If you’re waiting until your 30s — or even your 40s — to start a family, you’re not alone. In fact, the average age to have children has been climbing for decades. In 2016, women in their early 30s gave birth at a higher rate than women in younger age groups, according to the Centers for Disease Control and Prevention.
Why are more women putting off pregnancy? What are the health risks associated with advanced maternal age? And how can you mitigate these risks?
Health experts cite two major reasons the average age to have children is on the rise: declining teen pregnancy rates and loftier career aspirations of younger women.
“I think there is a big push now for women to be established in their careers before having children,” said Laurie McKechnie, a nurse practitioner at Lynn Women’s Health, an OB-GYN practice affiliated with Lahey Health. “Years back, your job was to be a mom and keep a home. Now, women are having careers and reaching further in their education, and some are climbing the corporate ladder. And having a family seems to put a damper on those things for some women.”
McKechnie says there are reproductive advantages to having children in your 20s — your egg supply is more robust, and genetic defects are less common in younger eggs. However, many women simply aren’t ready yet.
“I don’t think there’s anything wrong with waiting,” McKechnie said. “I have three girls, and I tell them, ‘Do not have a baby until you’re 30.’ And it’s only because I think women are accomplishing more these days, and being established in your life can make a big difference in your family. On the other hand, my mother is glad she had her children young so she could enjoy them — and now her grandchildren — later in life.”
“There are pros and cons to both sides,” she added. “I don’t think there’s a wrong answer.”
Advanced Maternal Age
Women who get pregnant at age 35 or older are considered to be of advanced maternal age; resultingly, their pregnancies are considered high-risk.
“There are some comorbidity factors that go along with aging, such as diabetes and high blood pressure, which cause concerns in pregnancy,” McKechnie said. “There’s an increased risk for genetic factors like Down syndrome after age 35, and (an even higher risk) after age 40.”
“The odds of multiple births also increases with advanced maternal age,” she added, “especially if you’re doing fertility treatments, and pregnancies involving twins are more high-risk.”
Still, many women have healthy pregnancies well into their 40s, thanks to better screening processes and imaging technology.
“We monitor blood pressure and glucose levels very closely, especially for women who have a pre-existing condition,” McKechnie said. “For women who have a sibling or parent with diabetes, we do an early glucose screening in the first trimester. Then, we test again heading toward the 26-week mark. We also have better ultrasound technology and genetic testing. There’s a blood test we can do in the first trimester for women over age 35 that looks for genetic abnormalities, so you don’t have to wait until the second trimester to find out if there’s something wrong. We also do an ultrasound to look at the nuchal fold on the back of the baby’s neck, which is an indicator of Down’s syndrome, and that can be done around 12 weeks.”
Ensuring a Healthy Pregnancy
If you’re waiting to have kids, here are four things you can do to improve your odds of having a healthy pregnancy.
1. Keep Yourself Healthy
Your overall health is the most important factor, McKechnie says. Eating well, refraining from smoking and using drugs, and drinking only in moderation are important.
“What keeps your everyday health in check is really important to having a healthy pregnancy,” she said. “If you have Type 2 diabetes or hypertension, make sure your blood glucose and blood pressure are well controlled before getting pregnant. A healthy BMI is important as well.”
2. Don’t Skip Your Annual Checkups
Annual wellness exams with your primary care provider help you stay on top of any underlying health conditions that might affect your pregnancy. Regular checkups with your OB-GYN are also important, especially if you aren’t having a period.
“You need a normal menstrual cycle to get pregnant, and people sometimes don’t take that into consideration,” McKechnie said. “Some hormonal birth control options suppress your cycle, and that’s not really a factor in fertility. But if a regular period has not been the norm for you, have that followed up on early. We can also do some lab work for women wanting to delay pregnancy to determine fertility.”
3. Consider Freezing Your Eggs
Egg freezing is a viable option for many women, but the best time to do it is in your mid-20s. And it’s not cheap — McKechnie says that storing your eggs could cost $8,000 a year.
That said, she does recommend having a consultation at a fertility center if you’re interested in egg freezing or are worried about your future fertility.
“Having that appointment with a reproductive endocrinologist, hearing what they have to say, and talking over your plans for later on, that’s a really good place to start,” McKechnie said.
4. Keep an Open Mind
If you can’t get pregnant the old-fashioned way, know that you still have options.
“There have been many advances in fertility treatments,” McKechnie said. “If women aren’t able to get pregnant using their own eggs, we can use donor eggs.”
“I think there’s a stress component that sometimes prevents people from getting pregnant easier, because you’re worried about how old you are,” she added. “Knowing that there are options, and being open to those options, can help alleviate some of that stress.”
For more information on advanced maternal age and pregnancy later in life, talk with your Lahey Health physician.