Advanced Maternal Age: Care Instructions

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Your Care Instructions

Advanced maternal age is the medical term for pregnancy in a woman who will be 35 or older on her due date. Most women this age have healthy babies. But a pregnancy at this age has a greater risk for problems than a pregnancy at a younger age. These include preterm birth and pre-eclampsia. They also include gestational diabetes, problems with the placenta, and genetic problems.

Most of these problems can't be prevented. But your doctor or midwife will follow you closely to catch most problems early. At every visit, your blood pressure will be checked to make sure it is normal. Your urine also will be checked for protein. Both high blood pressure and protein in urine are signs of pre-eclampsia. You also will be tested for diabetes.

You can decide if you want to have tests to find out if your fetus has certain genetic problems, such as Down syndrome. A fetus is the medical term for a baby before birth.

There are many things you can't control about pregnancy. But there is a lot you can do to help you have a healthy pregnancy. Do your best to eat well. And try to get plenty of exercise and rest.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor, midwife, or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Talk with your doctor or midwife about prenatal screening tests. These can help find Down syndrome and other possible problems.
  • Eat a balanced diet with plenty of protein, calcium, and iron. Be sure to include fruits, vegetables, and whole grains.
  • Talk to your doctor or midwife about an exercise plan. Many pregnant women enjoy walking, swimming, and prenatal yoga.
  • Make sure that you get enough folic acid. Folic acid helps prevent some birth defects, especially if you take it before you get pregnant. Your doctor or midwife will tell you how much you need. You can take folic acid pills.
  • Take your prenatal vitamins.
  • Drink plenty of fluids, enough so that your urine is light yellow or clear like water. Dehydration can lead to contractions. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor or midwife before you increase the amount of fluids you drink.
  • Check with your doctor or pharmacist before you take any over-the-counter medicines, vitamins, herbal supplements, or home remedies.
  • Do not drink alcohol. No amount of alcohol has been found to be safe during pregnancy.
  • Do not smoke. If you need help quitting, talk to your doctor or midwife about stop-smoking programs and medicines. These can increase your chances of quitting for good.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have sudden, severe pain in your belly.
  • You have had fluid gushing or leaking from your vagina and you know or think the umbilical cord is bulging into your vagina. If this happens, immediately get down on your knees so your rear end (buttocks) is higher than your head. This will decrease the pressure on the cord until help arrives.

Call your doctor, midwife, or nurse call line now or seek immediate medical care if:

  • You have signs of pre-eclampsia, such as:
    • Sudden swelling of your face, hands, or feet.
    • New vision problems (such as dimness or blurring).
    • A severe headache.
  • You have any vaginal bleeding.
  • You have belly pain or cramping.
  • You have a fever.
  • You have had regular contractions (with or without pain) for an hour. This means that you have 8 or more within 1 hour or 4 or more in 20 minutes after you change your position and drink fluids.
  • You have a sudden release of fluid from the vagina.
  • You have low back pain or pelvic pressure that does not go away.
  • You notice that your baby has stopped moving or is moving much less than normal.
  • You have vaginal discharge that smells bad.
  • You have severe vomiting with pain or fever, you vomit 3 or more times a day, or you vomit for more than 1 hour each day.

Watch closely for changes in your health, and be sure to contact your doctor, midwife, or nurse call line if you have any problems.

Where can you learn more?

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