35 is not the cliff everyone once thought it was.

Lisa Luther, MD
Obstetrician/Gynecologist, Department of Obstetrics & Gynecology, Massachusetts General Hospital

The average age when a person gives birth to their first child has been increasing for decades. What does this mean for people hoping to become parents but wanting to wait until their 30s or 40s? Lisa Luther, MD, obstetrician/gynecologist in the Department of Obstetrics & Gynecology at Massachusetts General Hospital shares insights on what it means to get pregnant and have a healthy pregnancy in your late 30s or early 40s.

The cliff is a myth

“There isn’t an absolute age when pregnancy becomes high risk,” Dr. Luther reminds us. “As a person gets older, the risk for complications does increase, but it’s not a stark line.”

Health care statistics are not individual risk assessments. When it’s reported that the risk of certain conditions increases as the age of the pregnant person increases, that’s because the trend exists across thousands of patients, but not all.

“Although age is an independent risk factor for medical complications during pregnancy, it is a patient's medical conditions that determine whether the pregnancy is high risk,” says Dr. Luther.

Optimize your health for pregnancy at any age

At any age, health conditions like high blood pressure can lead to complications during pregnancy. For anyone considering pregnancy, a preconception conversation with your or OBGYN, or when necessary a maternal-fetal medicine specialist, can be helpful. You can use that time to discuss your relevant health concerns like smoking, high blood pressure, diabetes, heart conditions, activity level, nutrition, etc.

“No matter what age you are, there’s a lot to consider before getting pregnant,” says Dr. Luther. “Pregnancy and parenting impacts not only your physical health but also your mental, emotional, and financial health as well.”

There’s data to support there are advantages for later in life motherhood. People who intentionally wait to have children later in life are more financially and economically stable. Feeling mentally and emotionally ready to start a family is also an important consideration. Maternal mental health is a facet of pregnancy, postpartum, parenting that deserves the increased attention it is receiving, especially with the FDA approval this summer of an oral medication for postpartum depression.

Are celebrities making it look “too easy?”

Recent celebrity pregnancies at ages 40+ have garnered a lot of media attention. Pregnancy at any age is never easy, though the access to resources they have can help mitigates some stressors, like fertility treatments, childcare, household support, and more.

“It’s valuable that celebrities are sharing their experiences with fertility, pregnancy, surrogacy, and miscarriage because it brings increased awareness to these topics that have unnecessary stigma associated with them,” says Dr. Luther. “The more people talk about these shared experiences—the good and the bad—the less alone people will feel, and hopefully that heighted awareness translates to more systemic support and resources for women and pregnant people.”

To-dos before your get pregnant, at any age

Gather your team

Pregnancy is not solo adventure. Talk with your partner (when applicable), your friends and family, and your health care team about your vision for a family. This can also include a preconception consultation with an OBGYN and conversations with your therapist.

Schedule a preconception consultation

Optimize your health

Pregnancy and parenting are not just physical experiences, but an emotional and economic one as well. Your physical health is important to consider and discuss with your primary care provider, both your habits like smoking, nutrition, and activity level, and existing health conditions, including high blood pressure, diabetes, and blood clotting disorders. Beyond physical health, your mental well-being and financial health will also be impacted by pregnancy and parenting. The Commonwealth of Massachusetts offers a range of resources on these topics.

Watch a video about tips for a healthy pregnancy

You can be intentional about family-planning

If you’re not quite ready to start a family, explore your birth control and reproductive health options. Your primary care provider or gynecologist can counsel you which method of birth control might be best for you. The Mass General Complex Family Planning Program also offers counseling and clinical care for all approved methods of birth control.

Learn more