{By: Dr. Charulata Bansal}

More women today are choosing to become mothers in their late 30s and 40s, driven by evolving social norms, shifting career priorities, and improved access to fertility and reproductive healthcare. While late pregnancy does come with different risks and challenges compared to conceiving at a younger age, it is no longer considered a medical rarity. With the right awareness, preparation, and support, women can experience healthy pregnancies and fulfilling motherhood—regardless of the number on their birth certificate.

In today’s world, delaying parenthood is often an empowered and intentional decision. Women may choose to postpone motherhood for various personal reasons—whether to pursue a fulfilling career, wait for the right partner, or simply because they don’t yet feel ready. For many, reaching a place of emotional and lifestyle stability allows them to approach parenthood with a stronger sense of self.

Advancements in reproductive medicine, such as IVF and egg freezing, have expanded options and provided reassurance that motherhood can still be possible later in life. While delayed pregnancy does come with unique physiological and emotional considerations, it also calls for thoughtful lifestyle adjustments and a personalised medical approach to ensure a healthy and supported experience.

Risk-Balancing With Control

The primary worry in late pregnancy is decline in fertility because the number and quality of eggs steadily decline after the age of 35, with older mothers presenting with relatively increased risk of chromosomal or genetic defects like Down syndrome, hence the general recommendation for non-invasive prenatal testing (NIPT). Fortunately, due to advanced technology, the detection and diagnosis of many gestational issues of concern, allows couples to make informed decisions even before attempting pregnancy.

Women older than 35 are actually more likely to have health complications in pregnancy - i.e. high blood pressure, gestational diabetes, and potentially serious complications like placenta previa or preeclampsia. Previous or existing health concerns such as thyroid imbalances or autoimmune disorders require even more monitoring and care.  While  these risks can seem daunting, they can often be mitigated or lessened, via early intervention, more aware habits, and routine appointments with care providers.

Ideally, planning for pregnancy later in life should happen before conception. You can have a preconception health assessment before conception to identify some areas of preconception health. When you can assess parameters like thyroid levels, blood pressure, and your weight, you can make lifestyle changes, if needed, days, weeks, or months ahead of time. Being aware of this information beforehand can set the stage for your pregnancy early on.

After you have confirmed your pregnancy you will usually be referred for ultrasounds, blood sugars, and blood pressure monitoring, throughout pregnancy, but especially as you approach your third trimester. Clinical protocols are one part of the picture, maternal mental and emotional health is important too.

The Importance Of Support Systems During Late Pregnancy

Women who find themselves pregnant at a later age, generally find support from those around them extremely beneficial. That support could be people, friends, family, or understanding workplaces that are sensitive to the  emotional & physical challenges that can come with the highs and lows of pregnancy. The people in your community can help you with doctor appointments and other related tasks, offer assistance in places you may need it, and, most importantly, allow  you to ease some of the your burden arising from a lone sense of being pregnant.
Supportive communities of peer support groups, classes, or courses can allow reassurance, provide a safe place to discuss your experience, and allow for shared experience, especially for women who feel isolated from pregnant peers or because they are simply older than most of their pregnant peers. Women living in urban places have had access to an array of maternity coaching, doula support, or even online communities for meaningful support, education, and empowerment, even in later-life pregnancies.

Developing Lifestyle And Well-Being

Nutrition and movement are still important parts of healthy late-pregnancy. A healthy diet containing iron, calcium, folic acid, and vitamin D, can help in healthy weight gain for the mother, thereby establishing mother and fetus's well-being. Moderate activities such as walking, prenatal yoga, or swimming help to regulate normal stress hormones and potentially prevent gestational diabetes, etc. Sleep hygiene, moderate caffeine intake, and avoidance of alcohol and tobacco consumption in late-pregnancy should be taken just as seriously.

A pregnancy after 35 comes with more checklists that may seem daunting, but it also presents more emotional maturity, greater financial stability, and clearer purpose. The most important thing is to welcome late-stage pregnancy with awareness, rather than anxiety - late pregnancy can be just as rewarding, at times more empowering experience as other stages of a woman's life with appropriate expert care, informed decision-making, and lifestyle to prioritise well-being.

The author, Dr. Charulata Bansal, is Consultant Obstetrics & Gynaecology, at Cocoon Hospital, Jaipur.

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]