up to 52.6 out of every 1,000 women aged 35 to 39, according to the CDC.

Clearly, more U.S. people than ever are delaying bringing little people into the world. But what does that mean about the odds of having a high-risk pregnancy?

Is any pregnancy after age 35 automatically a high-risk pregnancy?

Many doctors are quick to discount the belief that age 35 always and instantly draws a line between a healthy pregnancy and a high-risk one.

“We’ve learned that there’s nothing magic about age 35,” Sarah J. Kilpatrick, M.D., Ph.D., chair of the department of obstetrics and gynecology at Cedars-Sinai, tells SELF. “I would never tell someone that just because she’s 35 she has to see a high-risk doctor—only if there’s something in her history or something that happened during her pregnancy that warrants it.”

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