Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood
Ugh. Whoever came up with the term geriatric pregnancy should be sentenced to a month of watching nothing but infomercials. I mean really,
I can’t think of a better term to make a woman feel like her body is ill equipped to carry a healthy pregnancy. While science has shown us that as women (and men!) age, their fertility declines and rates for various special circumstances increase, it’s absurd to make every pregnant woman who is thirty-five or older join the Geriatric Pregnancy Club. In many ways, factors such as lifestyle, physical and mental health, and genetics play a much bigger role than age in how a woman’s body handles pregnancy. If you rock a healthy lifestyle, you likely have a much better chance of having a thriving pregnancy than a twenty-five-year-old who smokes, drinks, and thinks healthy eating is getting sliced strawberries on top of a funnel cake.
Understanding the offensive nature of the term geriatric pregnancy, many now slap the label advanced maternal age (AMA) on pregnant women thirty-five or older. But that’s not much better. Why do we need to label these women at all? Why can’t care providers just look at each pregnant woman as a unique human? Why can’t we look at her personal and family medical history, current health, and other personalized factors to determine what testing she should have and what circumstances she might be at risk for, instead of automatically treating her as a geriatric, and therefore high-risk patient?
To be fair, many care providers do treat women thirty-five or older in this customized manner, understanding that just because she’s been on Earth for a set number of rotations doesn’t mean she needs to see a high- risk doctor, get that amniocentesis, and schedule a C-section (something three of my clients were told they should have, simply because they were in their early forties). These are the care providers you want to find, primarily because if you’re seen by a care provider who perceives you as high risk only because of your age, you might have a higher chance of receiving unneeded interventions because their misguided perceptions color their recommendations.
More and more research is also showing that women of AMA aren’t actually at much higher risk for many of the special circumstances often attached to “geriatric pregnancies” than their younger counterparts. For example, a study published in Scientific Reports found that pregnant women over the age of thirty-four had only a slightly increased risk for gestational diabetes mellitus and hypertensive disorders than younger women. These researchers also found no increased risk of postpartum hemorrhage, preterm birth, low APGAR scores, or NICU admission for the babies of AMA women. And according to a study published in the journal Human Reproduction, women aged eighteen to thirty-four had a stillbirth rate of 0.47%, while women between thirty-five and forty had only a slightly higher stillbirth rate, at 0.61%.
So enough with the derogatory labels. It’s time for a change.
What to do
Minimize the anxiety that’s often produced by all the chatter about a geriatric pregnancy by trying the following:
- Find a care provider who doesn’t make you feel like a dusty china doll. There are a ton of amazing care providers who also roll their eyes at the term geriatric pregnancy. Put in the effort to find one. Ask friends and family members (especially those who had a baby after the age of thirty-four) for recommendations, and have a consult with your top choices. Ask them what their views are on women having babies after thirty-four, then hire the care provider who makes you feel most empowered about your ability to have a healthy pregnancy and birth experience, regardless of your age.
- Ask for a reframe. If the care provider you eventually choose or someone who works with them drops the term geriatric pregnancy, or even advanced maternal age, when referring to your unique pregnancy, ask them to stop, and tell them why. For example, if these terms replace your confidence and trust in your body with fear and doubt, explain that to your care provider. You can tell them you’re fine hearing about the tests and precautions they recommend (unless of course you’re not), but you’d like to keep labels out of the discussion.
- Remember that you’re a one-of-a-kind woman, not a statistic. Viva the cliché “Age is just a number.” It truly is just a number and means very little when it comes to how healthy your pregnancy will be. For example, my client Ava had her first baby in her early twenties, when she was a self-proclaimed “fast food addict.” She felt bloated, tired, and “fuzzy minded” during that pregnancy, which ended in an emergency C-section because of pre-eclampsia. When her thirties began, she cleaned up her lifestyle, and she became pregnant again at thirty-three. She loved this pregnancy, which came with ample energy, mental clarity, and no special circumstances. She had a complication-free vaginal birth after cesarean (VBAC). I saw pictures that proved she also looked younger in her thirties than she had in her twenties. So if all the lame geriatric labels are getting to you, remember that how you feel is much more important than the date on your birth certificate.
- Work your plan for healthy eating and exercise. Taking those prenatal vitamins and omega-3 supplements; loading up on fruits, veggies, and other nutritious fare; drinking lots of water; moving your body; and sleeping at least seven or eight hours a night will do wonders in helping you have a healthy pregnancy.
- Be curious about all the recommended tests. When you reach the age of thirty-five, care providers often recommend a heap of tests. If you feel good about all of them, great. But if you feel unsure about what is actually necessary, ask questions until you feel satisfied with the quality and clarity of the information you’re receiving. In addition, doing your own research can fortify you with information that may have been left out because of your care provider’s biases. However, make sure your resources are reliable. Studies published in peer-reviewed journals are a good place to start, and many can easily be found online.