The average age of first-time mothers has climbed steadily over the past few decades. Back in the 1970s, most women started their families around age 21. Today, that average is closer to 27, and a growing number of women are welcoming their first child in their mid to late 30s or beyond. With that shift comes a different set of questions, considerations, and (sometimes) worries.

Dr. Trace Deighan, an OB-GYN with Southeast Georgia Health System, and his patient, Mallory Manners, share what a later-in-life pregnancy really looks like, from the questions it raises to the outcome that made it all worth it.

Defining “Advanced Maternal Age”

The American College of OB-GYN defines a later-in-life pregnancy as advanced maternal age, beginning at 35. Risk is broken into tiers – 35 to 39, 40 to 44, and 45 and older – with certain risks increasing at each stage. “There are increased risks with pregnancy,” Dr. Deighan explains, including hypertensive disorders, preterm delivery, smaller babies at birth, and a higher likelihood of cesarean delivery.

Still, Dr. Deighan is quick to offer perspective. “There’s no low risk pregnancy,” he notes. Even a pregnancy that proceeds normally for 48 weeks can change quickly. “Every time you deliver a baby and they have a good outcome, it is a blessing and truly a miracle sometimes,” adds Dr. Deighan.

A Personal Journey

Mallory was 37 when she learned she was pregnant, turning 38 during her pregnancy. Her biggest early concern was understanding exactly what “higher risk” meant. “It was important to me to find out and ask the questions,” she shares. Dr. Deighan never made her feel rushed, no matter how many questions Mallory brought to each visit.

Staying active was a priority for Mallory throughout her pregnancy. She kept up with Peloton rides and walks until about 36 weeks… a personal goal she was proud to reach. But, as her pregnancy progressed, her blood pressure became a growing concern. “It was important to me to have the team that was supportive and communicating all of these things to me,” she recalls. “I wasn’t kept in the dark about anything.”

Watching for Warning Signs

While chromosomal risks are often top of mind in advanced maternal age pregnancies, Dr. Deighan notes that hypertensive disorders, including preeclampsia, are actually the most common concern. That is why prenatal visits increase in frequency later in pregnancy, sometimes to once a week or more, to monitor blood pressure and catch changes early.

“Situations can change very quickly, and you don’t want to be three weeks out from having seen the patient,” he cautions.

Building Trust When Plans Change

As Mallory began showing signs of preeclampsia, her care plan shifted. Dr. Deighan emphasizes how critical trust is in these moments. “If that development of that rapport did not happen, I wouldn’t expect her really to trust me with that,” he offers. That trust ultimately guided the decision to move toward an earlier delivery.

Mallory’s delivery became a high-risk, emergency C-section. But, she never felt afraid. “I never worried for a moment that my team wasn’t fully aware of what was going on,” she says. Her son, Philip, was born at seven pounds, seven ounces. “Overwhelming joy” is how she describes holding him for the first time.

Advice for Other Mothers

Dr. Deighan encourages preconception counseling visits for anyone with questions before becoming pregnant, and finding a provider who takes the time to listen. Mallory’s advice echoes that same openness. “Don’t be scared to ask questions,” she urges. “There are no dumb questions.”

For more information, visit sghs.org/maternity.