Geriatric pregnancy or advanced maternal age: Let’s talk terminology

Thirty-five going on...geriatric? No one likes to feel ancient, but when you're glowing and growing a tiny human, being labeled old is especially infuriating. If you've been tagged with this outdated term, don't sweat it – you're in fantastic company!

Why do age-related pregnancy stigmas exist?

Although it’s more common than ever before to have a baby in your 30s, or even 40s, the archaic social and cultural stigmas still exist.¹ The decision of whether or when to have children is influenced by both personal desires and external factors. Better access to birth control has afforded many women the opportunity to set aside family goals to pursue higher education, career aspirations, and financial stability. But outside influences and modern-day realities such as the high cost of living, lack of quality childcare and family support, marrying later in life, as well as higher than ever before fertility issues all contribute to an unprecedented number of 'older' women becoming first-time moms.¹

Given this increasing trend, why does this stigma persist?

Because advanced maternal age increases the risk of pregnancy and maternal complications, it can cause inherent bias in medical care.¹ A 2021 article in the “Journal of Women’s Health” emphasized the need for healthcare providers to be mindful of their own biases and to consider cultural, religious, and behavioral factors when assessing pregnancy risks in older women.¹

“Geriatric pregnancy” is now referred to as “advanced maternal age”

While 35 years of age has historically been used as the threshold for "geriatric pregnancy", now more commonly referred to as "advanced maternal age" or "AMA", recent studies suggest that this was an arbitrary cutoff. As of 2022, the American College of Obstetricians and Gynecologists (ACOG) now recommends dividing AMA individuals into five-year increments (35-39, 40-44) to accurately assess age-related risks.²

The latest data from the 2020 U.S National Vital Statistics Reports shows a growing number of women are choosing to have children later in life.² Pregnancies over 35 now account for nearly 19% of all pregnancies and 11% of first-time pregnancies in the U.S.³ The average age for first-time mothers has risen from 21.4 in 1970 to 27.1 in 2020.^1,3 As women's reproductive timeline changes, so does their reproductive lifespan.⁴

A 2021 study found that women's reproductive lifespan increased by 2.1 years, from 35.0 to 37.1 years, between 1959-1962 and 2015-2018. This is due to both earlier puberty (12.7 years) and later menopause (49.4 years).⁴

What are potential benefits of an AMA pregnancy?

While there are pros and cons of waiting to have children, waiting to have children can offer several advantages, such as pursuing higher education, achieving greater financial stability, and emotional maturity as well as having more time to dedicate to the joys and responsibilities of parenthood.

What potential risks of advanced maternal age pregnancy should I discuss with a doctor?

If you have any concerns about your potential pregnancy risks, speak with your doctor. According to the American College of Obstetricians and Gynecologists, advanced maternal age risks can include gestational diabetes,⁵ preeclampsia, and an increased likelihood of multiple pregnancies, early pregnancy loss, or Down syndrome.² 

Does being of advanced maternal age affect fertility?

If you're over 35 and trying to conceive it's a good idea to consult with a fertility specialist to discuss your options and create a personalized plan as your chances of getting pregnant  decrease by age: 6 

• 25% in your 20s and 30s
• 10% by age 40
• Unlikely, by age 45

You’re also at a higher risk for preeclampsia⁷ and endometriosis, which can affect fertility.^6,7

While research indicates that some pregnancy risks may increase with age, this doesn't guarantee a negative outcome. There exist specialists, known as perinatologists, that focus on high-risk pregnancies, which can be more common in older women. If you have any concerns about your pregnancy or your health, please don't hesitate to consult your healthcare professional.

What should I expect when trying to conceive at an advanced maternal age?

If you're considering an AMA pregnancy, it's important to consult with your doctor beforehand. They can provide personalized advice to optimize your health before conception.⁸ They can help you optimize your health and fertility, giving you the best possible start to your pregnancy journey.

Once you've confirmed your pregnancy, it's crucial to schedule an early prenatal appointment as your healthcare professional may want to discuss prenatal screenings and diagnostic tests to assess your baby's health:

• Prenatal screening tests assess risks and can be done before or during pregnancy. They look at the chance that the pregnancy will be affected by a birth defect or genetic disorder.⁷
• Prenatal diagnostic tests detect if a pregnancy is affected by a birth defect or genetic disorder and can only be done during pregnancy. That’s because they detect if the pregnancy is, indeed, affected by a specific birth defect or disorder.⁷

If you’re of AMA, know this: It’s a whole different world compared to several generations ago. We have certainly seen a cultural and societal shift when it comes to age and pregnancy, and more resources than ever exist to help you have the best experience possible.

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