In Your 30s
In Your 30s: Gaining Maturity vs. Waning Fertility
Many women who've rounded the bend of 30 may feel they've made great strides professionally and personally, making them more emotionally prepared for pregnancy. "For me, being in my 30s became all about having a family," says Mary Lindewirth of Gillette, New Jersey. "I had a great job, my husband and I were fixing up a house that we had bought, and we took wonderful vacations -- but I knew that if we didn't have kids we'd look back someday and wonder what we had really achieved."
The catch: While you were gaining life experience, your eggs continued to mature as well -- and now they're showing their age. The average woman is born with half a million available eggs, but those most sensitive to ripening are released first, leaving you with the slower specimens as you get older. So even if you conceived at the get-go last decade, don't expect the same speedy results now. You'll probably be trying for another three to six months, says Dr. Berry, even if you're in great shape and have no medical issues that affect fertility (such as endometriosis or uterine fibroids).
Waning fertility is most noticeable after the mid 30s, as Lindewirth can attest. "I was 35 when I conceived my first son, and it didn't take that long -- just four months," she says. "I wanted to have another baby as soon as possible afterward, but it didn't happen. I gave myself until 40 to conceive, and I just made it at age 39."
Once you get pregnant, however, you'll likely find that if you're fit and healthy, you may enjoy the energy usually associated with a younger woman. "Your physical well-being during pregnancy depends more on who you are than how old you are," says Dr. Berry. Be aware, though, that this is the decade when chronic conditions such as diabetes or high blood pressure, which complicate pregnancy, first become evident, says Dr. Swamy. This is especially true if you've packed on pounds with the passing years, since obesity increases the risk of many medical problems.
Also, even if you're in decent shape, starting at age 35, you have an increasing risk for pregnancy-specific conditions including gestational diabetes. In fact, age 35 marks the official start for "high risk" pregnancy. Why the scary-sounding cutoff? Because at 35, the odds of your having a baby with a chromosomal problem such as Down syndrome (in which a baby is born with an extra chromosome) are about equal to the risk of miscarriage from amniocentesis, a diagnostic test for chromosomal defects that examines amniotic fluid. (The fluid is removed through a needle inserted in the mother's abdomen.) "However, that risk [about 1 in 295] is actually still quite small -- it's just that it's higher compared with the risk of a 25-year-old," says Dr. van de Ven.
In addition, the risk of certain conditions, such as placenta previa, in which the placenta grows near the cervix and causes bleeding, increases with the number of previous pregnancies or cesarean sections, which is why it's most common among older women, notes Dr. Berry.
Kathleen Van Gorden Morse of Little Compton, Rhode Island, mulled over all her options when she became pregnant at 35. "Although I had friends my age who went straight to amnio, I wanted to start with a safer option, so I chose a type of ultrasound that looks at the baby's neck," says Van Gorden Morse. Known as nuchal translucency, this high-resolution ultrasound measures the skin fold at the back of the fetus' neck. "If it's larger than normal, it indicates a potential chromosomal defect," says Michelle Sang, MD, an ob-gyn in Portland, Oregon.