Reconsidering “Advanced Maternal Age”: communicating about pregnancy, disability risk and ageing

ABSTRACT

In this paper, I consider the term “Advanced Maternal Age” (AMA), which appears in various avenues of information for pregnant women, including medical literature and more “common knowledge” avenues of communication, such as government websites and online forums. I explore the increasingly routine use of this phrase, and I problematize its usual definition, to mean “35 or older.” I argue that this definition—rather than being a neutral, medical fact—is socially constructed, and the number 35 is arbitrarily chosen, in a way that perpetuates stigma against older women and their bodies. The definition ignores many relevant factors for considering medical “risk” and contributes to discourses that continue to frame pregnancy as risky, requiring expert surveillance and intervention. I also argue that the widespread use of this phrase in medical literature as well as other sites of discourse perpetuates the ableist idea that children with disabilities are undesirable or less valuable.

KEYWORDS:

• Advanced Maternal Age
• pregnancy
• disability
• women’s health
• prenatal testing

Acknowledgments

I would like to particularly acknowledge the two anonymous reviewers, whose thorough feedback led to considerable improvement of this article. I would also like to acknowledge those who have helped me develop the ideas in this article, or reviewed and commented on earlier drafts: Particularly Rena Bivens, Miranda Brady, and Daniela Mastrocola.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. Indeed, “Advanced Maternal Age” replaces antiquated medical terminology such as “elderly pregnancy” and “geriatric pregnancy.” These phrases were used routinely by the medical community, and still are in some areas, without irony, to describe 35-year-old women.

2. AMA is also used in terms of communicating information on risk of stillbirth, miscarriage, and infertility. These cases are not the focus of this article, but this certainly needs to be acknowledged since it is part of the information package of interest to potential parents as they consider the effects of maternal age. However, just as with disability risk, there is no evidence to suggest a sudden, sharp rise in risk at age 35. Much as with disability risk, the ageing process is much more complex than this, and differs for different people.

3. It is perhaps true that there is a focus on ageing because a woman can choose when she becomes pregnant much more easily than she can control her genes. However, the lack of emphasis placed on the influence of genes serves to bolster the importance placed on AMA.

4. Parity is defined as the number of times a woman has given birth to a baby at 24 or more weeks gestation. This simply means that older pregnant women are having fewer births.

5. A fluid-filled space at the back of the fetus’ neck is examined, with a larger than usual space indicating greater likelihood of a chromosomal disorder or other fetal abnormality (Prenatal Screening Ontario 2018).

6. Amnio stands for amniocentesis and CVS stands for chorionic virus sampling. Both are tests used to diagnose chromosomal disorders prenatally.

7. Many authors have argued that contemporary prenatal screening practices have important parallels with historical eugenic practices and that they perpetuate ableism (e.g., Shoshana Magnet 2013; Mills 2001; Nikolas Rose 2007; Shelley Tremain 2006).

Additional information

Funding

This work was supported by an Ontario Graduate Scholarship at Carleton University.

Notes on contributors

Melodie Cardin

Melodie Cardin is a PhD candidate in Communication Studies at Carleton University in Ottawa, Canada. Her research focuses on prenatal testing, women’s health and disability studies. Her M.A. is in Communication and Social Justice from the University of Windsor (Windsor, Canada) and focused on the integration of midwifery into the Ontario hospital system. E-mail: [email protected]