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Why Are You Considered of Advanced Maternal Age and High Risk If You’re Pregnant Over 35?
The official answer is that some studies, including data collected by Parkland Hospital that examined pregnancy complications from 235,329 deliveries between 1988-2007, indicate that after age 35 there is an increased risk of complications, especially pregnancy-induced diabetes and hypertension.
Babies with chromosomal abnormalities, like Down syndrome, are more likely to be born to younger women, since more young women give birth.
But many health care providers I’ve interviewed point out that 35 is an arbitrary number.
You don’t automatically morph into a high-risk person the day after your 35th birthday. And we all know women in their late 30s and early 40s who are less sedentary and much healthier than women much younger than they. When I sat down with two forward-thinking obstetricians and two forward-thinking certified nurse midwives in the Boston area to talk about the current state of obstetric care, I was surprised how forcefully they insisted that 35 is a meaningless number.
Instead of upholding the idea that women over 35 are high risk and should be treated accordingly, these medical professionals told me stories of how invasive medical intervention on women over 35 has caused problems. In the mid 1970s the test actually carried a greater risk of having a miscarriage than the moms had of having a baby with Down syndrome.
But by the time she was 35 in 1984 amniocentesis had become the standard of care for “older” moms.


She wasn’t sure what she would do with the information (that is, whether or not she would have an abortion) should the test come back positive for Down syndrome. It would be much more logical for pregnant women to be assessed individually for health risks, they said.
But if my friend’s mom had had her at 25 maybe my friend would have been sorry for a different reason. I would encourage any healthy, secure couple to have a baby in their early forties if they want to.
One can’t at all make any kind of generalizations as to whether having a baby after 35 is a good idea or not. Our daughter was 36 when she gave birth and she has a perfectly happy and healthy baby girl! But the risk of having a baby with Down syndrome increases with age (from about 1 in 1,250 for a woman who is 25, to about 1 in 400 for a woman who is 35).
The doctor would palpitate the belly, pulling the fetus’s head back as best he could with his hands. But she was sure that the anxiety it would produce and the risk to the fetus from the test itself was not worth it. A friend was telling me recently that she always hated it that her mom (who had her at 40 and her youngest sister at 45) and dad were older than her friends’ parents, and acted like fuddy-duddies.


And even if she were in middle age with children of her own, maybe Dvora Meyers would still not be ready to be caring for her aging mom.
This matters tremendously, more than even your doctor is telling you (because, despite his best intentions, your doctor has not been educated about preventive proactive medicine and good nutrition). I was saddened to read this essay by Dvora Meyers, a young woman whose mom had her when she was 42.
I have noticed that health follows wealth in the US, both in big cities like Dallas and in rural areas. She feels like her mom got old and frail before she was ready to be caring for an elderly parent. Did they control for SES when they made the “35 is advanced maternal age” determination? Last month, I ran Boston and re-qualified and just found out I was actually pregnant when I ran.




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