Anne Lipinski, MD Obstetrics/Gynecology Meadowview Obstetrics and Gynecology Columbia St. Mary’s Grafton Medical Center

May 23, 2008

I was 36 when I had my first baby and 40 with the second. Many women are having children later for a variety of reasons, and some of them worry that it may present additional risks to them and their babies. While there are some risks associated with advanced maternal age, age doesn’t seem to pose the same problems for this generation as it once did.

What has changed is lifestyle. The women I see today are much more physically fit and health conscious than women of generations past. By taking care of themselves, they reduce the risk of some ailments we associate with age, like gestational diabetes and hypertension. If they have been exercising, they have developed endurance and strength that will help during labor. The risk of chromosomal abnormalities does rise with age. On the other hand, a young woman who spends all day behind a desk without the opportunity to exercise or pay attention to good nutrition will have other risk factors. The key to minimizing risks at any age is to take good care of yourself before, during and after pregnancy.

Ideally, before getting pregnant, women should take time to consider their lifestyle. If you smoke, then quit. If your whole life has been focused on your career, take time to reevaluate your health habits. Start exercising. Pay attention to nutrition, and start taking a vitamin that includes folic acid. Also, make sure you are up to date on your vaccinations, especially for rubella. Once you are pregnant, you may not be able to get your boosters, depending on which ones you need.

All pregnant women are offered a test for cystic fibrosis. I recommend pre-pregnancy testing for this and other genetic conditions, if you have concerns about them. Discovering that both you and your husband are carriers of a genetic disorder may affect your decision to become pregnant.

Once you are pregnant at 35 or older, your physician may refer you to a geneticist or a perinatologist for counseling and/or testing. Through a genetic ultrasound, parents can be assured their baby is developing well. Through the CVS test or amniocentesis, parents will be able to determine if their baby has Down syndrome or some other chromosomal abnormality. I always ask my patients how this information will help them. What will they do with it? Some need the security of knowing what to expect. However, any invasive testing raises the risk for miscarriage, so that should be considered.

During pregnancy, continue taking good care of yourself. Get plenty of sleep. Lower your stress. Exercise and eat healthy food. It’s a great time to take evening walks with your spouse, talking about all the exciting changes in your lives. Older moms often have an advantage in that they may be in a more secure financial and professional situation, enabling them to focus more on health than on establishing themselves.

After birth, slowly get back to exercise. If you were exercising before and during pregnancy, then it will be easier to do. Also maintain your healthy diet. This is a time when you are establishing your family lifestyle. Make it a healthy one.

If you think you want a baby after 35, it is very reasonable to pursue it. And to enjoy it!