The Middle Years: Your 30s
If you opted to put off pregnancy until your 30s, you're in good company: According to the National Center for Health Statistics, the birth rates for women ages 35 to 39 doubled between 1978 and 2000.
Ella Moore, 32, of Austin, Texas, planned her first pregnancy in her 30s because she wanted to establish her career first. Though her husband was ready to start a family earlier, Moore had a job that she enjoyed, which required long hours and frequent travel. "Holding off to have a baby enabled me to move ahead professionally."
In fact, there's not much to fret about when you're expecting in your early 30s. "It's much like being pregnant in your 20s -- your health, energy, and fertility are still all at optimal levels," says Dr. Schwarz. Plus, the quality of your eggs is still very good, making the risks of genetic defects low.
Mollie McQuarrie, of Brooklyn, New York, waited until she was 34 to conceive so she could complete graduate school first. "It did take a while to get pregnant -- a little over a year -- and I had a miscarriage," she says. Unfortunately, the risk of losing a pregnancy is higher now: By ages 35 to 39, the odds hover at about 20 percent due to declining egg quality. However, McQuarrie was successful the second time and is now in her seventh month. "I'm happy having a child now," she says. "I'm more confident in who I am, so I have more to offer as a parent."
The progression of your 30s can also bring other changes. "Once you turn 35, your pregnancy will be monitored more closely," says Dr. Schwarz. One reason for that: The risk of birth defects rises at 35 -- the odds your baby will have Down syndrome is now 1 in 400 -- so expect your doctor to offer you an amniocentesis and/or other screening tests to check for it and other chromosomal abnormalities. One option is chorionic villus sampling (CVS), in which a catheter is inserted into the placenta to suction out a tissue sample; if everything is clear, you can skip having an amnio.
"Some women may also be offered a nuchal fold translucency, but the procedure is still being studied," notes Dr. Goldstein. This less-invasive test measures the back of the fetus's neck during an ultrasound scan; a thick nuchal fold can indicate an increased risk of chromosomal problems. It's less accurate than CVS, so a positive result will need to be confirmed by an amnio. Still, none of this is a cue to go into panic mode: About 95 percent of women who undergo prenatal testing receive good news. Even the cutoff number of 35 is arbitrary. "Your genetic risks are naturally increasing as you age," says Dr. Schwarz. "Thirty-five is simply the age experts agree that these tests should be offered."