As any woman of “advanced maternal age” can tell you, the narrative surrounding pregnancy after age 35 is not always the most uplifting. Much of what women encounter online tends to emphasize the risks associated with pregnancy after 35 rather than a woman’s considerable odds of enjoying a healthy pregnancy and delivery even into her 40s. 

While there are risks associated with childbearing later in the reproductive timeline, there are also simple and effective measures women can take to optimize their chances of having a happy and healthy pregnancy well after they blow out 35 candles. 

This article will discuss several of the research-backed things women of advanced maternal age can do to help improve their chances of maintaining a healthy pregnancy with relatively few complications. For more information about things you can do, check out “Nutritional Tips for Optimizing Pregnancy After 35”.

Seek prenatal care early and often

Prenatal care is important for women of all ages, but especially important for women of advanced maternal age, who bear increased risks of: 

• miscarriage,¹
• preeclampsia,²
• gestational diabetes,¹
• low birth weight (< 5.5 lbs. at delivery),²
• preterm birth (birth before 37 weeks of gestation),³
• early preterm birth (birth before 34 weeks of gestation)³

While this may sound daunting, rest assured that an increased risk of complications does not mean every pregnancy after 35 is “risky”, or doomed to be problematic. In fact, many women over 35 enjoy pregnancy outcomes similar to younger women.⁴ However, given that the risks of complications do increase with maternal age, routine monitoring of blood pressure and blood sugar levels at prenatal checkups can help older (ahem, chronologically endowed) mothers stay ahead of any complications that may arise.

For example, a retrospective study study examining the effects of regular prenatal care on the outcomes of high-risk pregnancies found that women who received regular prenatal care (≥ 6 visits) had a significantly decreased risk of preterm birth, low birthweight, and other labor complications. Conversely, women receiving fewer than six prenatal visits or inadequate prenatal care were more likely to experience adverse pregnancy outcomes.⁵

Consistent with these findings, a different retrospective study found that a delay in the onset of prenatal care for high-risk pregnancies was associated with increased risk of preterm birth, and that insufficient prenatal care was linked to an increased risk of low birthweight.⁶ In short, these studies show that seeking prenatal care early and often enables women at an elevated risk for complications to proactively maintain a healthy pregnancy. 

 In other words, having your health professional keep a close eye on you can mitigate some of the risks associated with advanced maternal age.             

Think happy thoughts and enjoy your pregnancy

Another way science suggests that women can promote their chances of having a successful and healthy pregnancy is by maintaining a positive outlook. Indeed, numerous research studies find an association between psychological state during pregnancy and birth outcomes.^7,8

Whereas many of these studies focus on the negative consequences of stress and anxiety on pregnancy outcomes, a study looking at the effects of maintaining a positive outlook during pregnancy found that higher maternal positive affect was associated with longer gestation length and reduced risk of preterm birth.⁸ Similar to receiving frequent prenatal care, these findings suggest that maintaining a positive outlook during pregnancy can potentially neutralize some of the risks of complications associated with later pregnancies.  

And there is plenty for women of advanced maternal age to feel positive about! Studies find that women who postpone childbearing tend to be more financially secure,⁹ more emotionally grounded, and in more stable, long-term relationships than their younger counterparts.¹⁰ (Anecdotally speaking, they are also less likely to name their kids after IKEA furniture, so that’s nice). 

Importantly, these maternal advantages have positive implications for children’s long-term development. For example, several longitudinal studies indicate that children born to older mothers experienced fewer behavioral, social, and emotional problems during childhood,¹¹ and achieved greater educational outcomes than siblings born when their mothers were younger.¹² So maybe there is something to this “advanced” maternal age after all.