Advanced Maternal Age Consultations

Did you know that about 53 out of every 1,000 women wait until they are between the ages of 35 and 39 to give birth? That’s a dramatic upward trend. In 1970, the average age of childbirth was about 21, according to the Centers for Disease Control.

So, what does this mean? For one thing, mothers are getting older and wiser. It also means that these women are slightly more susceptible to high-risk pregnancies.

Many women entering pregnancy at an advanced age consult with Dr. Rad. The doctor is double-board certified as an Obstetrician-Gynecologist with sub-specialty training in Maternal-Fetal Medicine.

What is advanced maternal age?

Advanced maternal age, according to the American Medical Association, is being 35 or older at the time of giving birth. It is one of the most common classifications in obstetrics today – and if this term applies to you, you are far from alone. In fact, the number of women choosing to start or grow their families in their mid-thirties, forties, and beyond has risen steadily for decades, driven by career goals, financial planning, and evolving personal timelines.

You may also have heard the phrase “geriatric pregnancy” – a clinical term that sounds far more alarming than it needs to. It simply means the same thing as advanced maternal age: a pregnancy in a woman aged 35 or older. Most modern providers, including Dr. Rad’s team, prefer the term advanced maternal age because it is more accurate and far less unsettling. A label should never define your experience, and we want you to feel informed and empowered, not anxious.

So why does 35 matter medically? The answer comes down to egg quality and quantity. Women are born with all the eggs they will ever have – roughly one to two million at birth. By the time a woman reaches her mid-thirties, that reserve has naturally declined, and the remaining eggs are more likely to carry chromosomal abnormalities. This is because eggs age alongside the rest of the body, and the cellular machinery that divides chromosomes correctly becomes less reliable over time. The most well-known result of this process is an increased likelihood of trisomy conditions, such as Down syndrome (trisomy 21), though the risk picture is nuanced and highly individual.

It is important to understand that the age of 35 is not a cliff edge – it is a statistical threshold at which certain risks begin to rise gradually. Many women in their late thirties and forties have healthy, uncomplicated pregnancies. What changes is the level of monitoring and specialist support that is recommended to give both mother and baby the best possible outcome. That’s where maternal-fetal medicine and the personal touch of a dedicated perinatologist make a meaningful difference.

Advanced maternal pregnancy guidelines

If you are 35 or older and planning a pregnancy – or already expecting – there are practical, evidence-based steps you can take to protect both your health and your baby’s. We understand that pregnancy at this stage can feel both exciting and uncertain, and that is completely normal. The good news is that with the right preparation and the right specialist by your side, most women of advanced maternal age have healthy, beautiful pregnancies. The guidelines below cover everything from your very first preconception visit through the daily habits that make a real difference – and they begin well before you conceive.

In addition to the specific steps outlined in each section, a few overarching habits form the foundation of a healthy pregnancy at an advanced maternal age. Reaching or maintaining a healthy weight before and during pregnancy reduces your risk of gestational diabetes, hypertension, and preterm birth – all conditions that become more common after 35. Avoiding alcohol entirely and quitting smoking as early as possible are equally important; both are linked to miscarriage, low birth weight, and developmental complications that no amount of supplementation can offset. And once you are pregnant, attending every scheduled prenatal visit is non-negotiable. Regular monitoring allows your care team to catch changes early, adjust your plan, and keep you informed every step of the way – because knowledge is one of the most powerful tools you have.

Think of the sections below as your personalized

roadmap. Each one addresses a specific area where proactive choices genuinely move the needle for women navigating pregnancy after 35.

Preconception checkup

Get a preconception checkup. This doctor’s visit ensures that you are healthy before becoming pregnant. Discuss your overall health, lifestyle choices, and apprehensions you may have about pregnancy. Talk with your physician about any notable family history and the medicines you are currently taking.

Manage chronic conditions

Be up to date on treatment for chronic conditions like diabetes, high blood pressure (hypertension), and depression. Discuss what medications you are taking for these conditions; some medicines are not safe for pregnancy.

Folic acid/Folate

Ingest 400 micrograms of folic acid each day. This vitamin helps your body make new cells. Taking folic acid before and during pregnancy can help prevent birth defects.

Avoid unsafe chemicals

Remove any unsafe chemicals at home and work, such as cleaning products and paint.

Decreases stress

Try to reduce your stress level. Your doctor may suggest options such as yoga and meditation.

Advanced maternal age risks

While advanced maternal age can put you at increased risk, the following problems can occur in pregnancy at any age. However, these difficulties become more prevalent after age 35. That said, the vast majority of women who become pregnant at 35 or older go on to have healthy, thriving babies – and with the right specialist in your corner, many of these risks are highly manageable. Remember: most moms have healthy babies.

Infertility

Older parents are more likely to have difficulty getting pregnant. If you have tried unsuccessfully for six months to become pregnant, talk to your doctor about seeing a fertility specialist.

One alternate option is in vitro fertilization (IVF), a procedure used to prevent genetic problems or assist with the conception of a child.

Miscarriage risk by age

One of the most emotionally difficult topics to discuss – but one of the most important – is miscarriage. The risk of pregnancy loss does rise with age, largely because older eggs are more likely to carry chromosomal abnormalities that prevent a pregnancy from continuing. At age 35, the miscarriage rate is approximately 20%. By age 40, that figure rises to around 40%, and by age 45 it can exceed 50%.

These numbers can feel frightening, but context matters: many women in their late 30s and early 40s carry pregnancies to term without complication, and close monitoring by a maternal-fetal medicine specialist means that any warning signs are caught early. We understand pregnancy can be a vulnerable and anxious time, and Dr. Rad’s team is here to support you every step of the way.

Medical complications

High blood pressure, diabetes, and gestational diabetes can cause difficulties such as the risk of miscarriage, growth complications, and troubles during birth. Women over 35 are roughly two to four times more likely to develop gestational hypertension or preeclampsia compared to women in their 20s. Gestational diabetes also becomes more common with age, affecting approximately 7-12% of pregnancies in women over 35. Both conditions are closely monitored throughout a high-risk pregnancy, and with proper management, the outcomes for mother and baby are very good.

Premature birth

Older parents are at higher risk of preterm delivery. This is when the baby is delivered before 37 weeks. Preterm babies can experience health difficulties later in life. The risk of preterm birth is roughly 11% in women aged 35-39 and increases further after 40. Regular ultrasound monitoring – including state-of-the-art 3D and 4D imaging – allows your care team to track fetal growth and cervical length so that any signs of early labor can be addressed promptly.

Birth defects and chromosomal conditions

The risk of birth defects, such as Down syndrome, rises with older women. Other genetic difficulties are more common because the woman’s eggs (oocytes) are older and may form an embryo with too many or too few chromosomes.

To put the Down syndrome risk in concrete terms: at age 35, the chance of carrying a baby with Down syndrome is approximately 1 in 350. By age 40, that risk rises to about 1 in 100, and by age 45 it is closer to 1 in 30. These figures are why prenatal screening and diagnostic testing are so strongly recommended for women with advanced maternal age – not to cause alarm, but to give you the clearest possible picture so you can make informed decisions.

It helps to see how that trajectory unfolds across a woman’s reproductive years. At age 25, the risk of Down syndrome is roughly 1 in 1,250 – a number most younger women never think twice about. At 30, it edges up to around 1 in 940. The shift becomes more noticeable through the mid-thirties, which is exactly why age 35 has long been used as the threshold that defines advanced maternal age.

Down syndrome is the most common chromosomal condition, but it is not the only one. Trisomy 18 (Edwards syndrome) and Trisomy 13 (Patau syndrome) also become more likely with age, and both carry serious implications for fetal development. The underlying reason is the same in each case: as eggs age, cell division becomes less precise, making it more likely that an embryo will have an extra or missing chromosome.

The good news is that modern prenatal screening has never been more accurate or less invasive. A cell-free DNA (cfDNA) test – sometimes called non-invasive prenatal testing, or NIPT – can screen for the most common chromosomal conditions from as early as 10 weeks using a simple blood draw. Nuchal translucency ultrasound, performed between 11 and 14 weeks, adds another layer of information by measuring fluid at the back of the baby’s neck. If screening results suggest a higher risk, diagnostic tests such as chorionic villus sampling (CVS) or amniocentesis can provide a definitive answer.

Dr. Rad offers all of these as part of his state-of-the-art maternal-fetal medicine care, and he will walk you through every result personally – because that is the Dr. Rad difference.

Other risks include miscarriage (pregnancy loss), congenital heart defects, hypospadias (abnormal male urethra), craniosynostosis (abnormal skull growth), clubfoot, and diaphragmatic hernia.

Placenta previa

With this condition, the placenta sits low in the uterus and partially or completely covers the cervix. This can cause extensive bleeding during birth. Even though rare, this condition affects women in their 40s three times as often as women in their 20s. Routine ultrasound exams throughout your pregnancy allow Dr. Rad to identify placenta previa early and plan your care accordingly, reducing the risk of complications at delivery.

Prenatal screening and testing for advanced maternal age

Once you understand the risks that come with advanced maternal age, the natural next question is: what tests can actually tell me how my baby is doing? The good news is that modern prenatal screening has come a long way, and several highly effective options are available.

Most providers recommend a combination of screening tests and, when needed, diagnostic tests. Here is a quick overview of what you can expect:

Cell-free DNA (cfDNA) screening, sometimes called non-invasive prenatal testing (NIPT), analyzes small fragments of fetal DNA found in your blood. It can detect chromosomal conditions like Down syndrome, trisomy 18, and trisomy 13 with a high degree of accuracy – and it can be done as early as 10 weeks.

Nuchal translucency ultrasound is typically performed between 11 and 14 weeks. It measures fluid at the back of the baby’s neck, which can indicate an elevated risk for chromosomal abnormalities. Dr. Rad offers state-of-the-art early fetal scans using cutting-edge 3D and 4D ultrasound technology, giving you a detailed picture of your baby’s development from the very start.

Chorionic villus sampling (CVS) is a diagnostic procedure performed around 10 to 13 weeks that analyzes placental tissue for chromosomal or genetic conditions. Unlike screening tests, it provides a definitive diagnosis.

Amniocentesis is typically offered between 15 and 20 weeks and involves testing a small sample of amniotic fluid. It is considered the gold standard for diagnosing chromosomal abnormalities and is often recommended for women with advanced maternal age.

If you are navigating these decisions and wondering what a high-risk OB/GYN actually does, a maternal-fetal medicine specialist like Dr. Rad can walk you through every option and help you choose the testing approach that feels right for your situation – no pressure, just expert, personalized guidance.

Cesarean delivery and labor considerations for older mothers

If you’re pregnant at 35 or older, one topic your care team will almost certainly discuss with you is the likelihood of a cesarean delivery. Research consistently shows that women of advanced maternal age have significantly higher rates of C-sections compared to younger mothers – and understanding why can help you feel more prepared rather than caught off guard.

Several factors contribute to this trend. As we age, the uterine muscle can become less efficient at contracting, which may lead to prolonged or stalled labor. Older mothers also have higher rates of pregnancy complications – such as placenta previa, preeclampsia, and gestational diabetes – that can make a vaginal delivery less safe. Add to that a greater likelihood of carrying multiples (which you can read more about here), and it’s easy to see why cesarean rates climb with maternal age.

That doesn’t mean a vaginal birth is off the table – many women over 35 and even over 40 deliver vaginally without complications. But it does mean having an honest, personalized conversation with your provider early in your pregnancy so you can plan accordingly. Labor induction is also more common in this age group, particularly when a pregnancy extends past the due date, since the placenta may become less effective over time.

Working with a high-risk OB/GYN who specializes in maternal-fetal medicine means your labor and delivery plan is tailored specifically to your health history, your baby’s development, and your personal preferences – not a one-size-fits-all approach. That personal touch is at the heart of everything Dr. Rad’s team does.

Prenatal screening and diagnostic tests

One of the most empowering things you can do during an advanced maternal age pregnancy is take full advantage of the prenatal testing options available to you. These tests fall into two broad categories: screening tests, which estimate risk, and diagnostic tests, which provide a definitive answer.

Nuchal translucency (NT) ultrasound is performed between 11 and 14 weeks and measures fluid at the back of the baby’s neck. A thicker measurement can indicate a higher risk of chromosomal conditions. Dr. Rad offers early fetal scans using cutting-edge 3D and 4D ultrasound technology, giving you detailed, high-definition images alongside clinically meaningful data.

Cell-free DNA (cfDNA) testing, sometimes called non-invasive prenatal testing (NIPT), analyzes small fragments of fetal DNA circulating in the mother’s blood. It can be performed as early as 10 weeks and screens for Down syndrome (trisomy 21), trisomy 18, trisomy 13, and sex chromosome conditions with a high degree of accuracy.

Chorionic villus sampling (CVS) is a diagnostic procedure typically performed between 10 and 13 weeks. A small sample of placental tissue is taken and tested for chromosomal or genetic abnormalities. Unlike screening tests, CVS provides a definitive diagnosis.

Amniocentesis is usually offered between 15 and 20 weeks and involves sampling a small amount of amniotic fluid. It is the gold standard for diagnosing chromosomal conditions and certain genetic disorders. A fetal echocardiogram may also be recommended to evaluate the baby’s heart structure in detail, particularly when screening results suggest an elevated risk of congenital heart defects.

Dr. Rad will walk you through each option, explain what the results mean, and help you decide which tests are right for your situation – because every patient deserves that personal touch.

What to expect from management with a maternal-fetal medicine specialist

If you have been referred to – or are considering – a maternal-fetal medicine (MFM) specialist, also known as a perinatologist, you may be wondering what that actually looks like in practice. Perinatology is the obstetrics subspecialty focused on high-risk pregnancies, and an MFM specialist like Dr. Rad brings an additional layer of expertise, monitoring, and coordination to your care.

Management typically involves more frequent prenatal visits and ultrasound exams than a standard pregnancy, closer tracking of blood pressure, blood sugar, and fetal growth, and a detailed birth plan that accounts for any complications that may arise. For women with advanced maternal age, this level of attentiveness is not excessive – it is simply the standard of care you deserve. At Dr. Rad’s practice, every patient is treated as a VIP, with 24/7 availability and the option for home visits, telemedicine consultations, and even travel visits for patients who cannot easily come to the office. That is the Dr. Rad difference.

How to minimize advanced maternal age complications

Advanced maternal age pregnancy risks are a reality. The good news is you can take meaningful steps to reduce these risks – and establishing a strong relationship with Dr. Rad is one of the most important ones.

Before we get to the clinical side, there is a lot you can do on your own to give your pregnancy the best possible start:

• Reach a healthy weight before conceiving. Excess weight raises your risk of gestational diabetes, preeclampsia, and cesarean delivery – all of which are already more common with advanced maternal age. Even modest weight loss before pregnancy can make a measurable difference.

• Get chronic conditions under control. High blood pressure, thyroid disorders, and diabetes should be well-managed before you conceive. Uncontrolled chronic conditions significantly increase the risk of complications for both you and your baby.

• Start prenatal vitamins early. Folic acid – ideally 400 to 800 micrograms daily – should be taken at least one month before conception to reduce the risk of neural tube defects. Starting early matters.

• Avoid alcohol, smoking, and recreational drugs entirely. There is no known safe level of alcohol during pregnancy, and smoking raises the risk of preterm birth, low birth weight, and placental complications that are already elevated at this stage of life.

• Limit caffeine. Most guidelines suggest keeping caffeine below 200 mg per day – roughly one 12-ounce cup of coffee.

• Reduce exposure to harmful chemicals. Pesticides, certain cleaning products, and environmental toxins have been linked to pregnancy complications. Choosing cleaner alternatives during preconception and pregnancy is a simple, proactive step.

On the clinical side, Dr. Rad can guide you through prenatal screening and testing. These tests can show whether your baby has an existing or potential problem before birth. These results also help Dr. Rad manage your pregnancy and plan for labor and delivery.

Dr. Rad may also order genetic testing or suggest you see a genetic counselor to learn, before birth, if your baby has underlying chromosomal abnormalities.

Think of it as a partnership: the lifestyle choices you make every day, combined with the expert, personalized oversight that Dr. Rad provides, give you the strongest possible foundation for a healthy pregnancy. We understand this can feel like a lot to navigate – and that is exactly why we are here to walk alongside you every step of the way.

Benefits of having a baby after 35

While much of the conversation around advanced maternal age understandably focuses on risks, it’s equally important to recognize that having a baby after 35 comes with some genuinely meaningful advantages. We understand pregnancy can feel like an anxious time, so let’s take a moment to look at the encouraging side of the picture.

Many women who become mothers later in life are in a stronger financial position, having spent years building their careers and savings. That kind of stability can make a real difference in accessing quality prenatal care, creating a comfortable home environment, and taking time off work with less financial stress.

Emotional maturity is another significant benefit. Older mothers often report feeling more confident, patient, and self-aware – qualities that translate beautifully into parenting. You’ve had more time to understand yourself, nurture your relationships, and clarify what truly matters to you. Research also suggests that women who give birth after 35 may experience certain cognitive and longevity benefits, with some studies linking later motherhood to sharper memory in later life.

Relationship readiness is another factor worth celebrating. Many women in this stage of life have established, stable partnerships and a strong support network – both of which contribute to healthier pregnancies and happier families.

If you’re an older first-time mom navigating this journey, know that you are not alone – and that with the right expert support, the odds are very much in your favor. That is the Dr. Rad difference.

More about Dr. Rad

Dr. Rad and his world-class obstetrics and gynecology team at Los Angeles Fetal and Maternal Care understand your healthcare needs before, during, and after birth. Our doctors provide compassionate care, help you understand your pregnancy, answer questions, and offer emotional support to help you safely navigate your pregnancy.

Dr. Rad has undergone rigorous training with high honors at prestigious, renowned institutions such as the David Geffen School of Medicine at UCLA, USC, Cedars-Sinai Medical Center, and UCSF Medical Center, as well as centers internationally in London, Austria, Israel, and Africa.  

We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Newport Beach, Irvine, and Downtown Los Angeles. We also offer in-home prenatal care and a fly-in program for out-of-town and international patients. Dr. Rad even travels to patients who need him throughout the U.S. and around the world.
If you can’t make it to Dr. Rad, he also offers virtual consultations worldwide.

Call us at (844) 473-6100 to schedule your consultation. We are currently accepting new patients.