Pregnancy after 35 and over 40: what it means for your care

You may have heard terms for being an older mum that aren’t kind or helpful. The reality is more reassuring. Here’s what age can and can’t change about your pregnancy care, and the choices you’ll be offered.

First, the good news

NCT, drawing on NICE guidance, says antenatal and labour care is the same as for those under 35 unless you have other risk factors. It also notes research suggesting that the health issues you have matter, not your age by itself. Studies it cites suggest older parents may look after themselves better in pregnancy, and are more likely to report an increase in happiness after a baby.

What age can change

Getting pregnant. NCT says it can get slightly harder as you get older. See improve your chances of getting pregnant.
Miscarriage. The chance of miscarriage goes up with age, for mothers and fathers. NCT, citing the Miscarriage Association, says you are still more likely to have a healthy pregnancy than a miscarriage.
Chromosomal conditions. The chance of Down’s, Edwards’ and Patau’s syndromes goes up from the age of 25. See combined screening and NIPT.
Pre-eclampsia. The NHS lists being 40 or over as a risk factor. See high blood pressure and pre-eclampsia.
Gestational diabetes. The NHS lists being over 40 as a risk factor. See gestational diabetes explained.

NCT says the evidence on premature birth is mixed: one study it cites found age made no difference once social and genetic factors were accounted for.

Screening is your choice

The NHS says it’s your choice whether to have screening. You’ll be told about the tests and scans at your booking appointment. You can say yes or no to each one, and you can ask for more time to decide. See your first midwife appointment.

Timing of birth

NCT says induction may be offered earlier, at 40 weeks rather than 41 to 42, but notes this isn’t in the NICE induction guideline. If it comes up, ask your team to explain their reasons and your options. See past your due date.

Looking after yourself

The things that help any pregnancy help yours: your vitamins (see folic acid and pregnancy vitamins), staying active (see exercise in pregnancy), and telling your midwife about any worries. NCT notes smoking carries a higher risk of death for over-35s than for younger parents.

Questions people ask

Is pregnancy over 35 high risk?

Not automatically. NCT says care is the same as for under-35s unless you have other risk factors. Your midwife will look at your health as a whole.

Do I have to have screening tests?

No. The NHS says it’s your choice whether to have screening.

Will I be induced early?

Possibly. NCT says induction at 40 weeks may be offered, but it isn’t part of the NICE guideline. Ask your team about their reasons.

Are my chances of a healthy baby much lower?

Some risks go up with age, but most pregnancies in older mothers go well. NCT quotes research showing health issues matter more than age alone.