Pregnant at 35 or Beyond? Here’s What You Should Know About Advanced Maternal Age (and How a Doula Can Help)

If you're pregnant (or thinking about it) at age 35 or older, chances are someone’s mentioned the term “Advanced Maternal Age.”

You might be thinking: "excuse you! I'm not old."

Or, you might be wondering how your age impacts this pregnancy and why your provider seems focused on it.

What Does “Advanced Maternal Age” Mean, Really?

“Advanced Maternal Age,” or AMA, is a term used when someone will be 35 years old or older at the time of giving birth. It’s not a diagnosis or a problem—it’s simply a category that tells providers to pay closer attention to certain risk factors.

And while that extra attention can sometimes feel like a lot, it doesn’t mean you’re high-risk by default or that you won’t have a healthy, smooth birth. Many people do!

What Are the Real Risks?

As we age, certain health risks do increase slightly during pregnancy. Here are some of the most commonly discussed:

• Chromosomal abnormalities: The risk of having a baby with Down syndrome increases from about 1 in 1,000 at age 30 to about 1 in 365 at age 35, and 1 in 100 by age 40.(Source: American College of Obstetricians and Gynecologists - ACOG)

• Gestational diabetes & high blood pressure: People over 35 are more likely to develop gestational diabetes and preeclampsia, but these can often be managed well with proper care.

• Stillbirth: The risk of stillbirth after 39 weeks is slightly higher for AMA pregnancies. A 2017 study found that people over 35 have a 1.4–2 times higher risk of stillbirth after full term compared to those under 35. However, the overall risk remains low—about 1 in 1,000 at 39 weeks.(Source: American Journal of Obstetrics and Gynecology, 2017)

• Cesarean birth: People 35 and older are more likely to have a C-section, often due to induction, stalled labor, or provider caution.

Why Do Providers Recommend Induction?

It’s common for providers to suggest induction around 39 weeks for people in the AMA category. This is based on evidence that inducing before the risk of stillbirth increases (typically after 40 weeks) may reduce the chance of complications.

A 2019 study published in The BMJ found that planned induction at 39 weeks in AMA pregnancies led to fewer perinatal deaths without increasing C-section rates. For many providers, this offers peace of mind—but that doesn’t mean induction is the only path.

You still have choices. And your birth preferences, values, and experiences matter just as much as the data.

How Doula Support Makes a Difference

This is where we come in. As your doula, I walk with you through the noise and nuance of AMA pregnancy, offering guidance, grounding, and support you can trust.

Here’s what doula care can offer:

• Clear, compassionate information: I help you understand the evidence, talk through provider recommendations, and prepare thoughtful questions so you can make informed decisions.

• Support during induction or spontaneous labor: Whether you’re planning a spontaneous birth or a medically-indicated induction, a doula is there for the full journey—providing comfort, encouragement, and physical support throughout labor.

• A steadier birth experience: People who have continuous doula support are 39% less likely to have a C-section, 15% more likely to have a spontaneous vaginal birth, and more likely to feel satisfied with their birth experience overall.(Source: Cochrane Review, 2017)

You Deserve Support—No Matter Your Age

Being 35 or older during pregnancy doesn’t mean you’re high-risk or behind—it means you're navigating a path many others are walking too, with strength and wisdom on your side.

And with the right support team—including your doula—you can feel informed, empowered, and ready.

Curious about how doula care fits into your birth plan?Let’s connect.