“Elderly primagravida.” That’s the official obstetric name for a woman who is pregnant with her first child at age 35 or older. And she’s the lucky one: If you read about fertility in sources such as this American Society for Reproductive Medicine guide for patients, one-third of women who have waited until 35 to start trying to get pregnant will never have a child at all.
Yet there are more and more of us delaying motherhood. A new government report finds a big increase in the number of women having two children after age 35 (see end of page 6 in the report; here's a quick summary). That means that women are not only having one baby after 35, they’re having two or more—and thus getting pregnant again at age 37 and up.
How is this possible, if fertility is so compromised for women over 35?
In short: Because it’s not. We have been lied to. (More precisely, given bad information; whether that was purposeful is hard to tell).
That statistic on one-third of women over 35 never having a child? It comes from studies of historical birth records, usually from the 1700s. More modern studies instead find that 90% of women over 35 are pregnant within two years. And even those studies were done before the modern ovulation prediction methods (such as the three I detail in The Impatient Woman’s Guide to Getting Pregnant.)
Yes, fertility declines beginning in a woman’s late 20s, with the decline accelerating after 35. But that doesn’t mean a woman in her late 30s won’t be able to get pregnant, just that it might take a few months longer. Fertility doctors concentrate so much on age because the techniques they use—such as IVF—have markedly lowered pregnancy rates among older women. But for natural conception, age rarely keeps women from getting pregnant until they are over 40. Even in their early 40s, though, most women are still able to get pregnant, especially if they use ovulation prediction.
When a woman over 35 has problems getting pregnant, fertility issues other than age are usually the culprit, including male issues such as sperm count and motility—almost half of fertility problems are due to male issues. (Yet how often do you hear that mentioned or agonized over? Not much.)
Some doctors are now saying that every woman who has yet to have her last child should have her ovarian reserve (egg count) tested. Yet many studies find that ovarian reserve makes little difference in natural conception (summary here).
I am one of these statistics: I had three children after I turned 35, the last born when I was 40. I was also told three years ago that I had a low ovarian reserve. Of course, I’m one person—the better proof is in the scientific studies finding good fertility in women over age 35, and the new statistics showing that more of us are building families with two or more children after 35.
Now if we could only all calm down and stop worrying about our fertility. That’s easier said than done—wanting a child is such a strong desire, and it’s at least partially out of our control. I say “partially” because there are some things you can do, which I reveal in the book. With a title like The Impatient Woman’s Guide, you can tell I was not exactly accepting of the idea that fertility was completely out of my control. But after we do all of those things, we just have to wait.
Fortunately, these new statistics suggest we won’t have to wait as long as we thought… and then we’ll get to be called an “elderly primagravida.” Roll up your support hose!
And share your story. I'd love to hear stories on all sides—those who had children after age 35, those who had problems doing so (and why), and those who had children when they were younger and were happy (or unhappy) they didn't wait.