Why Duchess Meghan's pregnancy at 39 is called 'geriatric' by some doctors

Meghan Markle, the Duchess of Sussex, is by no means old at 39, but when she announced her pregnancy earlier this month, she immediately fell into the "elderly mother" category, according to the medical community.
Like her first pregnancy at 37 years old with son Archie, Meghan's pregnancy is being treated as "geriatric" by the medical community - and labeled "geriatric" by many doctors - because she will give birth after she is 35 years old.
When Amanda Candy, a mother of two from Bethesda, Maryland, learned that she was geriatric when her first pregnancy was at age 34, she suggested the doctor come up with a new adjective.
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"I remember thinking, 'Whoa, I work in communications and you need a better term,'" Candy, a public relations expert, told Good Morning America when Meghan's first pregnancy was announced in 2018. "You can say I'm 'classic', 'vintage' or 'experienced', but please not 'geriatric'."
PHOTO: Prince Harry, the Duke of Sussex and Meghan Markle, the Duchess of Sussex visit Fraser Island, Australia, October 22, 2018. (Andrew Parsons / i-Images / Polaris)
Candy said the term "geriatric pregnancy" is now a running joke with her mother friends, most of whom are giving birth nearer Markle's age.
Although medical classification is something women joke about, Candy sees the real impact it has on women like herself.
“The unfortunate thing about a term like geriatrics is that it really puts pressure on women,” she said. "It makes you think about the clock ticking, and once it starts in your head you usually have trouble getting pregnant."
Being born later in life is a growing reality in the United States. Since 2007, the birth rate for women in their early 40s has increased by 19%, for women in their late 30s by 11% and for women in their early 30s by only 2%. According to the Centers for Disease Control and Prevention (CDC), birth rates of women aged 20 years and older decreased from 2015 to 2016.
Why "geriatric"?
"Geriatric pregnancy" is a term that most women seem to know or fear, but not all medical professionals use it.
According to a spokesman for the American College of Obstetricians and Gynecologists, "advanced mother's age" is the accepted term in the medical community.
The code that doctors use for billing purposes may not be particularly appealing to women either: older primigravida for a first pregnancy and older multigravida if the woman was previously pregnant.
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Although the terms "geriatric," "advanced age," and "elderly" are not loved by women of childbearing age, they reflect a medical reality, experts told ABC News.
"It's an arbitrary limit, but at the same time we understand that aging affects pregnancy and pregnancy outcomes," said Dr. Shilpi Mehta-Lee, a maternal fetal consultant at NYU Langone Medical Center. "And there are still more risks, even if you are over 40 years old."
The age of 35 was chosen decades ago by researchers trying to decide which pregnant women should have amniocentesis, a prenatal test that, according to Mehta-Lee, removes a small amount of amniotic fluid from the sac surrounding the fetus for testing perform.
By the age of 35, women were found to be at greater risk of having a baby with Down syndrome than the risk of losing pregnancy through amniocentesis.
Decades later, the terms geriatrics, advanced age, and the elderly are still associated with women 35 and over who are pregnant, but science has advanced so far that this age limit seems arbitrary.
"Women are much more concerned than just Down syndrome," said Mehta-Lee. "And some really healthy 35-year-olds will get better results than some 34-year-olds."
However, women 35 and over must grapple with the reality of time and aging.
Meghan, who lives in California with Prince Harry and Archie, turns 40 next August. She and Harry did not publicly disclose their due date and did not include in their pregnancy announcement how far Meghan is in her pregnancy.
Meg, I went to your wedding to see how this love story begins and my friend, it's an honor to hold it. Congratulations to the Duke and Duchess of Sussex on this good news! #Remoteshoot #shotonipad #shotbymisan pic.twitter.com/3iSYjydVj9
- Misan Harriman (@misanharriman) February 14, 2021
"All women have had our eggs since the fetus's life, and those are the same eggs we've had all our lives, and they start dividing more abnormally over time, so there are genetic risk factors," Mehta said -Lee. "And diabetes, high blood pressure, and obesity disproportionately affect women who are older, and these can affect the way we get pregnant."
Women who are pregnant in their mid-30s and beyond are at risk, according to Mehta-Lee, including miscarriages, genetic abnormalities, fetal growth problems, premature births, preeclampsia, and stillbirths.
What can you expect from a "geriatric pregnancy"?
While the risks can sound daunting, there are benefits to having a closely monitored pregnancy.
Candy, a Maryland mother of two, found the care she received comforting. She had a total of 10 sonograms during her pregnancy with her older son Brooks.
"As much as I hated the term 'geriatrics', getting so many sonograms was fantastic," she said. "It really calmed me down."
Mehta-Lee said the first thing she does with her advanced maternal patients is to talk to them about the pregnancy and what to expect.
"We spend a lot of time talking about their risks and we talk to them about the screening tests available," she said. "Some meet with a genetic counselor to make the decision about invasive testing, and this approach may be different than that of a younger patient."
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"Most women feel reassured after this conversation. They don't tend to be nervous," she added.
Mehta-Lee says women in their thirties and forties are first screened for Down syndrome and other chromosomal abnormalities in their pregnancy.
After that, they may have more ultrasound scans and more frequent doctor visits and tests as their due date approaches during their pregnancy than younger women.
"When someone is over 35, their doctor will do a little more research just to make sure everything is going well," said Mehta-Lee. "It gives the doctor a chance to look back, think again, and that's not necessarily a bad thing."
Editor's Note: This article was originally published on October 23, 2018.
Why the pregnancy of Duchess Meghan at 39 years old is described by some doctors as "geriatric" originally appeared on goodmorningamerica.com

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