20s? 30s? 40s?

Is there an ideal age for pregnancy? Unfortunately, this question is not as simple as it may seem to answer. It depends on a large number of factors and, as a result of a lot of changes in roles and relationships, the answer has finally changed significantly over the past few decades. As women have continued to seek and secure more advanced levels of education and job roles, the age at which many have started trying to conceive has advanced in a parallel fashion.

There are benefits and potential issues depending on whether you are in your 20s, 30s, 40s and beyond during pregnancy. Specific considerations follow.

Pregnancy in Your 20s
Benefits
As you may know, it is generally easiest to become pregnant when you are in your 20s. In fact, your body is best suited to handle a pregnancy during your 20s. Of course, this doesn’t mean that your body isn’t perfectly capable of maintaining a normal, healthy pregnancy outside of your 20s. However, most women will experience fewer (or milder) symptoms related to pregnancy when they are in this age range. In addition, the rate of having a miscarriage is generally lower, and women in this group tend to require fewer C-sections.

Also, relationships with other pregnant women are generally easier to establish when you are younger. The average age of first-time motherhood in the United States is right around 25 years old. Forming friendships with other mothers-to-be can be extremely helpful and can lead to more enjoyment from your pregnancy.

What to Consider, How to Prepare
When you become pregnant, it is normal for almost your entire life to be dedicated to the pregnancy. Many people in their 20s feel the need to get out and explore, have fun, stay out late and wake up late. However, this obviously can become problematic if you are pregnant, as many of these desires will need to be put on hold during pregnancy. For example, it’s difficult to go out dancing late if you’re experiencing morning sickness the following day and need to get to work.

Also, consider the fact that the circadian rhythm (which maintains normal sleep/wake cycles) of a newborn is frequently not perfectly in line with that of an adult, so plan some times to catch up on your sleep once your little one arrives. It takes a while for a baby’s sleep/wake cycle to align with that of Mom and Dad.

Another factor is the impact that a pregnancy may have on your career, your continuing education or any job training you may be undergoing. Completing academic and other programs may be difficult already. Adding pregnancy to the mix may present even more challenges. That said, many women have one or more pregnancies during this time, balance very well and become quite successful. It’s certainly possible, and it’s always best to try to gather as much support as possible from those around you.

As you probably know, the beginning of your career is often not the most financially flexible time of your life. Pregnancy can increase expenses both now and in the immediate future. Even with insurance, costs such as healthcare provider visits, additional testing, hospital stays (and subsequent time away from work), childcare, etc., can quickly add up, so be sure to plan accordingly.

First-time parents should make a point of savouring some time just for themselves. If you have parents or friends in the area who offer to help with babysitting or household chores, take them up on it. Having regular date nights alone with your partner may be very helpful, especially if you are recently married. Remember, you can only be at your very best as parents if you make time to take care of yourselves as well.

Pregnancy in Your 30s
Benefits
Although the risk of developing complications is slightly higher in your 30s than it would be in your 20s, most healthy women will do just fine with their pregnancies in their 30s. Some bothersome symptoms such as morning sickness and back pain may be slightly worse during this time period, though.

In your 30s you may benefit by having had some time for yourself, your marriage and your career. This can lead to a happier, more relaxed feeling about being pregnant, as having accomplished many of these goals before becoming pregnant can result in more complacency and taking things a bit easier. In addition, if you were married earlier in your 20s to your current partner, your marriage will have had some additional time to solidify before the addition of a child to your lives.

Also, you’re probably likely to know other women who are either currently or were recently pregnant. This will help you add a support network that can aid you during and after your pregnancy. In addition, being able to provide your child with a social environment including other children is excellent for the development of social skills.

What to Consider, How to Prepare
It may have taken you slightly longer to conceive at this age than at age 20, although most women are still able to eventually become pregnant.

Now that your career may be more established, it may be more difficult for you to step away from work. Although there is nothing wrong with continuing to work in most jobs during pregnancy, many women feel obligated to do so with the intention of not falling behind. It may be difficult for some to step away for postpartum leave as well. Weigh all your options so you can make the best choices for you and your family.

Pregnancy in Your 40s
Benefits
At this point, most women (and families as a whole) feel fairly secure in their career fields. Along with having slightly more flexibility to step away or slow down slightly during and after pregnancy, many women will be approaching a point in their lives with more financial freedom than when they were in their 20s. This can certainly lead to a significant reduction of stress related to pregnancy.

Most marriages will have had more time to develop and become solid by this point in a couple’s life. In addition, most women feel that they are more mentally prepared and willing to accommodate the sacrifices associated with pregnancy and parenthood.

A major benefit to becoming pregnant in your 40s can be summed up in one word: stability. This can lead to a more satisfying experience of being pregnant. In general, most pregnant patients in their 40s feel that they have finally reached a point in their social lives and career that allows them maximum time to care for both themselves and their baby.

What to Consider, How to Prepare
As most women know, the health risks associated with becoming pregnant in your 40s are slightly higher than if you’re in your 20s. In addition, most women will experience slightly more intense symptoms than are typical of most pregnancies (such as back pain, morning sickness, etc.). Also, the risk of maternal diabetes and the needs for a C-section increase significantly compared with women who are pregnant in their 20s.

Regular visits to your healthcare provider may help prevent some issues and complications. Continuing to exercise at a comfortable rate during pregnancy may help with the increased risk of gestational diabetes. Regarding exercise intensity, it is generally safest to limit exercise to a point where you can still hold a conversation comfortably without feeling as though you’re short of breath. Walking and water aerobics are excellent activities. Check with your provider prior to starting an exercise regimen.

One of the largest (and most well-known) increased health risks to the baby during this age are chromosomal abnormalities such as Down syndrome. The risk of Down syndrome increases from around 1 out of 100 pregnancies at age 40, and 1 out of 30 pregnancies by age 45. Although there isn’t much that you can do to prevent these problems, there are many screening tests that can be performed very early on to help you prepare. It is best to discuss with your provider which screening tests may be right for you.

Shane Drahos, MD, is a primary care physician currently at Stanford University completing a fellowship in sleep medicine.