Pregnancy in Your 20s, 30s, and 40s

"My husband, Marcin, and I have been married for two years, and we thought we'd hold off on getting pregnant because we're both still in school -- I'm studying to be a labor and delivery nurse. But we finally decided we couldn't wait. My mother was 20 years old when she had me, and I love how close we are. She really understood me growing up because she was such a young mom, and I want to have the same kind of relationship with my child. I've had a healthy pregnancy so far, although my whole body's gotten more swollen than I expected!"

"Physically, the 20s are the ideal time for pregnancy," says Peter Bernstein, M.D., an ob-gyn at Montefiore Medical Center, in New York City. That's because your body is primed to handle the demands of carrying a baby.

• You're at the lowest risk for pregnancy complications such as gestational diabetes, chronic hypertension, and preeclampsia.
• You're also less likely to have a baby with Down syndrome or with spina bifida. (At 25, your risk of having a baby with Down syndrome is one in 1,250. At 35, it's one in 378.)
• Once your baby's born, caring for and keeping up with her may not be as taxing for a younger mother. "I definitely had more energy in my 20s than in my 30s and 40s," says Diane Ross Glazer, Ph.D., a psychotherapist in Woodland Hills, California, who speaks from experience, having had a baby in each decade.

Your marriage is new, you're starting a career, and many of your pals don't have kids.

• "Get emotional support from other moms-to-be," says Shellie Fidell, a therapist at Women's Healthcare Partnership, in St. Louis.
• You're faced with how to juggle work and family before you've had time to get established. Do you forge ahead and try to do both, or delay your career or education?
• A new baby can be stressful on a new marriage. Once he or she is born, make time for each other.

"I've been married for four years, but I wanted to delay pregnancy so that I could focus on my career as an actress. Then one of my cousins, who was just 36 and had two children, died suddenly, and that spurred me on to have a baby, because it made me realize how short life can be. Now my husband, Richard, and I both feel ready to take that next step. I've always been very active, and I've continued to work out during my pregnancy, which gives me tons of energy. I even take kickboxing classes (though I've had to modify some of the moves!)."

You're at higher risk of developing certain complications. But the majority of healthy women still have uneventful pregnancies at this age. Here are the facts.

• Your risk of gestational diabetes and preeclampsia is higher now, as are the chances of having a baby with Down syndrome or other chromosomal abnormalities. "By age 35, the risk of chromosomal abnormalities is about 1 in 200, which is roughly the same risk as having a miscarriage from an amniocentesis," says Lorraine Chrisomalis, M.D., maternal fetal medicine specialist at Columbia-Presbyterian Eastside, in New York City. That's why many doctors only offer amniocentesis to women over 35.
• If you used fertility treatments, you're more likely to have multiples than women who conceived naturally.
• You're also more likely to have a C-section. Why? One theory: "When a woman is in her 20s, doctors tend to be more patient with a vaginal delivery and less inclined to do surgery," Dr. Bernstein says.

Many women in their 30s feel more psychologically ready for motherhood. Consider this.

• If it's your first baby, you've had time for yourself and your marriage, and you've accomplished some professional goals. This may give you peace of mind if you want to take a break to spend time with your baby.
• You're likely to know other pregnant women, so finding a support system shouldn't be a problem.
• Your marriage is probably on solid footing since you're older and more confident in yourself and in your relationship, points out Margaret Howard, Ph.D., a psychologist at Women and Infants Hospital, in Providence.

"I spent most of my 30s getting a successful business off the ground and traveling. I didn't get married until I was 42. I guess I always thought I'd have a baby someday, but I never worried about it. When we found out I was pregnant, my husband, Troy, and I were thrilled. I think my parents were even more excited, since they had pretty much given up on me! At my age, I think I have lots of wisdom and stability to offer my baby, so for me it's the perfect time to become a mom. I feel really good, and my doctor says the baby is doing great."

Having a baby in your 40s is common these days, and the majority of older mothers have totally normal pregnancies. Still, the risk of complications rises after age 40.

• If you're having multiples, there's an increased chance of delivering preterm or low-birth-weight babies.
• Your risk of chromosomal abnormalities continues to go up. (At 40, your chance of having a baby with Down syndrome is 1 in 106).
• The good news? If you're physically fit, eat well, and don't have preexisting health conditions such as diabetes or hypertension, your overall risk of other pregnancy complications isn't markedly higher than that of a woman in her 20s or 30s.

You're definitely prepared to have a baby at this point in your life, particularly if you married late or if you've gone through years of fertility treatments. Here are some things you can expect.

• The self-confidence and perspective you've picked up in your life may make you more patient in dealing with a demanding newborn.
• You might have higher expectations of yourself than someone in her 20s or 30s since you've waited so long and perhaps invested so much to get pregnant. Remind yourself that you don't have to be a perfect mother.
• It's likely you won't have as many friends with small children at this stage, so don't hesitate to make friends with younger moms. "Motherhood is the great unifier," Dr. Howard says. "When you're with your baby in the park, age issues sort of melt away because babies are the focus."

Copyright? 2005. Reprinted with permission from the January 2005 issue of Parents magazine.