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In today’s society, it has become more commonplace for women to consider pregnancy at age 35 or older for a variety of reasons. Some have pursued education, careers, or have married later in life than women did decades ago. And some are simply choosing to have one more baby in their lifetime, even after one or two previous pregnancies. Infertility problems are also more prevalent as a women gets older, and technology has helped these women succeed in achieving a much desired pregnancy. Statistically, there are more women over the age of 35 than any other era.
Due to the increasing popularity of late pregnancy, it is imperative to consider more desirable and friendly terms to use when referring to older pregnant women. The terms elderly primigravida, post-mature, and obstetrically senescent are somewhat negative. Less offensive terms such as mature primigravida or advanced maternal age may be more appropriate.
Health care providers have traditionally viewed any woman over the ageof 35, especially having her first pregnancy, as a high risk patient. Age alone does not predict risk, but several lifestyle factors, such as family history, socioeconomics, and demographics, have major impacts on the well-being of the mother and infant. The number and spacing of previous pregnancies, genetics of the parents, nutritional status, and prenatal care of the mother also play an important role in the pregnancies of older women. It is imperative, for all of these reasons, that benefits and risks to the mother and the baby be considered.
Some of the more common chronic diseases that may be present in womenover 35, and which may affect a pregnancy, are arthritis, hypertension, and diabetes. These can all be monitored, and technology helps in detecting and treating these diseases to assure a safe pregnancy. The risk that cannot be overcome by a healthy lifestyle is a chromosomal abnormality. It is not understood completely, but statistically, the genetic material within the egg is at a greater risk of being defective as the woman ages. The absence or addition of a chromosome can lead to Down syndrome.
Genetics testing is a standard of care offered to any woman 35 or older, due to potential increased risk. This should be a completely informed choice for the woman and her partner. The standard tests offered are chronic villa sampling (CVS) and amniocentesis. CVS testing can be performed as early as nine weeks, with results within a few days, yet amniocentesis has been around longer and used much more extensively. Amniocentesis is usually not performed until the fourteenth to sixteenth week, with results in a week or two. Both tests carry the risks of triggering miscarriage in less than one percent of all the women having the procedures. With either test come emotional and psychological effects, which may increase fear and anxiety about the normalcy of the pregnancy. Other potential complications of pregnancy-include a higher chance of twin pregnancy, gestational diabetes, pregnancy induced hypertension, and preterm labor.
Some of the practical matters to concern an advanced maternal age couple would be the career changes, child care, financial future shock of paying for college tuition at an older age, and the aging father and mother.
All is not negative for a woman who chooses pregnancy at age 35 or older. Some of the positive aspects can include a secure financial state, career and educational goals that have usually been achieved, and a marriage or relationship that has had an opportunity to reach a certain stability. Another important aspect would be the woman’s increased confidence in child rearing abilities due to maturity.
All prospective parents, regardless of age, are
encouraged to attend both childbirth and parenting classes to gain confidence
in new experiences. A baby demands a great deal of energy, attention, and
love and a prepared couple can embark on this journey knowing not only
how to meet these demands,but also aware of the resources available to
help them along the way.
