What Age is High Risk Pregnancy?
Technically, a woman can get pregnant in early adolescence when she has her first period through menopause when she stops having periods, but is there a perfect time for pregnancy?
Pregnancy is a major commitment, and deciding to get pregnant is a life-changing decision that most people do not take lightly. Most women prefer to be mentally, physically, and financially prepared for all stages of pregnancy and childbirth. Ideally, the best time to get pregnant should be when it works best for you. However, adolescence and menopause pose different challenges for pregnancy, thus limiting the years when a woman can successfully get pregnant. Fertility, especially for women, diminishes with advancement in age, making it harder to plan for pregnancy much later in life.
What are the Peak Reproductive Years?
Regardless of when a woman decides to get pregnant, it is not uncommon for women to wonder how old is too old to get pregnant. According to the American College of Obstetricians and Gynecologists, a woman’s peak reproductive years are the late teens through the late 20s.
During development, a female fetus has about 6 million eggs. At birth, the baby has all the eggs she would ever have in her lifetime – about 1 to 2 million of them, although only about 300-400 eggs will ever be ovulated during her reproductive lifespan. By puberty, a woman’s egg has diminished to about 300,000 eggs, and she will go on to lose about 1000 immature eggs monthly. By age 30, most women have just about 12 percent of their prebirth egg supply. By age 40, the number is about 3 percent and keeps decreasing until a woman reaches menopause, around 51 years old. Although menopause marks an end to fertility, most women are no longer fertile years before the onset of menopause, making the years prior to menopause a challenging time to get pregnant.
How does Age Affect Fertility?
As the number and quality of eggs decline, a woman’s ability to get pregnant also starts to decrease. According to the Society of Reproductive Medicine, females experience a reduction in fertility in their early 30s. Women are half as fertile in their 30s compared to their 20s. By age 35, things speed up, and by the time a woman turns 45, her ability to conceive naturally is significantly reduced. A 25-year-old woman has a 25-30% chance of conceiving in every monthly cycle; a 30-year-old has about a 20% chance; and a 40-year-old-woman has just a 5% chance of getting pregnant in that same period.
How does Infertility Affect Pregnancy?
Infertility problems also affect maternal age at pregnancy. According to the National Institute of Health (NIH), about 12-15% of couples in the U.S. are unable to get pregnant after a year of unprotected sex. The NIH estimates that problems with fertility are:
- one-third from the man
- one-third from the woman
- one-third from both man and woman or from unknown reasons
Most women trying to get pregnant at an advanced age are often faced with fertility challenges and naturally seek help from fertility clinics. Fertility clinics provide reassurance of successful pregnancies at an advanced age, subsequently leading to more women postponing pregnancy until much later in life. Unfortunately, advancing age has a negative impact on insemination and fertility treatments. Women in their 20s and 30s are more likely to have successful outcomes than those over 35 years old and beyond.
Current Trends in Pregnancy
In the United States, there has been an overall increase in the number of women who are getting pregnant in their 30s and 40s, and this number is expected to keep rising.
Women are postponing pregnancy for many personal reasons including career priorities, education, financial concerns, and remarriages. Women, especially those who intentionally decide to have babies later in life, may worry about dealing with infertility when they are ready to have babies at this stage in life. And those who are dealing with infertility might be uncertain about how long they should safely try to have a baby without increasing the risk of pregnancy complications.
According to a recent report by the Center for Disease Control and Prevention (CDC), birth rates are highest in women aged 30-34 compared to other age groups across all demographics. The report, which was based on the data collected from 3.61 million births in the U.S. in one year, showed that the birth rate for women in their 20s has been steadily declining to a record low while the mean age of the expectant mothers has increased to a record high.
Risks of Pregnancy in Advanced Age
Pregnancy later in life can increase the risk of complications to the health of the mother and baby. As a woman ages, the risk of pregnancy complications like miscarriage, chromosomal abnormalities, still birth, gestational diabetes, and c-section increases. Women aged 35 and older are more likely to have complications with pregnancy compared to younger women. Some pregnancy complications that are more common in advanced age include:
The older the woman is, the more likely that she would have a pre-existing medical condition like high blood pressure, a disease that is common in older people. High blood pressure prior to pregnancy can worsen during pregnancy, increasing the risk of preeclampsia – a condition that usually occurs around 20 weeks of pregnancy and is characterized by high blood pressure and organ damage. Preeclampsia can be potentially fatal to both mother and baby. Although preeclampsia is more common in older mothers, it can also occur in young pregnant women with no history of high blood pressure.
Most older women worry about having a baby with Down Syndrome, a chromosomal abnormality where a developing fetus has an extra chromosome. Down Syndrome is more common in babies born to older women.
Babies are typically born with 46 chromosomes; however, a baby with Down Syndrome has an extra copy of chromosome 21. This condition is known as Trisomy 21 and causes mental and physical challenges to the baby. A baby with Down Syndrome typically has a flattened face, almond slanted eyes, poor muscle tone, small hands and feet, and other medical challenges. According to the Center for Disease and Prevention (CDC), Down Syndrome occurs in about 1 in every 700 babies and is more prevalent in babies born to older women.
The American College of Obstetricians and Gynecologists estimates that Down Syndrome occurs in 1 in 1480 kids born to women at age 20; 1 in 940 at age 30; 1 in 353 at age 35; 1 in 85 at age 40; and, 1 in 35 at age 45. Although medical advances, prenatal screening, and diagnostics tests can detect genetic abnormalities and birth defects, knowing that your unborn child might have permanent health challenges is psychologically challenging for any pregnant woman.
Another pregnancy risk common in older women is multiple pregnancy. As the ovaries age, women release more than one egg per month and this could lead to multiple pregnancy. Also, older women are more likely to be on fertility treatment, which sometimes leads to multiple babies. Although most multiple pregnancies lead to healthy babies, some common complications of multiple pregnancy include gestational diabetes, anemia, miscarriage, preterm labor, cesarean delivery, and a higher risk of congenital abnormalities.
When is the best time to have a baby?
Determining the best age for pregnancy is not an exact science. The American Society for Reproductive Medicine estimates that by age 40, a woman’s chances of getting pregnant drops to less than 5 percent per cycle.
- The cessation of ovarian follicular function
- Natural childbearing population and the age of most women during their final childbirth
- successful pregnancy among artificially inseminated women
suggests that natural fertility and reproductive potential of a female ends around 39-41 years old. And according to the American College of Obstetricians and Gynecologist, “by 45, fertility has declined so much that getting pregnant naturally is unlikely for most women.”