Planning for Pregnancy in Your Thirties: 3 Things to Consider Before You Start Trying

By Sheila Scott · Aug 2019

Women are waiting longer than ever to start their families. In 2017, the birth rate for US women in their thirties surpassed women in their twenties for the first time. For women who have planned every step of their education and careers, it can feel natural to approach pregnancy with the same level of research — but knowing where to start is often the challenge.

1. Genetic Counseling — More Than Family History

Many women are referred to genetic counseling during the first trimester, but there's no reason to wait. Meeting with a genetic counselor before you start trying — especially with a family history of any genetic condition — can make a meaningful difference. Genetic counseling also isn't just for those with known family history: most genetic conditions affecting newborns and children have no prior family history, because they're caused by recessive mutations that parents carry without knowing.

2. Carrier Screening

ACOG recommends carrier screening for Cystic Fibrosis, Spinal Muscular Atrophy, and ideally hemoglobinopathies for all women considering a pregnancy. Additional screening is recommended based on ethnicity and family history. Expanded carrier screening panels testing 200+ conditions are available — a genetic counselor can help you decide which approach best aligns with your goals and values.

3. Preconception Checkup

A preconception checkup with your doctor will screen for health conditions that can affect pregnancy and fertility. If you're taking medications, this is the ideal time to discuss their potential impact on a pregnancy. ACOG recommends an infertility evaluation after 12 months of trying for women under 35, 6 months for women 35–40, and within 6 months for women over 40.