I Had a “Geriatric” Pregnancy and Gave Birth at Age 45. Here’s Why I’m Proud of That.

The first time I saw it written down, I actually laughed. There it was, attached to my very healthy, very ordinary third pregnancy: advanced maternal age. And in the softer, chattier version that shows up in waiting rooms and comment sections and your cousin’s text message: geriatric.

I was 45 and I felt strong and ready for this pregnancy. I had grown so much as a mother, I had done the healing I needed to do, and I was feeling better and more capable than in my thirties. And somewhere in a file, I was elderly.

So I did what I always do when a word starts running my life. I went and found out where it came from. What I found made me stop being annoyed by it.

It made me proud of my little geriatric pregnancy. And by the end of this, I think you might feel the same way.

A quick, honest note: I’m not a medical professional and this isn’t medical advice. Always check with your own healthcare provider, especially about pregnancy and fertility. Read this as encouragement, not a prescription.

First, what “geriatric pregnancy” actually means

Not much, actually. It isn’t a disease or even a diagnosis. It’s a statistical risk category.

There is no “medical condition” called geriatric pregnancy. There’s no test for it, no treatment for it, and no change that automatically occurs on your 35th birthday. It’s a category. A box you get sorted into if you’ll be 35 or older on your estimated due date.

The current clinical term is advanced maternal age, or AMA.

Past 40 some providers say very advanced maternal age, and past 45, extremely advanced maternal age, which I have to tell you is a genuinely funny thing to be called while you’re standing in a Target buying newborn clothes while your same-age bestie is visiting her son in college (true story).

“Geriatric” isn’t even the official word anymore. It’s a piece of old vocabulary that fell out of the textbooks and kept living in ordinary speech, the way words do. And once you know where it came from, that makes complete sense. Because it’s much, much older than you’d guess.

But the phrase makes me laugh. It makes me think of the “I’ve fallen and I can’t get up” commercials that I grew up watching (before the internet came along, mind you). So, I’m wearing it as a badge of honor and celebrating my geriatric self having a baby at age 45. Because I do think that’s something to be proud of.

It was originally “elderly primigravida”

Let’s go into the history for a moment. Before we were geriatric, we were elderly primigravidae. That was the actual clinical term for a woman having her first baby after 35, a formal term used by doctors about patients.

The earliest formal definition came in 1958, when the international body of obstetricians and gynecologists set the line at 35. But the phrase was already floating around well before that. There’s a paper in the American Journal of Obstetrics and Gynecology from 1942 using it, out of a hospital in the Bronx.

Here’s my favorite part of that 1942 paper. The authors set out to test the common belief that older first-time mothers have harder labors. And they concluded that age had a “trivial” influence on how labor went.

So let’s pause there… back in 1942, doctors looked at the assumption we’re all still carrying around to this day, and found it mostly didn’t hold up. And we kept the assumption anyway. And we kept the word.

And the judgment.

Then by 1967, a researcher was pointing out that the 35 line was too rigid to begin with, since risk climbs gradually from the mid-twenties onward rather than jumping at one singular birthday. By 1990, an editorial in the New England Journal of Medicine was noting that the term had been no source of joy for the growing number of women having babies later in life.

So doctors have been quietly saying this label is clumsy for more than half a century.

Where the 35 number actually came from

This is the part I wish every woman knew, because it changed how I felt about my entire pregnancy. The number 35 was never a measurement of your body. It was the answer to a completely different question: who should we offer an amniocentesis to?

In the 1970s, amniocentesis became a reliable way to test for chromosomal conditions. But it’s a highly invasive procedure, and back then it carried a real risk of pregnancy loss, roughly 1 in 200. So doctors needed a sensible place to draw a line: offer it to everyone, and you’d cause losses. Offer it to no one, and you’d miss things.

They looked for the crossover point. The age where the chance of finding a chromosomal condition roughly matched the chance the test itself would cause a loss. At 35, those two numbers were close enough to even: about 1 in 270 against about 1 in 200.

That’s it. That’s the whole origin. Thirty-five was the age where the math on a test balanced out.

Imagine that you’re turning 35 on Monday. On Sunday your pregnancy is “normal” and on Monday you’d suddenly be considered “AMA” or “geriatric.” But your biology didn’t change overnight; it’s not really that simple.

It was a scheduling decision. And somewhere along the way, it got translated into a statement about women’s bodies, as though something switches off at 35 rather than a form getting checked.

And then it gets better

When I dug further, I found something that genuinely made me put my phone down.

A historical analysis published in 2003 went back through how 35 was actually selected. And the researchers concluded that the tidy risk-balancing story we all repeat isn’t fully supported by the record. Their finding was that the cutoff was chosen largely on economic cost-benefit analysis (what was worth paying for) rather than a purely medical assessment.

I want to be careful and fair here, because I care more about being honest with you than about winning an argument. The risk-crossover reasoning was genuinely part of the conversation, and this is one historian’s reading of a complicated record.

But it should still land. Millions of us women have been led to organize our hopes, timelines, and fear around a number that was shaped in part by what was cost-effective to offer in the 1970s.

They didn’t assess you. Nobody measured your body, your labs, your energy, your life when throwing this number around. A committee picked a blanket threshold, and half a century later it’s the reason a stranger feels comfortable calling you elderly.

The number didn’t age well. The word aged worse.

Everything that made 35 a reasonable line has since changed.

Amniocentesis is far safer now than it was in the seventies: modern estimates put the procedure-related loss risk dramatically lower than the old 1 in 200 figure. And we now have non-invasive screening that can be done with a blood draw, with no procedural risk to your pregnancy at all. (Still, even though I was pregnant at 45 and was offered a routine amnio, I declined one based on the results of my anatomy scan.)

Which means the original math is gone. The crossover point that produced the number doesn’t exist in the same way anymore. ACOG now recommends that screening be offered to patients regardless of age, which is exactly what you’d expect once the risk of testing dropped through the floor.

And here’s the thing I really want you to have. In its own current guidance (at the time of writing this article), ACOG describes the 35-year threshold as an arbitrary one, and notes that some of the risks associated with older age don’t meaningfully show up until 40 and beyond.

Arbitrary… their word, not mine.

The organization that governs American obstetricians titles its guidance “Pregnancy at Age 35 Years or Older.” Not geriatric. Not elderly. They moved on. The word stayed behind, in group chats and gender reveal comment sections, continuing to shape how many women (and the public) think about pregnancy.

Now let’s talk about my generation

Here’s the detail that finally made me laugh. That definition was set in 1958.

Nineteen fifty-eight. Dwight Eisenhower was president and The Everly Brothers were on the radio.

The women it was written about were our grandmothers. Some of them were having babies in an era before seat belts were standard, when about four in ten American adults smoked, and when nobody had heard the word sunscreen.

That’s who “elderly at 35” was describing. And the label never got a software update.

Meanwhile, look at who’s using it now. I was born in 1980 and landed right on the seam between Gen X and millennial — the short time period that people call Xennials or the Oregon Trail generation. We had a beautiful analog childhood and a semi-digital adulthood. We rode in the back of the station wagon with no seat belt, drank out of the garden hose, ate fast food when the ingredients were somewhat wholesome, sharpened our pencils at the front of the classroom, and died of dysentery in a computer lab (that’s an Oregon Trail reference, fyi).

We were raised a little feral, and I think it made us stubborn in a useful way. We’ve never been especially good at accepting a category just because someone handed it to us.

And here’s the part that isn’t just a joke. We grew up watching The Golden Girls and reruns of The Brady Bunch. Blanche, Dorothy, and Rose from The Golden Girls were in their 50s and looked at least 20 years older, while Alice from The Brady Bunch was in her 40s and looked much, much older.

My generation hasn’t aged that way, and I think this is a real reason why. These women looked like our grandmothers but they were just middle-aged.

If you compare most women in their 40s today to the images of Blanche, Dorothy, and Rose, there’s a major difference. Yes, TV wardrobes and hair styles played a part, but so does lifestyle. (And, it’s not just filters or cosmetic surgery.) Adult smoking in this country has fallen from 42.4% in 1965 to under 10%, and smoking is one of the single biggest drivers of how a face ages. Add better skincare, nutrition, exercise, sun protection, and an overall anti-establishment nature (hello, we were teens in the 90s) and you have a rebellious generation that doesn’t want to age like their parents or grandparents.

The research backs up the feeling, too. A large study of aging found that people born in later decades arrive at the same age with better physical and mental functioning than the generation before them; for example, a 68-year-old born in 1950 had roughly the capacity of a 62-year-old born ten years earlier. Six years of difference, just from being born later into a better-informed world.

Now, I have always promised you honesty, so here’s the other half. That trend isn’t automatic and it isn’t universal; some researchers are tracking the opposite drift in chronic disease and metabolic health in more recent generations. Being born a couple of decades later doesn’t come with a warranty of superiority.

Which is exactly my point, and it’s the same one I’ve been making for several years. The advantage isn’t automatic based on your birth year; it’s the choices you’ve made and what you’ve done with your lifestyle. The food, the healthy swaps you’ve made, the toxic load you’ve been reducing — those play a huge role in your health outcomes. And that should be no surprise.

Now here’s why I’m proud of my geriatric pregnancy

I could have spent this pregnancy feeling insecure about being an older mom or being insulted about my AMA or “geriatric pregnancy”. I’ve decided to be extremely proud, instead.

Because the risks were real and I walked in with faith anyway. I’m not going to pretend the numbers don’t exist; I’ve written honestly about the risks, including the hard ones. Miscarriage risk climbs. Screening matters more. I read all of it, I went to every prenatal appointment, and I said yes to medical support with informed consent and with my eyes wide open.

Because I’m proud of my body’s ability to create life in my forties. Yes, I’ll be an older mom, and people can say what they want to about that, but the upside to that is that I am a far more experienced mom. I am such a calmer, more confident mom in my forties than I ever was in my thirties. And I love my body for each pregnancy and each child it has given me, but I am especially proud that my fertility is still going… that is a flex if you ask me!

Because I brought something to this pregnancy I didn’t have at 30. A decade of learning what my body actually needs. The ability to advocate for myself in a room full of people with clipboards. Taking care of myself on purpose, long before there was any baby to do it for. My body wasn’t running on empty when this started; I had worked on my health and wellness for a long time.

Because I know exactly how rare and hard-won this is. Being a mom and seeing my kids grow up so quickly, coupled with eight years of secondary infertility, taught me not to take a single blessing or a moment of this for granted. There’s a kind of gratitude that only comes from waiting a long time, and it made me a better mother through everything.

Because “geriatric” is a fossil and I’m not. The term is an artifact from a world with no seatbelts and oldies on the radio. I’ve always been a critical thinker when it comes to my health and my own medical care, and I strongly believe in informed consent. While the medical world may apply this term to me, I never took it too seriously. (In fact, my OBGYN was pretty amazing and didn’t treat me like a medical specimen at any point throughout my pregnancy.)

Yes, I did opt into extra screenings and I agreed not to go too far past my due date. But otherwise, I know my own strength and my abilities, and I knew that nothing about me was geriatric.

And maybe somebody needed to say it out loud. Being somewhat in the public eye, I didn’t announce this pregnancy until my baby had already been here a few months, and part of that was the fear I carried the whole time. Fear that was placed onto me by society, telling me that I was too old to create life. So, if sharing my experience getting pregnant naturally at 45 and embracing my geriatric pregnancy makes it even a little better for one woman in her forties reading this with a positive test or an ultrasound in her hand, that’s worth the whole article.

Why you should be proud, too

If you’re pregnant in your forties, or hoping to be, here’s what I want you to remember.

You are doing something that takes more intention than almost anyone around you understands. You are doing it in a body you’ve spent decades learning. You are doing it with resources, self-knowledge, and a willingness to ask hard questions that a 25-year-old version of you simply didn’t have yet.

And you’re doing it in growing company. Birth rates for women in their early forties are at their highest point in generations, and they’ve been climbing for decades. So, you’re far from alone. More women are becoming mothers in their forties today than at almost any point in modern history. Every one of those numbers is a real woman who was also called geriatric and had a baby anyway.

What to actually do when someone labels you geriatric

Here’s the practical stuff. Your healthcare provider (whether you go with a midwife or OBGYN is up to you, even at your old age 🤣) might care for you differently than they would a 25-year-old patient. And that’s ok, because you and I want the best outcome for your pregnancy. It’s ok for them to approach you with a slightly elevated level of care. What isn’t really ideal (in my opinion and my preference) is for them to treat you like you’re fragile, simply because of your age. There might be valid reasons for you to be considered high-risk, but age doesn’t necessarily have to mean an automatic referral to the perinatologist for high-risk care. (Again, I’m not a doctor so please talk to yours.)

Ask for your numbers, not your category. If a provider brings up your age, the most useful question you can ask is: what does that change about my specific care plan? Sometimes the answer is meaningful, like an extra scan, a conversation about low-dose aspirin, or earlier screenings. Sometimes the honest answer is “not much.”

Both are totally valid. What you want is a response that is specific to you, rather than a label about women of “your age” in general.

Know that “high risk” is a scheduling term, too. It usually means you get watched more closely. Being watched more closely is a good thing, and it’s very different from being in danger. It’s also important to build a good relationship with your doctor or midwife so be sure to ask lots of questions and work with them to find the right approach to your prenatal care.

Let yourself find a provider who talks about your options instead of your odds. I had one, and it changed how I moved through all nine months. If yours leads with doom every visit, you’re allowed to go find another one.

And for the relative at Thanksgiving? My honest answer is that you don’t owe anyone a debate; in fact, I didn’t tell a lot of people that I was pregnant for this reason. You can either respond with a brief acknowledgment such as, “That’s an old word for a totally normal pregnancy” or say something like “Plenty of mothers give birth in their 40s” and then follow it up with a “pass the peas” or “have you tried the corn yet”. You definitely don’t owe anyone an explanation; also remember that not everyone will understand you and that’s okay.

One last thing

Now, as positive as I am about my pregnancy and as confident as I was, I honestly spent a good chunk of my pregnancy subtly holding my breath while waiting for permission to share my happiness. At every appointment, it felt like I needed one more piece of good news before I could let myself celebrate. It never really came until she was in my arms.

If I could hand you one thing, it would be that permission, early. Not because the risks aren’t real; they are, and we’ve talked about them a few different times. But because a horrible label built out of 1970s testing budgets doesn’t get to be the loudest voice in your pregnancy. So don’t take that phrase too seriously.

I might be in my mid-forties but in my head, I’m still somewhere around 34. And I think a lot of women are in the same boat.

You’re not elderly, you’re not advanced anything. You’re a woman having a baby, doing it with more information and more intention than most people ever bring to it.

I’m proud of my geriatric pregnancy. Be proud of yours. 💛

If a baby is in your heart and you’re wondering whether it’s too late, start here. If you want the specifics of what I actually did leading up to when I got pregnant at 45, it’s all in Fertile After 40. And if you want to be around women who get it, my 40+ pregnancy group is right here waiting.

More in 40+ Pregnancy:

• I Got Pregnant Naturally and Had a Baby at 45
• Pregnancy and Postpartum in My Mid-40s Were the Easiest of My Life
• 27 Creative Pregnancy Announcement Ideas for Social Media