More people are starting families later in life. Now, more than 12 percent of first-time mothers in the United States are ages 35 or older, according to the Centers for Disease Control and Prevention. In 2000, it was just 7.4 percent.
The reasons for this increase vary, but improved assisted reproductive technology (ART) has played a role. It’s generally more difficult to become pregnant as you reach your mid-30s, but ART techniques like using donor eggs and freezing eggs to extend fertility have helped many people conceive.
Here’s what to know if you’re thinking about becoming pregnant at 35 or beyond.
What is advanced maternal age?
A pregnant person who is 35 years old or older is considered to be of advanced maternal age. Because they are older, they have a higher risk for pregnancy-related complications, such as:
- Preeclampsia, or persistent high blood pressure that develops during pregnancy
- Gestational diabetes, or diabetes that develops during pregnancy
- Having twins, triplets, or more, especially with fertility treatment
- Miscarriage
- Low birth weight
- Caesarean section
- Stillbirth
Prenatal and postnatal care are important for all pregnant people and may not be significantly different once a person hits 35. But to ensure the healthiest pregnancy possible, healthcare providers (HCPs) may monitor someone of advanced maternal age more frequently from pregnancy onset through birth, and sometimes afterwards. For example, they may have more ultrasounds and blood tests to monitor both the fetus and the mother’s health.
What about genetic differences?
While many people have healthy pregnancies past the age of 35, children born to women of advanced maternal age have an increased risk of genetic conditions, such as Down syndrome.
This happens because egg quality declines as a person ages. A certain number of eggs are present at birth, and as someone ages, so do their eggs. Getting pregnant after turning 35 increases the chances that chromosomes—the DNA and protein that make up someone’s genes—won’t pair up correctly or become damaged. This can result in having a baby with genetic differences.
If you are 35 or older, your OB/GYN will likely recommend screening or diagnostic tests during pregnancy. A screening test can tell whether your fetus is at higher risk of a genetic difference, while a diagnostic test can if one is present.
Does a father’s age affect pregnancy?
As men reach their late 30s, 40s, and especially their 50s, semen quality generally declines, which can affect pregnancy. Some studies have found that older fathers are linked to:
- Lower fertility rates
- Greater chances of certain pregnancy and birth complications, such as miscarriage and preterm birth
- Higher risk of genetic differences
Research on paternal age is limited but ongoing. So, if you’re concerned about how it might influence a pregnancy, it’s best to speak with your OB/GYN or another trusted HCP.
How can I prepare for a healthy pregnancy?
It’s important to understand: Being older and pregnant does not mean you or your fetus will develop complications—just that you have a higher chance than someone who is younger. Many people have healthy, successful pregnancies after 35.
If you are thinking about becoming pregnant, be sure to schedule a preconception appointment with an OB/GYN. During this visit, you can discuss fertility and steps to take to prepare your body for pregnancy. These may include:
- Eating a healthy diet
- Getting enough physical activity
- Avoiding tobacco, alcohol, and illicit drugs
- Managing stress, including getting sufficient sleep
- Taking folic acid supplements
- Managing any chronic medical conditions
- Protecting yourself from potentially dangerous environmental and chemical exposures
Remember to bring a list of any questions you might have and take notes during the appointment. You may want to bring a partner, family member, or friend to help.
Sources: National Center for Health Statistics. T... + 7
- National Center for Health Statistics. Trends in Mean Age of Mothers: United States, 2016–2023. June 13, 2025.
- American College of Obstetricians and Gynecologists. Pregnancy at Age 35 Years or Older. August 2022. Reaffirmed 2025.
- American College of Obstetricians and Gynecologists’ Committee on Clinical Consensus-Obstetrics; Gantt A; Society for Maternal-Fetal Medicine; et al. Obstetric Care Consensus #11, Pregnancy at age 35 years or older. Am J Obstet Gynecol. 2023 Mar;228(3):B25-B40.
- Cleveland Clinic. Advanced Maternal Age. May 5, 2025.
- March of Dimes. Pregnancy After Age 35. February 2025.
- UT Southwestern Medical Center. How Does a Father’s Age Affect Fertility and a Baby’s Health? October 13, 2023.
- Ha AS, Scott M, et al. Sociodemographic Trends and Perinatal Outcomes in Fathers 50 Years and Older. JAMA Netw Open. 2024 Aug 1;7(8):e2425269.
- Kaltsas A, Moustakli E, et al. Impact of Advanced Paternal Age on Fertility and Risks of Genetic Disorders in Offspring. Genes (Basel). 2023 Feb 14;14(2):486.
