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What to Expect When You are Pregnant at 42 (or Later)


If you are pregnant or trying to get pregnant over 40, you might have a lot of questions and some anxiety around your pregnancy. You may have heard that you should be under 35 to have a safe pregnancy. In fact, doctors say moms-to-be over 35 are of “advanced maternal age” and pay close attention to their prenatal health.

However, the good news is that most women in this age group have a perfectly healthy pregnancy and deliver a normal baby. A healthy pregnancy is not just about age - and knowing what to expect can help keep you and your baby safe.

You are also not alone. Hundreds of thousands of babies are born to women over 40 every year, and the number is growing.

The societal expectation is also changing as more women have sought to invest in their careers before bringing a precious little one into the world. Let’s discuss what to expect when pregnant at 42 or even later.


Do I need special prenatal care?

Prenatal care is vital for a healthy pregnancy, regardless of age. However, because the risks are generally higher for women of advanced maternal age, doctors often recommend extra prenatal care for women in their 40s. 

To better plan your pregnancy journey, here are three things you can do first.


1. Discuss the best prenatal care options with your doctor

    Do your research, and talk to your doctor to figure out what prenatal care plan is best for you and your baby. If you are pregnant at 42, you will likely see your doctor more often than someone in their 20s and 30s. 

    Your doctor will be there to answer any questions you may have and monitor your pregnancy. Depending on the risk factors, you may also be referred to a maternal-fetal medicine specialist or a high-risk obstetrician. Your doctor may also connect you with a genetic counselor to discuss prenatal testing, including genetic testing.


    2. Load up on the key nutrients

      A healthy diet and prenatal vitamins must work hand-in-hand to support your and your baby’s health. In fact, studies have consistently found that a vast majority of women are low in at least one key prenatal nutrient. For example, one in eight women has low Folate, Choline, and Iodine levels. Other studies have found a much higher prevalence of inadequate nutrient levels among pregnant women.

      Eating a balanced diet that includes a wide variety of whole foods can help cover all the bases. Try incorporating nutrient-rich foods with high levels of Choline, Folate, and other key prenatal nutrients. 

      Folate: Folate is the natural form of what you probably know as Folic Acid. Folate is a B vitamin that supports the growth and development of cells, most importantly, the cells that form the baby’s central nervous system. Low Folate levels in pregnant women, especially early in pregnancy, can lead to congenital abnormalities in the baby’s brain and spine, as well as other health risks. 

      The CDC recommends that pregnant women take 400 mcg of folate each day. Your doctor may recommend higher amounts, depending on your specific situation.

      Vitamin D: Vitamin D is another essential vitamin for a mom-to-be. Vitamin D supports calcium absorption and is necessary for healthy bone growth. This vitamin also works with Vitamin K to increase calcium absorption and retention, which helps the baby’s development of strong bones while protecting the mom’s bones. 

      According to the American College of Obstetricians and Gynecologists, women should consume about 1,000-2,000 IU of Vitamin D daily as a baseline. Endocrine Society recommends a higher amount, and your doctor will likely recommend a higher daily amount, if your Vitamin D levels are low.  

      Calcium: Calcium is key to keeping your bones strong. Did you know that babies develop their bones entirely relying on the calcium taken from the mother? Because of this, pregnant women will need more calcium to support their baby’s development while protecting the health of their own bones and teeth.

      After 40, your body starts to experience bone loss gradually, so a sufficient calcium intake is even more important. According to the National Institute of Health, pregnant women should consume at least 1,000 mg of calcium daily. 

      Of course, taking the recommended amount doesn’t guarantee a healthy pregnancy. However, nutrition is the foundation of a healthy pregnancy and the well-being of you and the baby. It’s a relatively easy action to ensure your body is getting the proper nutrients to support a healthy pregnancy for you and your baby.

      Even with a balanced diet, the additional nutritional needs during pregnancy can leave you with gaps. You can always supplement with the essential vitamins and minerals in the form of prenatal vitamins, to support a healthy baby and mom before, during, and after pregnancy.


      3. Learn more by reading “It Starts With the Egg” 

        It Starts With the Egg,” written by Rebecca Fett, is a best-selling book that helps take the guesswork out of finding the best supplements that support egg health and female reproductive health.

        This comprehensive, science-driven guide discusses nutrition and lifestyle habits that support fertility with realistic, actionable steps - including strategies for women in their late 30s and into the 40s. If you are looking for answers, you may want to put your feet up and delve into this insightful read.

        Brain Health from Birth,” also by the same author, is another excellent read, which focuses on the ways to support the healthy development of the baby’s brain and cognitive function.

        Also, try Ovaterra's supplement quiz to build your prenatal supplement strategy.


        Are there more risks if you are pregnant in your 40s?

        While there is always a risk with pregnancy at any age, the potential risk does increase with age. Know what you may need to be on the lookout for, and discuss prevention strategies with your doctor.



        It may take longer to get pregnant

        Female fertility peaks in our 20s and begins to decline rapidly after about 35. According to the American Society of Reproductive Medicine, women above the age of 40 have a five percent chance of becoming pregnant each month, compared to the estimated 20 percent at age 30.  

        While the chances may seem low, many women eventually get pregnant and deliver healthy babies after the age of 40.

        If you don’t get pregnant within six months of having unprotected sex, it’s recommended that you visit your doctor. Don’t prolong the waiting game. Given the natural progression of female fertility, you may need to act quickly in your 40s. The sooner you see a doctor and identify the challenges, the easier it can be to address them.


        You may have higher risks of complications

        Complications during pregnancy can happen at any age, but the risk increases as you advance in age. Follow the prenatal care plan developed with your doctor to reduce your risks, mitigate the consequences of any inevitable complications, and focus on taking care of your newborn.


        Which complications are more common in women over 40?

        Gestational diabetes

        Gestational diabetes is a condition that can happen during pregnancy when your body cannot produce a proper amount of insulin. One of the risk factors for gestational diabetes is age. While 2 to 10 percent of pregnant women may develop gestational diabetes, it is more common among women over 40. 


        Larger babies

        Everyone loves plump baby cheeks, but a larger baby does pose some risk of complications like difficult delivery. Women over 40 have a higher chance of having a baby whose birth weight is over 10 lbs. Larger babies at birth often correlate with gestational diabetes. Your healthcare provider will track your baby's weight during pregnancy.


        Delivery via a Cesarean

        More commonly known as a C-section, a cesarean is a surgical procedure to remove the baby through the abdomen and uterus. Women undergo a cesarean for many reasons, but you are twice as likely to need a C-section if you are over 40.  According to a study, 47% of women over 40 have babies via C-sections.



        There are many potential causes of preeclampsia and blood pressure issues during pregnancy. Preeclampsia can be attributed to some immune function disorders or placental problems.  

        No matter the cause, preeclampsia can appear as early as 20 weeks and have many associated conditions. One of the suggested risk factors for preeclampsia is advanced maternal age.

        Visible symptoms of preeclampsia include swelling of the hands and feet. Headaches, blurred vision, and higher protein content in the urine can also be a sign of preeclampsia. Treatment will vary, but may include an early delivery with frequent mother and fetal monitoring during the pregnancy and labor. 


        Baby’s health conditions

        Babies also have a greater risk of developing health conditions when the mother is over 40. These conditions include low or high birth weight, placental concerns, and chromosomal abnormalities. 

        Being pregnant over 40 does not mean you or your baby will definitely develop a health condition. However, it is important to work closely with your healthcare provider to know what to watch out for, how to manage your particular risks and what actions to take to increase your chance of a healthy pregnancy.


        Will my age affect my labor and birth?

        The short answer is yes, it can. Women over 40 can have higher risks of complications during labor and delivery. Sometimes, babies are born premature (before 40 weeks) or have a low birth weight. You'll undergo frequent monitoring during labor and birth if you have high blood pressure or gestational diabetes (two relatively common conditions affecting pregnant women of advanced maternal age that can also impact labor). 

        Women in their 40s often seek more physical activity and maintain a healthier diet than their younger pregnant counterparts. Exercise and a balanced diet, while obviously not a panacea, can be a boon for an older mom and her baby for a potentially smoother labor and birth.


        Advantages of being an older mom

        While medical risks do increase with age, there are advantages to having children later in life, such as:

        • You may be more emotionally mature and can handle the stress better
        • You may be in a more mature relationship that better supports the baby’s early years
        • You may be more financially ready for the additional responsibilities of caring for a child
        • You’ve had time to enjoy your early years, which can enrich your baby’s development
        • You are likely comfortable in a steady career that can accommodate the newborn weeks better

        Aiming for a pregnancy at 42 - or later - is a good impetus to start making healthy choices for you and the baby. And by now, you know what that means: eating well, exercising regularly, taking your prenatal vitamins, and most importantly, taking care of your mental and physical health. As you move through life, you’ve gained the knowledge and tools to do those things.



        Whether you are just starting your pregnancy journey or are already pregnant at 42, it’s important to gather the facts and speak to your healthcare provider about your plans. That way, you can increase your chances of successfully mitigating any risk factors and having a healthy pregnancy. 

        Your next steps: Take our quiz to find the prenatal supplements that best support your needs, and read "It Starts With the Egg" by Rebecca Fett to learn more about how to support pregnancy at an advanced maternal age.


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