Are you treated differently by your doctor/midwife because you are PG after 35?

fromvatobk · February 2014

Hi everyone. I'm new to the board and I just found out this am that I am pregnant with my second. A wonderful surprise! I had my first at 34 and am now 39 (will deliver at 39). I have read all of the scary "high risk" information on the internet, etc., but am wondering if this prenatal care experience will be really that different from the last. I am very healthy in general and had an uncomplicated first pregnancy. I am a little concerned about what being labeled "advanced maternal age" will translate into in terms of prenatal stuff. I know there are extra tests, but it seems like some doctors do a lot of extra stuff if you are over 35. I have my first prenatal appt next week, but hadn't really discussed this with my midwife at my last well-woman gyn checkup because I wasn't actively TTC. I'd appreciate any insight. TIA

dannie2011 · February 2014

My OB treats me no different at 40 then my other OB treated me when I was 18-24 (older kids). I got one extra ultra sound at 18 weeks with a Perinatologist, then was released to my regular OB. I did get the the Verify blood test done at the Peri appointment but only because the insurance would cover it just because of my age. He didn't say I needed it just if I wanted to I could.

dragonfly711 · February 2014

I just turned 40. My Dr does not treat me different at all that I know of. I am a FTM but he always has to remind himself that I am AMA. He keeps saying I don't look it. Guess that is a good thing.

I had genetic testing done and have had US at 7,12,16,20, and another at 27 weeks other than that all has been fine.

Beachgal72 · February 2014

I honestly have nothing to compare to since this is my first pregnancy at 41, but I don't believe I have had anything different than someone younger than me aside from the Verifi test which was optional and mostly covered by my insurance. That test is something I would have wanted to get no matter what my age if available. Thankfully my doctor never treats me like a "geriatric"

fromvatobk · February 2014

Thank you ladies!

DTNZ4Ever · February 2014

No different from 30/31 to 35/36. The only thing was that I got genetic testing done which is a noninvasive blood test from me. But I don't think that test was around when I was pregnant in 09.

SurpriseAt39 · February 2014

Yes and no.

At 39, I had no additional testing. (Bloodwork, amnio was offered, but I declined)

At 40, the same additional bloodwork and amnio was offered, and again declined. I agreed to the weekly NSTs starting at 30 weeks. And biweekly BPP starting at 30 weeks as well.

My hospital's policy is to deliver a 40(+) year old woman at not more than 40 weeks due to potential early placental degradation.
I don't have a problem with the NSTs and BPPs.

MommyAtty · February 2014

Some practitioners will treat you differently. I recommend you find one who works a lot with older mothers. They tend to understand better that once you get last the genetic testing, you really aren't significantly different than anyone else growing a baby. I had a coworker whose OB was ridiculous. She was doing all sorts of extra appointments and weekly sonograms the entire last half of her pregnancy. She was 35 at delivery and had no other risk factors and her pregnancy was completely uneventful. It was just that OB's procedure. I was 38 when I delivered, and I had an OB who flat-out told me I was healthier and in better shape than 90% of his patients in their 20s.

aherman2778 · February 2014

Im not treated any different now at 36 than when I was with my other pregnancies at ages 19-24. I declined all the additional testing as well.

Reynar1229 · February 2014

My doctor kind of sucks, but I had transferred to her at 16 weeks due to an insurance change and I'm kind of stuck. She came highly recommended but I truly think she believes my name is AMA. I'm 36 and this is my second child (I had my first at 31.) She makes me feel like my kid is going to be messed up because I am so ancient. She suggests every test known to man, even though everything that I have had done so far has come back completely normal. She also loves to quote statistics for older moms, as if I would like to worry more than she has already made me! I'm hoping that she isn't available when I deliver! I find this all so strange because I live in NYC where moms over 35 are super common. I despise going to my appointments. Thankfully I'm already 31 weeks, so not much longer to go!

coffee bean · February 2014

DTNZ4Ever said:

No different from 30/31 to 35/36. The only thing was that I got genetic testing done which is a noninvasive blood test from me. But I don't think that test was around when I was pregnant in 09.

this exactly.

stephmc76 · February 2014

My doctor also had children after 35 so she totally makes me feel comfortable. We did the MaterniT21 test but she didn't force it, and because of my age insurance should cover it.

springbeduk2 · February 2014

I think the only differences so far were getting the Maternit21 test and then after the 20 week A/S the perinatologist who reviews that recommended growth scans every 4 weeks and then BPPs every week after 32 weeks. The midwives passed along that recommendation but would have respected our choice if we declined those extra scans. We've gone for the growth scans because it is fun to see the baby and I still have some PGAL anxiety (even though my losses were way early and I should probably just chill out) so any reassurance that LO is growing OK is welcome. I'm more annoyed about and less convinced about wanting weekly BPPs so soon ... still thinking about those. May hold off a couple weeks then start scheduling them.

Otherwise, the midwives I'm seeing have been really relaxed about the AMA thing and stress that my husband and I (though I'm less sure why his health matters) are in good health and the say that is more important than age. They did not say that they'll have to intervene/induce before 42 weeks (their standard practice) because of my age when I asked how late they let people go. I guess I should double-check that.

If your doc is stressing the AMA too much for your taste see about getting a 2nd opinion/meeting someone at another practice and switch if they are more reasonable about it. If your insurance and geography allow that option.

gurtygirl · March 2014

My doctors are so wonderful. I have had a spontaneous miscarriage (1:4-5) and a molar pregnancy (1:1000), so they have taken an interest in me. I feel like I do get extra attention but it could be because they have been through the losses with me. I am so blessed to have them.

2redtulips · March 2014

My age combined with having a loss in 2012 means there have been a few extra tests, but my doc has been great about treating me like any other pregnant woman otherwise. He keeps telling me, "Let's keep having these boring appointments, ok?" I agree with him - boring is good.

He's got a great bedside manner and he's very reassuring. Great for when my pgal brain or AMA brain kicks in.

enigmasara · March 2014

It's funny this question was asked because we went out to lunch with friends over the weekend & one asked me if I was getting sick & tired of being labeled AMA. She just had a baby & I guess heard this a lot. It was mentioned once to me, when the doctor mentioned the MaterniT21 test (which we did), and hasn't been mentioned since. I don't feel old, my medical history is pretty unremarkable, and (knock on wood) everything is going great with this pregnancy, even though I did need some help with getting my progesterone levels high enough to ovulate.

moroccojade · March 2014

When I mentioned TTC at my age (38) my doctor just shrugged. It is so normal in our area. I am the "baby" mom in my daughter's grade 1 class. Most of the moms are in their mid-late 40s. Two are even grandmothers already! Some of the dads look well into their 50s.

It does mean I can choose a bit of extra testing....

I haven't met my new midwives yet, but I am guessing they will be fine, too. The COL is so high where we are, very few people can afford kids in their 20s and early 30s.

flyinmommy · March 2014

My OB is great. She had her babies at my age and totally gets that its really not that uncommon now.

DTNZ4Ever · March 2014

DTNZ4Ever said:
No different from 30/31 to 35/36. The only thing was that I got genetic testing done which is a noninvasive blood test from me. But I don't think that test was around when I was pregnant in 09.

EDIT: also at the end I had NST every week for the last month, which I didn't with DS1.

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