Aisha (name changed) migrated to Australia in her mid-20s as a student. Like many women from migrant and faith-based communities, her early years were focused on survival, study, work, financial stability, and supporting family back home. Marriage and children came later. At 37, she became pregnant for the first time.
When antenatal screening for Down syndrome was discussed, Aisha declined. Her decision was religious. She believed testing would only create anxiety, and that she would continue the pregnancy regardless. Her baby was born with Down syndrome. Aisha loved her child deeply, but later told me, “I would never have changed my decision. But if I had known earlier, I would have prepared myself, my family, and the support my child would need.”
Her story is not about regret. It is about information, preparation, and understanding the system.
Why pregnancy after 35 is so common
Pregnancy after 35 is no longer unusual. In Australia, nearly one in three mothers are now aged 35 or over. Women today spend longer studying, building careers, migrating, caring for family members, or waiting to find the right partner. Society has changed faster than biology, and many women now begin families later than previous generations.
Fertility: a slope, not a cliff
Women are often told fertility “falls off a cliff” at 35. This is misleading and fear-provoking. Fertility usually declines gradually through the 30s and more noticeably after the late 30s, particularly after 40. Some women conceive easily in their late 30s; others struggle earlier. The challenge is often not conceiving one child, but completing a family when time is tighter later in life.
Looking ahead: the role of egg freezing
A common question from younger women is, “Should I freeze my eggs now, just in case?” This reflects modern realities. Careers, finances, and relationships take time.
Egg freezing does not stop ageing, but it can pause the biological clock of the egg. Eggs frozen in the late 20s or early 30s are biologically younger than eggs produced later. If used in the future, risks linked to egg age reflect the age when the eggs were frozen, not the woman’s age at pregnancy.
Egg freezing can offer choice for women who know they are likely to delay pregnancy. It is best considered after discussion with a fertility specialist and with realistic expectations.
What risks increase after 35, and why
Pregnancy after 35 is common and usually safe with good medical care. However, some risks do increase with age, and understanding them helps women make informed decisions.
As women age, eggs are more likely to have chromosomal changes. This is why conditions such as Down syndrome become more common. This change is related to egg age, not lifestyle or anything a woman has done wrong. Miscarriage risk also increases with age, largely because many chromosomal changes prevent pregnancies from continuing.
Medical conditions such as gestational diabetes and high blood pressure in pregnancy, including pre-eclampsia, are seen more often, particularly when combined with other risk factors. Labour may be longer or more complicated, and caesarean birth becomes more common. Some babies may be born earlier, smaller, or need short-term special care.
It is crucial to keep perspective. For most women, the absolute risk remains low, and modern antenatal care is designed to detect problems early and manage them safely. Age alone does not determine outcome; overall health, lifestyle, and quality of care matter just as much.
The often-missed benefits of pregnancy after 35
Pregnancy after 35 is not only about risk. Many women bring emotional maturity, stability, and strong engagement with healthcare. They are often more proactive and informed. Research also suggests that women who have children later in life may live longer, and pregnancy hormones may have lasting positive effects on brain health, including memory, later in life.
Screening is about preparation, not pressure
Antenatal screening is often misunderstood. Screening tests estimate chance; they do not diagnose. Diagnostic tests provide certainty but are only done if a woman chooses.
Even for women who would never consider ending a pregnancy, screening can still be valuable. It allows families to prepare emotionally, organise support, plan delivery in the right hospital, and connect early with services. Declining screening is a valid choice, but it should be an informed one, not driven by fear or confusion.
What options exist if pregnancy is delayed
Life circumstances, especially not finding a partner ready for parenthood, can delay pregnancy. Today, women have more options than ever before.
Some single women choose to become mothers using donor sperm, becoming “solo mums by choice”. This is safest when done through registered fertility clinics with appropriate screening and legal protections.
For women aged 35 or older who have been trying for six months without success, early medical advice is recommended. If IVF is needed, earlier treatment generally offers better outcomes, as success rates decline with age.
After 40, IVF success using a woman’s own eggs drops significantly. In these cases, donor eggs from a younger woman can greatly increase the chance of pregnancy.
The bottom line
Pregnancy after 35 is a life stage, not a diagnosis. Yes, risks increase, especially after 40, but for most women those risks remain small and manageable with good care. Egg freezing offers some women added choice. Fertility treatments offer further options. Antenatal screening offers preparation.
The most important message is this: knowledge is not fear. Understanding fertility, options, and the healthcare system allows women to make decisions aligned with their values, beliefs, and hopes. With the right support, most women aged 35 and over will experience healthy pregnancies and welcome healthy babies, prepared, informed, and confident.
Age matters.
But care, knowledge, and choice matter more.
Dr Preeti Khillan is a Melbourne-based obstetrician and gynaecologist with extensive experience caring for women from diverse cultural backgrounds across all stages of pregnancy and birth.
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