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While pregnancy over 35 were called ‘high risk’, many clinics today deem pregnancies into early 40s as manageable under careful medical supervision. Still, the risks rise with age
While high-profile cases like Katrina Kaif’s and advances in medical care have made late pregnancies more achievable, a woman’s mid-to-late 20s and early 30s remain the healthiest and safest time to conceive. (Photo: Instagram)
It is no longer uncommon to hear that women are conceiving and giving birth in their 40s. Thanks to advances in reproductive medicine, genetic screening, egg freezing, better prenatal care, and shifting social norms, the old boundaries of “too late” are being redrawn. So, is age 42 becoming the new baseline for motherhood? And what must a woman’s health look like in order to carry a pregnancy safely beyond the age of 40?
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While pregnancy over 35 used to be labelled “high risk,” many hospitals and clinics today deem pregnancies into the early 40s as manageable under careful medical supervision. Still, the risks rise progressively with age—and the decision to have children later must be entered into with full awareness of those risks.
Medical experts often refer to pregnancies in women aged 35 and above as “advanced maternal age” (AMA). For many, the threshold shifts: some use 40, others 42 or 45, depending on health, fertility choices, and medical technology. But whether 42 is “normal” or advisable depends greatly on individual health, egg quality, and access to specialist care.
What Constitutes The ‘Right Health Profile’?
If a woman in her 40s wants to optimise her chances of a healthy pregnancy and delivery, several factors come into sharp focus:
Pre-existing health conditions
Hypertension, diabetes, thyroid disorders, obesity, and cardiac conditions—all these need stable management before conception. Having such comorbidities increases the risk of complications during pregnancy.
Ovarian reserve and egg quality
As women age, their ovarian reserve (number and quality of remaining eggs) declines. Chromosomal abnormalities (aneuploidy) risk increases, making miscarriage, genetic disorders, or failed implantation more likely.
Lifestyle and fitness
Maintaining a healthy weight, good cardiovascular fitness, a balanced diet, a non-smoking status, and low stress builds a better foundation. Women in their 40s today are generally healthier (in many cases) than earlier generations, which helps.
Access to assisted reproductive technologies (ART)
Use of IVF, preimplantation genetic testing (PGT), egg or embryo freezing earlier, and advanced monitoring can mitigate some age-related risks.
Close obstetric surveillance
Frequent prenatal care, screening for gestational hypertension, gestational diabetes, fetal growth, placental function, and readiness for complications is essential.
If these factors align favourably, pregnancy at 42 can succeed — but it is not without elevated risk compared to younger pregnancies.
Celebrity Pregnancies In The 40s
In popular culture, having a baby in one’s 40s is becoming more visible. One high-profile case is actress Katrina Kaif, who reportedly conceived in her early 40s. Her pregnancy adds to a growing list of celebrities globally who defy traditional age norms—leveraging fertility treatments, genetics screening, and top-tier medical support to carry safe pregnancies later in life.
These celebrity pregnancies fuel the narrative that late motherhood is possible, but they also tend to omit the risks, preparation, and medical overhead involved. For a typical woman, reproducing that success requires more than hope—it requires careful planning, specialist care, and acceptance of elevated risk.
What Are The Real Risks Of Advanced Maternal Pregnancy?
Pregnancy at an advanced maternal age is associated with a higher incidence of complications—both maternal (for the mother) and foetal/neonatal (for the baby). Below are key risks and what data shows:
Maternal Risks
Hypertensive disorders: Higher incidence of gestational hypertension, preeclampsia, and severe preeclampsia. In some studies, advanced age women saw 38% hypertensive complications vs 14% in younger cohorts.
Gestational diabetes: Significantly more common; older women may already have borderline glucose tolerance. One study found 44.2% of AMA pregnancies had diabetes vs 20% in younger controls.
Cesarean section rates: Higher likelihood of surgical delivery, whether electively or emergently, because of complications or foetal distress.
Preterm labour and delivery: Increased risk of giving birth before full term. One study observed 25.8% preterm in AMA vs 14.5% in younger women.
Placental problems: Placental insufficiency, abruption (placenta peeling from the uterine wall), and other placental pathologies are more common.
Postpartum hemorrhage, morbidity: Greater risk of bleeding after delivery, complications in recovery.
Stillbirth, miscarriage: Chromosomal abnormalities increase miscarriage risk; foetal death risk also rises with maternal age.
What Are The Risks To The Baby?
Low birth weight and intrauterine growth restriction (IUGR): Some infants may not grow fully in the womb.
Preterm birth and associated complications: Immature lungs, NICU admission, and developmental challenges.
Chromosomal abnormalities and genetic disorders: Down syndrome, trisomy 18, etc., risk increases significantly with maternal age.
Stillbirth and perinatal mortality: The risk of death around the time of birth rises. In some cohorts, maternal mortality was higher in older mothers.
Thus, the higher the maternal age, the higher the risk across a continuum. But risk is not destiny: many pregnancies in the 40s proceed to full-term healthy births with careful monitoring and interventions.
Where Does India Stand In Fertility?
India’s total fertility rate (TFR) has been steadily declining. In many states, fertility is now near or below replacement levels. When more women delay childbearing, it can further push childbearing later, compressing fertility into shorter windows, increasing pressure on reproductive health services.
Delayed motherhood may contribute to secondary infertility: women who have had one child but later try for a second may find conception harder due to age-related decline or intervening health issues. Recent reporting suggests rising secondary infertility in India, linked to PCOS, lifestyle changes, delays, stress, and reduced ovarian reserve.
If the pattern of having children later becomes more common, India may see a paradox: while fertility remains stable or declines, the demand for assisted reproductive technology, fertility preservation (egg freezing), and perinatal care for high-risk pregnancies will soar.
Impacts On The Health System
Health system burden: High-risk pregnancies require more intensive care, more frequent monitoring, potential ICU stays, genetic testing, specialised delivery facilities, and Neonatal Intensive Care Unit (NICU) support—which stresses resources.
Socioeconomic disparities: Only women with means and access to good medical care can realistically manage late pregnancies safely. This could exacerbate inequality.
Intergenerational health: Babies born from advanced maternal age pregnancies sometimes have slightly elevated risks of metabolic diseases, congenital anomalies, or developmental issues, which may ripple into population health.
Policy & planning: Public health systems may need to account for shifting maternal age distributions in maternal mortality, maternity care infrastructure, and perinatal services.
So, Is ‘42’ The New Normal?
Not yet. While high-profile cases and improving medical support make late pregnancies more possible, the “normal” age to bear children in India remains younger—mid to late 20s, early 30s—for most women, especially in non-elite settings. The risks rise steeply beyond 40, and only those with favourable health, resources, and access to advanced care are likely to succeed.
However, what is shifting is the definition of “safe pregnancy age.” The medical cut-off is creeping upward. The social norm is bending. Whether 42 becomes the new normal depends on how widely safe protocols, fertility preservation, monitoring, and medical access spread.
Key Takeaways And Advice
Women planning to delay pregnancy should maintain optimal health, manage chronic conditions, and consider fertility preservation (egg freezing) early.
Specialist consultation is essential: fertility experts, high-risk obstetrics, and genetic counselling should be involved from the planning stage.
Continuous monitoring during pregnancy: frequent scans, glucose monitoring, blood pressure checks, placenta function, foetal growth, and readiness for complications.
Public systems need to adapt: Maternal care, high-risk antenatal programmes, capacity building for hospitals, and access in rural areas need reinforcement.
Social awareness: High-profile celebrity success is not a universal template. Every late pregnancy carries trade-offs.
About the Author
Shilpy Bisht, Deputy News Editor at News18, writes and edits national, world and business stories. She started off as a print journalist, and then transitioned to online, in her 12 years of experience. Her prev…Read More
Shilpy Bisht, Deputy News Editor at News18, writes and edits national, world and business stories. She started off as a print journalist, and then transitioned to online, in her 12 years of experience. Her prev… Read More
September 26, 2025, 12:42 IST
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