Pregnant women over 35 are sometimes categorized by doctors with a term that doesn’t characterize their true age: “geriatric pregnancy.”
It’s a term that Naomi Cahn—a professor of family law at the University of Virginia, who had both of her children after she was 35—calls “outdated,” adding that “35 is not the magic dividing line that we might think.”
Sure enough, the term “geriatric pregnancy” has sparked backlash for conjuring an image of a ticking biological clock during a time when women already face a lot of pressure to have children. While traditional ideals may lead one to believe older pregnancies are rare, they actually account for nearly 20% of pregnancies in the country—with 11% of those being first-time pregnancies, according to the American College of Obstetricians and Gynecologists.
The rise in older-age pregnancies, up 900% over the past five decades, marks a shift in women who are waiting for financial or emotional stability before making the commitment to raise a child.
Why more women are having children later in life
Cahn had known she wanted to have children since she was in her early twenties, but she wanted to wait until she finished law school before trying to conceive.
In 1983, she graduated from Columbia University School of Law at the age of 25, and then began a job hunt that’s all too relatable for new graduates, spending the subsequent five years moving through the ranks of jobs at six different law firms. She didn’t feel she could rely on those jobs to afford a child, though. And besides that, she was dealing with infertility issues that were expensive to afford.
When she finally gave birth to her first child via in vitro fertilization (IVF), she was in her mid-thirties and had just secured a law professor position at George Washington University, which she described as a “stable, long-term job that was designed to lead to tenure.”
Cahn’s journey is familiar to many other women who are waiting to reach a slightly older age bracket before trying to conceive. More than half of U.S babies born in 2023 had mothers who were older than 30, according to Centers for Disease Control and Prevention data, and birth rates for women in their thirties are at higher levels than in the past four decades, according to a University of Rochester Medical Center report.
Cahn said the growing population of women who defer having children until they are financially stable and have a partner who is also committed to investing in children can be understood by a “blue family model,” named to reflect families who plan for children based on their earning capacity and reciprocal investments from both parents, compared to a “red” family model, rooted in religious teaching and long-standing cultural morals, according to Cahn’s research.
It’s based on the idea that there are increasing financial returns to higher education, she said, and that more women seek financial stability before having a child “to make sure you can invest all of the resources you want to with your children.”
The fact that birth rates are rising among women over 35, she said, “seems to be in accord with that model.” When they’re younger, she said, pregnant women tend to face more workplace challenges, including fewer promotions, bigger wage gaps, and inadequate paid time off. What’s more, less than half of employed women with higher incomes said their employers offered paid family and medical leave, and that number drops to 33% of women with lower incomes, according to an analysis by KFF, a health policy research group.
Financial security is important not only for the future of the child, but also for mothers navigating the unpredictable complications of pregnancy. Indeed, infertility now affects one in five Americans.
Unexpected complications were the case for Cahn, who was told she needed bed rest for 15 weeks after doctors were concerned she would have a premature delivery.
“Had I been in a position that would not have allowed me to take time off,” she would have been unemployed at a pivotal moment in her pregnancy, she said, warning that it’s a situation many other pregnant women face.
“If you’re in a temporary job, gig job, or one that doesn’t provide benefits, you would not have had that flexibility,” she said. And alarmingly, maternity-leave offerings are declining, according to a report by the Best Place for Working Parents, a community forum of business leaders. The report found that companies are discontinuing maternity leave as a standard employee benefit, and the share of companies offering them dropped from 82.2% before the pandemic to about 73% in 2021.
At least in the medical community, though, things are changing for the better about how we characterize pregnancies. The medical community has been phasing out the term “geriatric pregnancy,” and its replacement term, “advanced maternal age,” is meant to better characterize the pregnancy risk factors, like gestational diabetes, high blood pressure, preeclampsia or premature birth, that come with each passing decade in a woman’s life.
New guidelines set by the American College of Obstetricians and Gynecologists emphasize that pregnancy risks should be characterized in five-year age groups—like ages 35–40, 40–44, et cetera—rather than one collective maternal age group that applies to anyone past age 35.
“There are different reasons for having children after age 35,” Cahn said, with infertility issues and financial security just a few. Beyond that, she acknowledged a particularly tricky double standard women often face while deciding to have kids: Do it soon before the biological clock runs out, or do it later once you have enough means to provide a child.
It means the old—and often hated—advice rings true: “There is no right time to think about having children.”
