Geriatric pregnancy and advanced maternal age: What to know about having a baby after 35

When most of us hear "geriatric," we picture something entirely different than a healthy woman in her late 30s or early 40s who's ready to start or grow her family. That’s why the term "geriatric pregnancy" may come as a surprise.

In obstetrics, a geriatric pregnancy means any pregnancy in a woman aged 35 or older.

But here's some perspective that might help: Most women 35 and older go on to have healthy pregnancies and healthy babies.

Let’s take a closer look at what a geriatric pregnancy is, what women over 35 should know about starting a family and what support is out there for you.

What is a geriatric pregnancy?

A geriatric pregnancy refers to any pregnancy in a woman aged 35 or older. You may also hear the term advanced maternal age (AMA), which is the more current, preferred language most providers use today. If your provider or your paperwork uses either term, they mean the same thing: your due date occurs when you are 35 years or older.

The age of 35 became the clinical threshold decades ago, largely because that's when researchers began to see a statistically measurable—though still modest—increase in certain pregnancy-related risks, particularly chromosomal differences like Down syndrome. It was a practical cutoff for deciding who should be offered additional screening, not a declaration that something is wrong with you.

It's also worth saying plainly: 35 is not a cliff. Risk does not suddenly spike on your birthday. It increases gradually along a continuum, starting well before 35 and continuing slowly after. The line exists for clinical guidance, not to alarm you.

Why more women are waiting—and why that's okay

The number of women having a first baby after 35 has been rising steadily for four decades, and that trend continues. Women are pursuing careers, finding the right partner, building financial stability or simply taking time to feel ready.

The reality of pregnancy after 35 is more nuanced than headlines often suggest. Yes, some risks increase with age. But most women in this age group have uncomplicated pregnancies. What does change is the level of monitoring and the conversations you'll have with your care team.

Fertility: What changes after 35

It is true that fertility and reproductive health do naturally decline with age. Women are born with a finite number of eggs, and both the quantity and quality of those eggs decrease over time. This is why it may take longer to conceive after 35, and why your OBGYN may recommend evaluation sooner than for younger people.

If you're between 35 and 40 and have been trying to conceive for six months without success, it's a good idea to seek an evaluation with a reproductive specialist. For women 40 and older, that conversation should happen even earlier, within about three months of trying.

A visit with your OBGYN is always the right first step. Your doctor can assess your overall reproductive health, discuss your goals and connect you with a fertility specialist or reproductive endocrinologist if needed. There are more options available today than ever before.

Prenatal screening and testing: What to expect with advanced maternal age

Once you're pregnant, you'll have access to a range of prenatal screening options. All pregnant women are offered these, but some are especially relevant—or exclusively offered—to women with advanced maternal age. Here is what you might expect:

• Non-invasive prenatal screening (NIPS) is a simple blood draw, typically done around 10 weeks, that screens for chromosomal conditions. Prenatal genetic screening is highly accurate and carries no risk to the pregnancy.
• First-trimester screening combines a blood test with an ultrasound (nuchal translucency measurement) to assess risk.
• Diagnostic testing—including chorionic villus sampling (CVS) and amniocentesis—can provide a definitive diagnosis rather than a risk estimate. While this testing is the most accurate, these invasive procedures carry a small risk, which is why they're offered selectively and always a personal choice. Your provider will walk you through the benefits and tradeoffs of each option.

If your screening results show an elevated risk, or if you have other medical factors, your OBGYN may refer you to a maternal-fetal medicine (MFM) specialist, also called a perinatologist. These are high-risk pregnancy experts who work alongside your regular OBGYN to provide additional monitoring and specialized care when needed.

Open dialogue with your care team throughout this process is essential. There are no wrong questions.

Geriatric pregnancy: Real risks and real reassurance

Compared to women under 35, women with advanced maternal age have a somewhat higher risk of certain conditions, including:

• Gestational diabetes: High blood sugar that develops during pregnancy and typically resolves after delivery.
• Preeclampsia: A pregnancy complication marked by high blood pressure that can affect the mother's organs.
• Placenta previa: When the placenta partially or fully covers the cervix, it can cause bleeding.
• Cesarean delivery: A surgical procedure to deliver a baby through a C-section.

The risk of chromosomal differences like Down syndrome also increases gradually with age. Multiple pregnancies (twins, triplets) are slightly more common, particularly in women who've used fertility treatments, like in vitro fertilization (IVF).

Existing conditions like high blood pressure or diabetes can also complicate pregnancy and are more likely to be present as we age.

That said, most of these conditions are manageable with appropriate monitoring and care. Women 35 and older who receive consistent prenatal care are well-positioned for healthy outcomes. The goal of all this extra attention isn't to worry you—it's to catch anything early when it's most treatable.

The benefits of advanced maternal age

Here's something that often gets lost in risk-focused conversations: there are real advantages to having children later in life.

Research suggests that older mothers tend to be more emotionally prepared for parenthood, financially stable and deliberate in their decision to have a child. Some studies have even linked later maternal age to better cognitive outcomes in children, and to certain longevity benefits for mothers.

You bring wisdom, patience and intention to this experience that younger parents are often still developing. That matters.

Before you get pregnant: Preconception planning

Regardless of your age, if you're thinking about getting pregnant, a preconception health visit with your OBGYN is one of the most valuable things you can do. This appointment is an opportunity to:

• Review your overall health and any existing conditions that could affect pregnancy
• Discuss any medications—prescription or over-the-counter—that may need to be adjusted
• Check your immunization status and test for immunity to rubella and other conditions
• Screen for genetic carrier status
• Talk through nutrition, prenatal vitamins (including folic acid) and healthy lifestyle habits like maintaining a healthy weight and avoiding alcohol and tobacco

This visit is also when you can raise any questions or concerns about your fertility timeline. Your provider can help you understand your options and create a plan that's right for you.

Getting the right care team in place

Pregnancy after 35 works best when you have the right people around you. Your care team includes:

• Your OBGYN
• Maternal-fetal medicine specialists for higher-risk situations
• Fertility and reproductive specialists, if you're having difficulty conceiving
• Virtual postpartum support once your baby arrives.

You don't have to navigate any of this alone—and you shouldn't have to feel alarmed by a term that was coined decades ago.

Whether you're newly pregnant, actively trying or just starting to think about it, your first step is a conversation with someone who can meet you where you are and a program that helps you find the pregnancy care you need.

Find an OBGYN near you to talk through your pregnancy goals and build a plan that's right for you.