A pregnancy after age 35 may require special precautions. But advances in medical care have made it safer than ever before, and most women in their late 30s and 40s do have healthy pregnancies and babies. Still, there are factors to keep in mind if you're considering a pregnancy after age 35.

Understand the risks
As the 20s are considered the optimal reproductive phase in a woman's life, 35 and beyond is usually considered the threshold for various risks and complications such as:

Ovulation Problems
Women are born with all the eggs they'll ever have. Once you are into the mid-30s, the eggs tend to decline in quality - and you may ovulate less frequently, even if you're still having regular periods. Does this mean you can't get pregnant? Surely not. It may simply take longer. If you're older than 35 and have been unable to conceive for six months, you might have to consult your doctor for advice.

Multiple Pregnancy
Age-related hormonal changes may cause you to release more than one egg at a time, which boosts the odds of conceiving non-identical (fraternal) twins. The use of assisted reproductive technologies - such as IVF - may also play a role. Since these procedures typically enhance ovulation, they're more likely to result in twins or other multiples.

Gestational Diabetes
This type of diabetes occurs only during pregnancy, and it's more common as women get older. Effective control of blood sugar through diet, exercise and other lifestyle measures is essential during pregnancy. Sometimes, medication is needed as well. Women with gestational diabetes often have very large babies, making vaginal delivery more difficult.

C-section Delivery
Older mothers have a higher risk of pregnancy-related complications - such as high blood pressure, gestational diabetes and placenta previa. These problems can lead to a C-section delivery. Labour problems tend to be more common in first-time mothers older than age 35. And if you're carrying twins or multiples, you're most likely to need a C-section.

Risk of chromosome abnormalities
Babies born to older mothers have a higher risk of certain chromosome problems, such as Down syndrome. An amniocentesis is routinely considered for women who will be 35 or older at delivery. In this test, the doctor removes a fluid sample from the amniotic sac surrounding the baby. The fluid is then examined to see if there are any chromosomal problems such as Down syndrome and to check for other conditions, such as spina bifida and other neural tube defects.

Miscarriage
The risk of miscarriage increases as you get older - perhaps due to the higher likelihood of chromosomal abnormalities.

Now that you are aware of the risks and challenges you'll face, it's important that you also understand that most women - including those over 35 - do have healthy pregnancies and healthy babies. As long as you take care of your health and your baby's and follow your doctor's advice, you are more likely to be one of them.

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