Pregnant at 35 or older: chances, risks and tips

More than one in four children born in Switzerland today has a mother who is 35 or older. There are many personal reasons for choosing to get pregnant later in life. The most common reasons for late maternity:

• Stable partnership: A stable relationship with a partner who is suited to parenthood is an important factor in deciding whether to have children. Many women delay maternity until they find such a partnership.
• Careers: Women who have children later in life may want to complete their education and establish themselves professionally before starting a family.
• Financial security: A steady income makes family planning easier and means fewer worries in maternity.
• Longer life expectancy: Life expectancy in Switzerland today is 86 for women and 82 for men. Women today have more time to pursue various life goals before getting pregnant later in life.
• Medical advances: Artificial insemination (in vitro fertilisation, intracytoplasmic sperm injection), social freezing (freezing unfertilised eggs) and treatments such as hormone therapy and intrauterine insemination increase the likelihood of pregnancy at an older age.

Pregnant at 38, pregnant at 39, pregnant at 40? What are the chances of getting pregnant at an older age? Although the likelihood of pregnancy drops as women age, late maternity offers many advantages.

Late maternity, conscious lifestyle choices

Studies show that many women who consciously opt to get pregnant later in life make healthy lifestyle choices as well. They eat a balanced diet and avoid alcohol and nicotine. Older mothers get plenty of exercise and sleep. At the same time, older mothers are more emotionally stable and mentally prepared for pregnancy and parenting. Moreover, women who get pregnant later in life generally attend check­ups early and regularly and take advantage of check­ups for high-risk pregnancies (prenatal diagnostic). All these factors increase the odds of a healthy late pregnancy and a birth with few complications.

Medical care

Swiss medical care for pregnant women is very good – and that includes care for high-risk pregnancies at an older age. Regular check-ups, modern diagnostics and medical specialists help to identify risks early on. Thanks to prenatal tests and personal advice, older mothers are generally well informed. This increases the safety of mother and child and contributes to healthy late maternity – even in the case of high-risk pregnancies.

Late maternity: insurance

In Switzerland, expectant mothers are well insured during their pregnancy and maternity. Basic insurance covers the costs for:

• Pregnancy check-ups
• Ultrasound examinations
• Medication on the specialities list of the Federal Office of Public Health for treating pregnancy-related complaints
• Antenatal classes
• Childbirth
• Postnatal care by a midwife or specialist carer
• Breastfeeding guidance
• Medical follow-up checks
• Medically necessary laboratory tests

Pregnancy at an older age is possible but carries certain risks; the risk of complications during pregnancy and childbirth increases with age.

What is a high-risk pregnancy?

At what point do we use the term “high-risk pregnancy”? There is no universal definition of high-risk pregnancy. Doctors assume a pregnancy is high risk when there is an increased likelihood of complications before or after the birth, or when there is an increased risk of the mother or baby becoming ill or dying.

Common reasons for a high-risk pregnancy include the age of the pregnant woman (late maternity), being very overweight or underweight, substance abuse (smoking, alcohol, drugs), health problems such as high blood pressure or diabetes, multiple pregnancy (twins or more), problems from an earlier pregnancy, or infection during the current pregnancy.

But at what age is a pregnancy deemed risky? From the age of 35, a pregnancy is considered a high-risk pregnancy. In these cases, experts refer to advanced maternal age, older mothers or geriatric pregnancy.

This doesn’t mean that pregnant women this age or older will always suffer complications. Some pregnancies at an older age can progress entirely without problems. There is therefore no reason, from a medical point of view, to advise women over 35 not to get pregnant.

Likelihood of pregnancy at an older age

Women’s fertility declines significantly around the age of 35. The same applies to late maternity by means of social freezing. The best chance of a woman having a child after freezing her eggs is when her eggs are retrieved before the age of 34.

The table below shows the likelihood of pregnancy at different ages:

Increased risk of miscarriage

Around 15% of all pregnancies end in miscarriage. This risk increases for later maternity. A woman who is pregnant at 40 has double the risk of miscarriage of a pregnant 20-year-old. The older you are, the greater the risk.

Increased risk of gestational diabetes and high blood pressure

Older women with a high-risk pregnancy are at greater risk of gestational diabetes. Research also indicates that women who have children later in life are more likely to suffer from high blood pressure during their pregnancy than younger women.

Risk of chromosomal abnormalities

The likelihood of the baby being born with a chromosomal abnormality (e.g. Down syndrome) increases with the age of the expectant mother.

Pregnant after 35: what are the recommended examinations?

For a pregnancy that proceeds with no problems, seven check-ups and two ultrasound examinations are recommended, regardless of the mother’s age. The first check-up includes a look at the patient’s medical history, a clinical and gynaecological examination and an examination for varicose veins, and oedema (swelling in the legs, particularly the ankles). Subsequent examinations include checking for weight, blood pressure, fundal height (a measure of the size of the uterus), urinalysis and listening to the foetal heart. In Switzerland, the costs for these examinations are covered by health insurance companies (basic insurance).

High-risk pregnancies: how often do you need check-ups?

How many ultrasounds and other check­ups are recommended for a high-risk pregnancy and how often should older mothers go to the doctor ideally? Health insurance companies cover many additional examinations for high-risk pregnancies. These include more frequent check-ups and ultrasound examinations. The risk of a baby being born with a chromosomal abnormality is significantly higher for women over 40. Prenatal examinations are therefore especially important for older mothers. For ultrasounds or other check­ups, talk to your gynaecologist, who will assess which additional examinations are necessary if your pregnancy is considered high risk.

It is absolutely possible for women who have children later in life to have a healthy pregnancy. These tips will help you:

• Nutrition: Pay attention to your diet when you’re pregnant. Pregnant women need additional minerals, proteins, trace elements and vitamins. A balanced diet will help you get all the nutrients you need and contributes to your well-being and the healthy development of your baby.
• Folic acid: This vitamin is important for cell division. In the early stages of pregnancy, the cells divide billions of times – which is why pregnant women need plenty of folic acid during this time. It is recommended that women take folic acid in a synthetic form, in addition to a balanced diet, before and during their pregnancy.
• Exercise: Older mothers are at greater risk of gestational diabetes. Getting plenty of exercise helps to lower this risk.
• Mental health: Why not try meditation, gentle yoga or targeted relaxation exercises. They can help you regulate and reduce stress. Talk to other older mothers – in forums or self-help groups, for instance. This may give you extra peace of mind and support your mental well-being.
• Forward planning: Talk to your employer. Planning your maternity leave and your return to work thoroughly will help to minimise challenges later on. It can be helpful to talk to your partner early on about how you are going to share tasks and how they can support you.
• Regular check-ups: It is recommended that older mothers be closely monitored by their gynaecologist and attend all necessary check-ups and examinations.

Late maternity brings both opportunities and challenges. Women who consciously decide to get pregnant later in life often benefit from more stability in their life and their financial situation. At the same time, pregnancy at an older age is a risk and requires closer monitoring from medical professionals. Thanks to targeted medical care, healthy late maternity is very much an option today. Get all the information you need early on and make sure you follow a healthy lifestyle and attend all necessary check-ups. Would you like to know more about high-risk pregnancies and health insurance? We are happy to advise you. You can also browse our article on trying to conceive and pregnancy. Here, you will find a wide range of information about trying to conceive, pregnancy and the time both before and after the birth.