Dr. Laura Gaudet’s medical residents at the Ottawa Hospital are mostly women in their thirties, she said, and some are in a “personal crisis.”
They’re in the middle of their training, but they’d like to have a baby someday. And they’re wondering whether they have to do it before they turn 35. “It’s a common question that I get,” said the high-risk obstetrician and member of the University of Ottawa Division of Maternal Fetal Medicine.
With now over half of births in Canada happening to women over 30, according to the Society of Obstetricians and Gynaecologists of Canada, this is a pressing question to a growing number of people. Many women may have heard that fertility declines after 35 and the risks of a pregnancy grow. And it’s true that both these things happen as someone gets older — but it’s not tied to a specific year.
“Practically speaking, from an obstetrician’s point of view, the sooner women can have their babies the better. But there’s nothing magical about 35 that says you have to have them before 35 compared to after 35.”
Dr. Nicole Todd, a gynecologist at the BC Women’s Hospital and Health Centre, agrees. “There’s not something that definitely happens on one’s birthday when they turn 35,” Todd said.
It’s more of a gradual change and increased likelihood of various problems.
Risks of older pregnancy
Gaudet puts the risks into three categories.
First, a woman’s fertility gradually decreases over time. “The risk of infertility does go up as you get older such that for all intents and purposes, by the time a woman is 42 or older, pregnancies become few and far between.”
Another risk that increases with age is the risk of miscarriage or chromosome disorders like Down syndrome.
“The third category of risks is for pregnancy complications like diabetes and hypertension which do increase with age as well.” While a mother who is in relatively good health — active and at a healthy weight, among other things — might have a lesser risk of complications like hypertension, there’s no way around the fertility decline or higher chances of chromosome disorders, said Gaudet. They’re simply tied to age.
Although these risks are real and she wants women to be aware of them, Todd says that they shouldn’t necessarily prevent a woman from choosing to get pregnant later in life if she wants. “There’s no time limit for wanting to choose to get pregnant or trying to get pregnant, to attempt a pregnancy.”
“There absolutely is no deadline.”
Women who are considering getting pregnant should visit their doctors beforehand to discuss all the possible risks and ways to mitigate them, she said. And if they’re older mothers, then doctors can keep close attention for any signs of problems.
Most women will have happy, healthy babies after the age of 35, said Gaudet, though she wants women to be conscious of the elevated risks. “The majority of pregnancies, especially those that clear the 12 week mark, if you make it through the first trimester, then the majority of pregnancies are going to end with a healthy mother and a healthy baby.”
Sooner the better
With that said, Gaudet and Todd agree that it’s better for a woman to have children sooner rather than later.
“Somebody once gave me a great piece of advice,” said Gaudet. “There’s never going to be a great time to have a baby.”
“There’s always going to be a reason not to have a baby. But if having a family is important to a woman, then probably as soon as it would no longer be an absolute catastrophe to have a baby, then people should consider it.”