Q&A: Pregnancy is scary, but at 42 years-old It can be terrifying.

Wow! What a great story! Congratulations! Of course you are scared—it is hard to believe that you might actually get the baby you were dreaming of, after all the roadblocks you have faced. But the odds are in your favor at this point.

If you look at the biggest barriers to successful pregnancy at age 42, the first is fertility, and the second is first-trimester miscarriage. After that, the chance of chromosomal conditions like Down syndrome (DS) is increased compared to a younger woman, but 98 to 99 percent of 42-year-old pregnant moms are carrying fetuses that do not have DS. Several different strategies are available for prenatal detection of DS if you want to know. The other issue is that women are more likely to have developed underlying medical conditions by (ouch) middle age. Gestational diabetes and hypertension are both more common in older moms-to-be. Good obstetrical care can prevent many of the negative consequences of maternal medical conditions.

We hear so much about the problems associated with advancing age, it is sometimes hard to believe that everything can go well! But you have already gotten past two of the most difficult hurdles of "advanced maternal age"—the decrease in fertility and the risk of early miscarriage. The most likely outcome for you now is a healthy baby! Good luck!