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“I was 19, 29, and 32 when I had my sons,” says Darlene Demell, of Pembroke, Ontario. “I wouldn’t change anything about any of my pregnancies. I don’t think it had any effect on my attitude or my health—I guess it was the perfect time for me.”
The “ideal age,” physically, for a woman to have a baby is under the age of 30. “Fertility peaks from age 20 to 25 and begins to decrease at age 30,” says Dr. Patricia Tiernan, MD, OB-GYN, from Bourbonnais, Illinois. Generally women this age are healthy, without chronic medical conditions, and have lots of energy.
Reasons for Waiting
“I sometimes wish I had started earlier, but we waited because we wanted to do things in the ‘right’ order: get married, buy a house, get a dog, then try to get pregnant,” says Stacey MacDonald, of East Haddam, Connecticut. At 28, she became a first-time mom, and now at age 32 feels like she “only has a couple of years left to have another baby.”
Emotionally, many women in their twenties say they are not ready for the responsibility, commitment, and change of lifestyle that a baby brings. This reason, along with career objectives, financial stability, and personal goals, among others, may be why the average American woman’s age for having a baby has been steadily rising since 1970, according to statistics from the Centers for Disease Control and Prevention (CDC). First births among women ages 30 to 39 have doubled in the past 15 years, and those for women 40 and older have increased 50 percent.
“When I started practice 25 years ago, we considered a woman who was having her first baby and was older than 35 years of age to be an ‘elderly primigravida.’ Nowadays, women are waiting to start a family,” says Dr. Lawrence Jay Rappaport, MD, an OB-GYN specialist. “There is no problem at all in carrying a pregnancy to term at any age prior to menopause.”
Healthy Women, Healthy Babies
“Several medical studies have shown that healthy pregnant women between the ages of 34 and 44 have almost the same odds as 25-year-old women for bearing healthy babies,” writes Carol Winkelman, author of The Complete Guide to Pregnancy After 30. “Thus, when it comes to safety for the baby, healthy older women do almost as well as younger women.”
But what about the older mother-to-be’s health? As women age, they may expect more challenges, including increased fatigue, more frequent medical conditions, and an increased risk of birth defects. However, the biggest challenge may be fertility.
A woman’s fertility generally begins to slowly decrease at about age 32 or 33 . Some physicians believe that fertility decreases dramatically in a woman’s mid to late thirties. “Fertility decreases with age,” says Dr. Randy Morris, MD, from Chicago, Illinois. “This decrease is most likely due to aging of the eggs and the chromosomes inside them.” This means that women are born with all the eggs they’ll ever have—a 35-year-old woman has 35-year-old eggs.
Older moms may have to make more decisions about prenatal tests for birth defects, including amniocentesis, chorionic villus sampling, or high-resolution ultrasound. Michelle Byers, of Pittsburgh, Pennsylvania, remembers, “I felt confused and more nervous during my second pregnancy.” Michelle had her first baby at 29 and her second at 34. “Each test my doctor offered made me more anxious about the health of my baby,” she says. Women should inform themselves about all the options and make their own choices based on what is best for them and their babies.
The Risk of Birth Defects
The risk of giving birth to a child with a birth defect does increase as the mother’s age increases. Approximately one in 1,400 babies born to women in their twenties has Down syndrome. “At age 40, your risks more than triple, leaving you with a 1 in 39 risk of a genetically unhealthy baby,” writes Winkelman. “However, there is still a 97 percent chance that your baby will not have a chromosomal abnormality. Although your risks of chromosome problems are considerably ‘higher’ when you are 40 than when you are 35, they are not necessarily ‘high’ from an absolute point of view.”
Age alone does not predict whether a pregnancy will be high risk. Several factors, such as family history, genetics, health, pre-existing conditions, and prenatal care of the mother also have major effects on the well-being of the mother and infant.
Women over 35 with a chronic disease such as hypertension or diabetes need to be monitored to ensure a safe pregnancy. Pregnant women over 35 tend to have a higher occurrence of gestational diabetes and preeclampsia (pregnancy-induced high blood pressure). “However, all pregnant women get tested for gestational diabetes at 28 weeks,” says Dr. Rappaport.
Emotionally, many women find that their thirties and beyond are a perfect time to get pregnant. “I feel blessed to have experienced college, travel, a rewarding career, and now motherhood,” says Belinda King, of Tampa, Florida. “I am a much better mom at 41 than I would have ever been at 21.”
Mary LaRosa experienced pregnancy for the first time at 24 and had her fourth child at 44. “My pregnancies were all great,” says the Boston, Massachusetts, mom. “My first was special because I really wanted to be a mom. Being pregnant at an older age was special, too. I generally knew what to expect. There were still a few surprises, but I enjoyed the pregnancy immensely.”
Improvements in treatment for infertility and the fact that more women over 40 are in excellent health have enabled women in their forties and even fifties to get pregnant. However, many women still face conflicting medical opinions. Although some doctors think pregnancy over 40 is reasonably safe, many physicians believe that it is not ideal, and having an easy pregnancy at age 50 or older is rare. According to the CDC, in 2000, there were 255 births to women ages 50 to 54, a substantial increase over the 174 births reported for 1999. And that number continues to rise.
Whether you are 25 or 55, the key to having a healthy baby is being in good health before becoming pregnant. Taking care of yourself early on may facilitate your getting pregnant, staying pregnant, and giving birth to a healthy baby. Eat a balanced diet, maintain a healthy lifestyle, and receive appropriate prenatal care. Other recommendations include getting enough folic acid in your diet, limiting caffeine consumption, exercising regularly, avoiding alcohol, and not smoking.