Too Old To Have a Child: Debunking the term “Advanced Maternal Age” and Improving Patient Care

For starters, let’s define the term “Advanced Maternal Age (AMA).” AMA is a term commonly used in the medical field to refer to a woman who is pregnant, and after the age of thirty-five (35) during the time of delivery. Pregnancy at any age comes with some risk, but why do some doctors use fear and shame older women for having children later in life? AMA women do not need to hear that the worst is going to happen with their pregnancy and baby solely based on being over 35 years of age and without presenting with any other risk factors. Can we be a little more positive in the healthcare system, have a little more faith and assess each patient individually, before forming a generalized opinion on a pregnancy outcome?

I have issues with AMA women being automatically labeled a “high risk pregnancy” solely based on being older than 35 and without assessing other factors and the health of the individual patient. I know what the research says and there are studies that have concluded woman 35 and older may be at higher risk for pregnancy-related complications (adverse maternal and perinatal outcomes). I don’t want to turn a blind eye and pretend like some of the adverse outcomes like higher risk for miscarriage, gestational diabetes mellitus, pre-eclampsia, stillbirth and chromosomal abnormalities etc. aren’t real concerns. However, I think that medical professionals can do a better job at focusing on the patient showing up in front of them and not necessarily jump to conclusions and base care/treatment recommendations solely on statistics. It’s like saying everybody who lives in a particular zip code are at higher risk for diabetes and hypertension, and patient shows up and automatically offered medications to treat diabetes and hypertension. That doesn’t sound logical or like the proper standard of care, and it’s one thing to counsel the patient based on certain risk factors and another to offer and make treatment recommendations without conducting any diagnostic and patient-specific exam to determine if that patient indeed falls under that particular high risk category. Thus, in my opinion AMA does not and should not automatically = High Risk Pregnancy. Lumping all patients together and making treatment decisions solely based on statistics is “lazy medicine,” in my opinion. I respect the people who work in the medical field, and during and after the height of the COVID-19 pandemic, they are our heroes for the sacrificial work that they do, often endangering their own safety for the greater good. I also applaud the work that’s being done to address the black maternal health crisis. As a health care lawyer and a patient at various points in my life, I understand some of the unique challenges in the healthcare system. Some of the problems are not easy to fix. However, there is always room for improvement, and we should do our best to focus on those areas where we can actually make a difference. I am hoping that the physician and patient relationship can be greatly improved by offering more patient-centered and individualized care and less reliance on statistics.

There are many reasons why people become parents later in life, and age can sometimes truly be nothing but a number. Older pregnant women need more support and may need to be more closely monitored for certain risk factors; however, this can be done without making the pregnancy journey more stressful and making the regular prenatal appointments an unpleasant experience. If Mother Nature has not permanently closed down the shop, and a woman is blessed to become pregnant at an older age, let’s not use fear and labels to create unnecessary stress and worry for that Mama. The perfect age for motherhood is so subjective and is an individual decision. If you are healthy and have always taken care of yourself (i.e. eat well, exercise and with no major health issues), and everything still works in reproductive organs as intended, go ahead and celebrate the joy of motherhood at whatever age God chooses to bless you with said child! Just know that sometimes this might mean finding the right care team who is going to support and educate you on this journey without leading through negativity/fear and creating unnecessary anxiety and stress during a time that is supposed to be joyful!