Geriatric Pregnancy: What Are The Risks of Advanced Maternal Age?

• What is a geriatric pregnancy?
• What age is considered an advanced maternal age?
• What are the risks of advanced maternal age?
• Can you have a healthy pregnancy after 35?
• What tests and extra care might be offered for advanced maternal age?
• How to support a healthy pregnancy after 35
• Benefits of becoming a parent later in life
• Trying to conceive after 35
• Using donor sperm after 35

A geriatric pregnancy is any pregnancy where the mother is 35 or older at the expected date of delivery. While the term still appears in online resources, older medical resources and everyday conversation, the preferred clinical term is now advanced maternal age.

Turning 35 does not mean pregnancy risks suddenly increase significantly. Instead, it marks the point at which healthcare professionals begin discussing age-related considerations more comprehensively with aspiring parents.

The most common clinical threshold for advanced maternal age is 35 years. However, pregnancy care is never based on age alone. Healthcare providers also consider:

• Overall health
• Existing medical conditions
• Previous pregnancies
• Fertility history
• Whether you're expecting one baby or more

Statistically, risks tend to become more noticeable as age increases, particularly closer to 40. However, that does not mean all pregnancies at advanced maternal age are risky. Someone having a baby at 38 with no underlying health conditions can have a relatively straightforward pregnancy, while a 28-year-old with medical complications may need additional monitoring, care and support.

Although most pregnancies after 35 progress normally, some complications become more common as you age. It is important to remember that these are increased chances rather than certainties. Most people will not experience these complications.

Miscarriage and pregnancy loss

The chance of miscarriage gradually increases with age because chromosomal abnormalities become more common as egg and sperm quality declines (NICE). 

Chromosomal conditions

The chance of chromosomal conditions, such as Down syndrome, increases with maternal age (JHM). Prenatal screening helps estimate the likelihood of certain conditions, while diagnostic tests can provide more definitive answers. 

Gestational diabetes

Gestational diabetes becomes more common as maternal age increases and the way the body handles insulin changes (JHM). It can often be managed successfully through monitoring, dietary changes and medication.

High blood pressure and pre-eclampsia

Older pregnant people have a greater chance of developing high blood pressure or pre-eclampsia (Lancet). Regular antenatal appointments help healthcare professionals identify and manage these conditions early.

Multiple pregnancy

Multiple pregnancy refers to a pregnancy where the mother is carrying more than one child. The likelihood of having twins and triplets increases with age and can carry additional risks, such as a higher chance of high blood pressure, preterm birth and a caesarean section delivery (JHM).

Premature birth and low birth weight

Advanced maternal age is associated with a slightly higher chance of premature birth or babies being smaller than expected (JHM). Extra monitoring may be recommended if there are concerns about your pregnancy.

Caesarean birth

People over 35 are statistically more likely to have a caesarean birth. However, many over-35s still have uncomplicated vaginal deliveries, and healthcare providers are well equipped for caesarean sections. Around 45% of all children in the UK are delivered via C-section (NHS).

Yes, many over-35s have healthy pregnancies and healthy babies. Good prenatal care, appropriate screening and careful, age-appropriate management of existing health conditions all support positive outcomes.

Increasingly, women choose to start families later to prioritise their careers, because they want to be more financially stable or simply because they feel like they have the time to wait until they are ready. Modern maternity care is well equipped to support pregnancies in people of advanced maternal age. 

We do not mean to unnecessarily worry you. We believe in empowerment. We want to inform you about the age-related risks associated with pregnancy and provide you with all the information you need to make an informed decision, inspire confidence and ensure you are in a position to advocate for yourself and receive the best possible care.

Most people over 35 receive the same routine antenatal care as everyone else, with additional monitoring offered where appropriate. Depending on your circumstances, your healthcare team may recommend:

• Prenatal screening for chromosomal conditions
• Diagnostic testing if needed
• Ultrasound scans to monitor your baby's growth
• Screening for gestational diabetes
• Regular blood pressure checks
• Extra antenatal appointments if you have existing health conditions or pregnancy complications

The exact care you receive depends on your medical history, pregnancy and local clinical guidelines.

We often discuss advanced maternal age in terms of risk. However, there are many positive aspects to becoming a parent later in life.

Many “older” parents feel more emotionally prepared and confident in their decisions. Life experience can bring greater self-awareness, resilience and a clearer understanding of personal priorities. These parents are also more likely to have greater financial stability and stronger support networks. This can help make parenthood feel less overwhelming and give you more freedom to parent the way you want to.

For those using donor sperm, becoming a parent later may be the result of careful planning and a thoughtful decision about the kind of family they want to create. There is not a "right" age to become a parent. What matters most is having access to appropriate care, accurate information and the support needed to make the best decisions for you and your family.

Fertility gradually declines after 35, so it may take longer to conceive. Though this does not mean pregnancy is unlikely, it makes early assessment more valuable if you are trying but yet to conceive. If you are exploring pregnancy without a male partner, our guide to using donor sperm to get pregnant explains the main routes and choices.

Healthcare professionals generally recommend seeking medical advice:

• After six months of trying to conceive without success if you're 35 or older
• Sooner if you are 40 or over, or know you have fertility concerns.

Your fertility specialist will usually recommend a fertility assessment that may include hormone tests, ultrasound scans, ovarian reserve testing and, where relevant, semen analysis.

Depending on the results and your personal circumstances, treatment options can include IUI, IVF or ICSI. Speaking to a fertility clinic early can help you understand your options and choose the treatment that best suits your individual circumstances.

Solo mothers by choice, same-sex female couples, and heterosexual couples experiencing male-factor infertility might consider using donor sperm to conceive. Choosing donor sperm is a personal decision, and whether it is right for you depends on your fertility health, medical history and family-building goals. 

For heterosexual couples where the male is over 35, using donor sperm might mean a slight reduction in the likelihood of some pregnancy risks (Stanford). However, age tends to have a more pronounced effect on egg number and quality, and current evidence suggests age-related fertility decline affects females earlier and more significantly.

Is geriatric pregnancy the same as advanced maternal age?

Yes, both terms refer to a pregnancy where the mother is 35 or older. However, advanced maternal age is now the preferred clinical term, as it avoids the negative connotations associated with geriatric.

Is 35 really a high-risk pregnancy age?

No. Being pregnant at 35 does not automatically mean the pregnancy is high risk. The 35-year threshold is designed to give healthcare professionals a clear marker for beginning more thorough discussions of certain age-related risks. Many people over 35 have healthy pregnancies, and overall health, medical history and lifestyle all influence pregnancy progress.

Is 40 too old to have a baby?

No. Many people have healthy pregnancies in their forties, either naturally or with fertility support. However, fertility becomes more time-sensitive with age, and some pregnancy risks increase. If you are considering pregnancy at 40 or older, speaking to a fertility specialist early can help you understand your options.

Are miscarriage risks higher after 35?

Yes, the risk of miscarriage increases slightly the older you are, partly because chromosomal changes are more likely as egg and sperm quality declines. However, many pregnancies after 35 are healthy and carried without complication to term. 

Do women with advanced maternal age get more ultrasounds?

Not always. Some people may be offered additional scans or monitoring, but this depends on individual circumstances. Your age, medical history, pregnancy progress and local maternity guidelines all influence whether extra monitoring is recommended.

When should I speak to a doctor or fertility clinic?

If possible, speak to a healthcare professional before trying to conceive, especially if you are over 35 or considering donor sperm. You should also seek support if:

• You are over 35 and have been trying to conceive for six months without success
• You are 40 or older
• You have known fertility concerns

For people considering donor sperm, an early consultation with a fertility clinic or donor sperm provider can help explain treatment options, donor selection and the steps involved.