Is it risky to have a baby after turning thirty-five?

You've asked a complicated question about a current issue, considering the recent trend (since the 1970s) in women choosing to delay childbearing. Possible complications face women over 35 years old who wish to become pregnant and have a baby, including:

Decreased fertility
A woman is born with all of her eggs, and her fertility begins to decrease in her early thirties. Conception becomes more difficult as she progresses through this decade. While fertility treatments are available, they are expensive, stressful, and hard on a woman's body.

Increased chance of having twins
Although a woman in her thirties is less fertile, she is also more likely to carry twins.

Increased risk of miscarriage
Chances of a pregnancy ending in miscarriage increase as a woman ages; this is probably related to the increased risk of a mother in her thirties having a baby with a chromosomal abnormality.

Increased risk of birth defects
The chance of a baby being born with a birth defect increases greatly with the increasing age of the mother. This is particularly true of such conditions as Down's syndrome:

• A twenty-five-year-old woman only has a one in 1250 chance of having a baby with Down's syndrome.
• By age thirty, her chance becomes one in 952.
• By age thirty-five, she has a 1-in-378 chance.
• By age forty, she has a 1-in-106 chance.
• And by age forty-five, a woman has a 1-in-30 chance of having a baby with Down's syndrome.

Complications
Older mothers face potential complications during pregnancy or the birth process at a higher rate than younger mothers. These can include:

• high blood pressure
• diabetes
• increased chance of problems with the placenta (the organ that provides the baby with oxygen and nutrition while it develops in the uterus)
• increased chance for complications during labor and delivery, including an increased rate of Caesarian section

This list of complications faced by "older" mothers may seem daunting, and no one of any age can control everything that happens while trying to conceive and carry a pregnancy. You can, however, do some things to increase your chances of having a healthy pregnancy and baby. For example, even before you are pregnant, you can get a pre-pregnancy check-up and do pre-pregnancy planning with your obstetrician or nurse-midwife. You can also:

• stop smoking
• stop drinking alcohol, since no amount is considered safe
• refrain from using street or recreational drugs, over-the-counter medications, or prescription medicines without your health care provider's knowledge and approval while you are trying to conceive and throughout your pregnancy
• exercise regularly before becoming pregnant; continue exercising with your health care provider's approval throughout pregnancy
• get to and maintain a healthy weight before becoming pregnant
• follow your health care provider's guidelines for healthy weight gain during pregnancy
• begin taking a multivitamin containing at least 400 milligrams of folic acid before you even begin trying to conceive, and continue to take it throughout pregnancy, to help prevent birth defects
• schedule and keep regular prenatal visits with your provider throughout your pregnancy

Here's to healthy babies, moms, and informed decisions,