I got pregnant with my youngest baby at 35 and wondered how that might change my birth plans. Can you have a natural birth after 35? Are there greater risks, is it harder, and what does it take? Fortunately, my midwife reassured me things would go well - and I found great tips for having a baby after 35...
There are a number of steps to increase your chances of a natural birth after 35. Eat well and exercise during pregnancy so you’re healthy and ready for labor. Use childbirth techniques to keep labor moving and to position baby for an easy delivery. Natural birth lowers risks to you and baby, even after 35!
Use these practical strategies to keep yourself and your baby healthy and happy during pregnancy... and each of these tips sets you up for a great natural birth after 35, too.
The Truth About Childbirth After 35
You may be surprised to discover that increased childbirth complications for women over 35 aren’t universal. In fact, complication rates vary widely by location and place of birth.
A British study comparing healthy, low-risk first-time moms of varying ages found that rates of intervention and complications for mothers birthing outside of a hospital were dramatically lower - even among mothers over the age of 35 (Li et al., 2014).
This chart compares women who planned a hospital birth versus those who planned an out-of-hospital birth and it helps to show that rates of intervention are not simply tied to age - the difference is quite significant:
Header | Hospital Births | Planned |
|---|---|---|
Augmentation (trying to speed up or get labor going) | 42.2% | 22.6% |
Instrumental Delivery (forceps or vacuum) | 29.5% | 19.4% |
Cesarean Section | 23% | 11.2% |
On average, the planned Out-of-Hospital Birth rates are about 5% higher for women aged 35-39 vs women aged 25-29, as you can see in the table below:
Header | 25-29 | 30-34 | 35-39 |
|---|---|---|---|
Augmentation | 17.4% | 19.9% | 22.6% |
Instrumental Delivery | 15% | 17% | 19.4% |
C-Section | 8% | 9% | 11.2% |
There is an increase, but it’s very small. The odds are in your favor - and there are steps you can take to prepare for a smooth, safe natural birth after 35.
Understand the interventions
I highlighted some of the most common interventions in the table above - and as you can see, those interventions are not inevitable. While a few more women may truly need extra help, most women don’t.
The same steps younger women take to avoid unnecessary interventions will help you:
Childbirth Preparation
A key during pregnancy is childbirth preparation. Women of any age benefit from taking a comprehensive childbirth class - and then practicing the skills you learn in class!
I’ve covered some basics above, and I’ll outline important steps below, but I can’t emphasize enough how important it is to prepare for childbirth. Sure, birth is natural, but just like you’d prepare for any athletic event, you need to prepare for birth.
Mamas who are 35+ are at an advantage because they’re more likely to seek support and to prepare thoroughly - so use that advantage (Nottingham-Jones et al., 2020)!
Don’t just go through a childbirth course, dig into a course that teaches you skills and techniques you can use during your baby’s birth. My MamaBaby Birthing online classes show you how to work with your body and your baby during birth - no matter what comes up. That’s what you need - choose a childbirth method that encourages practice and gives you and your birth partner techniques to use during the most intense part of labor…
…and then practice those techniques! Try out the positions. Pay attention to your breathing. Work on relaxation. If you use the skills during pregnancy, they’ll be there when you need them during your baby’s birth!
Prevent Complications Before They Start
Fast facts about common complications and interventions in women over 35:
- Cesareans are more common (Rydahl et al., 2019)
- Induction is more common (Einarsdóttir et al., 2018)
- Results on instrumental delivery are mixed (Einarsdóttir et al., 2018)
- Women over 35 are more likely to hemorrhage (Oakley et al., 2016)
- Overall, complications due to age are low (Lina Herstad et al., 2016)
- Rising rates of intervention are not fully explained only by age (Carolan et al., 2010)
While women find it easier to make peace with interventions if they’re over 35, most women still want a natural birth (Aasheim et al., 2013).
And most women can make that happen - as noted above, the higher rates of interventions aren’t explained simply by age (you also saw that in the charts above). Place of birth is one factor, but there are others.
For example, the increase in cesareans may be partly attributable to higher epidural use in women over 35 (L Herstad et al., 2014). Epidurals can contribute to labor dystocia, meaning labor is slow, or contractions are ineffective, or the baby isn’t moving down well.
Many complications, such as hemorrhage, can be prevented by taking proactive measures during pregnancy and by guarding the labor process during birth.
The best way to increase your chances of a natural birth after 35 is to be proactive about stopping complications and interventions before they start.
Go into childbirth well nourished
Go into labor and birth well nourished - it's essential! This is true no matter what age you are, but it’s especially important when you’re over the age of 35. Your pregnancy diet does a lot more than grow a healthy baby...
...it also helps expand your blood volume, which delivers nutrients to your baby and to every system of your body. It helps you body prepare for breastfeeding, as well (women over 35 are more likely to breastfeed their babies, yay!).
When you go into labor well-nourished, you have a full blood volume - about 60% more blood than you had pre-pregnancy. That gives you a lot of extra circulation and nutrition to get through labor, and it also means extra insurance in the immediate postpartum time (right after baby is born) and in the first few days postpartum as your body changes rapidly.
Your pregnancy diet nourishes your placenta and in turn your baby, so your baby is strong and healthy through labor the placenta and umbilical cord keep functioning well throughout pregnancy, labor, and delivery.
Grow a baby that’s not too big (and not too small)
Women over 35 sometimes gain more weight during pregnancy, but that’s okay. You can eat a rich, nourishing pregnancy diet that includes plenty of protein and healthy fats while choosing lower carbohydrate choices. For example:
These choices are rich in nutrition and will help you grow a vibrantly healthy baby. Staying lower in carbs means that your baby is more likely to be sturdy and healthy - but not really big, which can be important if you’re worried about slow labors (conversely, evidence shows that having a really small baby can slow labor down - so you want a baby of average or slightly above-average birth weight).
Listen to my podcasts with Lily Nichols for more information: Why Your Pregnancy Diet Advice is All Wrong and How to Handle Gestational Diabetes.
Go into childbirth ready to get moving
Staying active during your pregnancy is essential. Childbirth is an athletic event. It may not seem that way when you watch movies and shows featuring birth, but women weren’t meant to be reclining on their backs all through labor.
Since one of the biggest concerns with labor over 35 is keeping things moving, it benefits you to be ready to move!
You don’t have to dance your way through labor (though that strategy is likely to result in a smooth natural birth) - but you should be able to change positions.
The best thing to do if labor is moving slowly is to change positions - even to get up and move around to shift baby.
The best thing to do if you’re finding labor very painful is to change positions.
The best thing to do if baby doesn’t seem to be coming down is to change positions.
Do you see a pattern?
Movement during labor is important, so you want to be comfortable moving. This means get to know good positions for labor and birth, but staying active during pregnancy is more important - you need the energy and stamina to move around, and to handle the work of labor.
Moving baby down and out
I’m sure you’ve figured it out by now - being able to move around during labor is important!
Since we know slow labor and “stuck babies” are often used as a reasoning for interventions in women over 35 (and all women, for that matter), knowing how to keep your baby moving is important.
Stay active during early labor. Don’t wear yourself out, but taking gentle walks, dancing, etc. can help you keep your pelvis open and flexible, which helps your baby get into a good position. A well-positioned baby helps keep contractions effective and keeps your cervix dilating.
Knowing different positions and being able to move is crucial when baby is moving slowly. I have a don’t-miss video that explains this in detail in my free Natural Childbirth Mini-Class - click here to register (the tip is in video #2!).
Choose a supportive care provider
As you saw above, where a woman gives birth can make a big difference - and one of the reasons is due to care providers. The women in the British study had midwives.
I don’t think you need to birth at home, and I think it’s fine for you to choose a doctor if that’s what you want to do. But make your choice knowing about your care provider and the place you'll give birth. Look at the cesarean rate for the hospital you plan to birth at. Know your doctor or midwife’s c-section rate. What’s your care provider’s policy on induction?
What kind of attitude does your care provider have towards women who are 35 or older? Is your care provider supportive, or do they feel that you’ll need a lot of interventions?
Care provider attitudes vary dramatically, and it pays to shop around. Get to know these statistics - don’t settle for “I don’t share statistics because you never know what will happen” or a similar statement. It’s true that birth never goes the way you expect it, but statistics give you a glimpse into how your care provider usually handles things…
…and you need to make sure that fits with what you want.
Related Questions
What are my natural birth options after 35? You can plan almost any birth after 35 - you can choose a doctor or midwife, and you can plan a home, hospital, or birth center birth. Choose a care provider supportive of you and willing to answer all your questions.
Is 35 too old to have a baby? While it's true that rates of birth defects and stillbirth increase slightly after 35, it's not a large jump. Your health before pregnancy and your nutrition, exercise, and preparation throughout pregnancy help you have a healthy family and a great natural birth.
(NOTE: Want a Perfect Birth Plan Template? Use this template and step-by-step videos to write a birth plan that gets your birth team on your side for a beautiful birth experience! Get the birth plan kit here.)
References
- Aasheim, V., Waldenström, U., Rasmussen, S., & Schytt, E. (2013). Experience of childbirth in first-time mothers of advanced age – a Norwegian population-based study. BMC Pregnancy and Childbirth. https://doi.org/10.1186/1471-2393-13-53
- Carolan, M., Davey, M.-A., Biro, M. A., & Kealy, M. (2010). Older Maternal Age and Intervention in Labor: A Population-Based Study Comparing Older and Younger First-Time Mothers in Victoria, Australia. Birth, 24–29. https://doi.org/10.1111/j.1523-536x.2010.00439.x
- Einarsdóttir, K., Bogadóttir, H. Ý., Bjarnadóttir, R. I., & Steingrímsdóttir, Þ. (2018). The Effect of Maternal Age on Obstetric Interventions in a Low-Risk Population. Journal of Midwifery & Women’s Health, 526–531. https://doi.org/10.1111/jmwh.12888
- Herstad, L, Klungsøyr, K., Skjaerven, R., Tanbo, T., Forsén, L., Åbyholm, T., & Vangen, S. (2014). Maternal age and emergency operative deliveries at term: a population−based registry study among low-risk primiparous women. BJOG: An International Journal of Obstetrics & Gynaecology, 1642–1651. https://doi.org/10.1111/1471-0528.12962
- Herstad, Lina, Klungsøyr, K., Skjærven, R., Tanbo, T., Forsén, L., Åbyholm, T., & Vangen, S. (2016). Elective cesarean section or not? Maternal age and risk of adverse outcomes at term: a population-based registry study of low-risk primiparous women. BMC Pregnancy and Childbirth. https://doi.org/10.1186/s12884-016-1028-3
- Li, Y., Townend, J., Rowe, R., Knight, M., Brocklehurst, P., & Hollowell, J. (2014). The effect of maternal age and planned place of birth on intrapartum outcomes in healthy women with straightforward pregnancies: secondary analysis of the Birthplace national prospective cohort study. BMJ Open, e004026. https://doi.org/10.1136/bmjopen-2013-004026
- Nottingham-Jones, J., Simmonds, J. G., & Snell, T. L. (2020). First-time mothers’ experiences of preparing for childbirth at advanced maternal age. Midwifery, 102558. https://doi.org/10.1016/j.midw.2019.102558
- Oakley, L., Penn, N., Pipi, M., Oteng-Ntim, E., & Doyle, P. (2016). Risk of Adverse Obstetric and Neonatal Outcomes by Maternal Age: Quantifying Individual and Population Level Risk Using Routine UK Maternity Data. PLOS ONE, e0164462. https://doi.org/10.1371/journal.pone.0164462
- Rydahl, E., Declercq, E., Juhl, M., & Maimburg, R. D. (2019). Cesarean section on a rise—Does advanced maternal age explain the increase? A population register-based study. PLOS ONE, e0210655. https://doi.org/10.1371/journal.pone.0210655
