If you’ve ever heard the phrase “geriatric pregnancy” or said it yourself, with air quotes, then you may have wondered: who invented this term anyway? Let’s take a deep dive into who coined the term “geriatric pregnancy,” its origin, its impact, and its hoped-for future (spoiler alert: retirement).
Who invented “Geriatric Pregnancy”?
When you’re expecting in your 30s and 40s, you get labeled a lot: “advanced maternal age,” “high risk due to age,” and, of course, “geriatric pregnancy.”
Geriatric? Just because I’m knocked up at 37? At 39? Or, 42?
By the fifth time you’ve heard this term (no longer officially used by the medical world, btw), you’re probably starting to wonder: who invented geriatric pregnancy?
Before we get into the history of the term, its evolution, and its side effects (both positive and unintended), let’s take moment to be in our feelings.
Today, an estimated 20% of first-time parents in the U.S. are over the age of 35. For the first time in recorded history, more people over the age of 40 are giving birth than teens. So, why are we made to feel like we’re mutants? The fastest-growing group working to address the birth rate decline, and we’re judged for starting too late?
Rage at a low simmer? Good. Let’s dive in.
What Does “Geriatric Pregnancy” Actually Mean?
Technically, it’s a colloquial term used to describe pregnancies in people over 35, but the medical world has largely (and recently) retired it.
Elderly Primigravida (the Predecessor)
If you guessed that the term “geriatric pregnancy” stems from an even more horrifying quasi-Latin phrase coined by (presumably) white dude obstetrics researchers in the 20th century, we can definitely be friends.
“Elderly Primigravida” was the preferred clinical research term to describe a woman who is in their 30s or older and pregnant for the first time. “Primi” comes from the Latin word “primus,” meaning “first,” and “gravida” comes from the Latin word “gravidus,” meaning “pregnant” or “laden.”
Cue inappropriate jokes about “gettin’ laden.”
U.S researchers generally give two dudes credit for coining “Elderly Primigravida:” Waters and Wager. Curious? You can read an excerpt of E.G. Waters and H.P. Wager’s obstetrics research from 1950 on “pregnancy and labor experiences of elderly primigravidas.”
Of course, in typical American fashion, Waters and Wager are given credit for someone else’s work. A published reference to the term “elderly primigravida” actually may have appeared two decades earlier in 1931 in a British medical journal, by another (presumably) white dude named William Nixon.
And, of course, there could be even earlier concepts in non-Western medicine.
It was hard to find out much about the lives of these physician researchers, Nixon in the U.K. and Waters and Wager in the U.S. Were they simply data nerds looking for the smallest statistical significance to make a name for themselves?
Were any of them a “geriatric daddy?” Maybe, as a young man, Dr. William Nixon fell in love with a hottie in her 40s and, thinking she couldn’t get pregnant, they had copious amounts of unprotected sex. Maybe she mistook pregnancy symptoms for perimenopause (let’s imagine the state of women’s health in the 1920s was similar to today – wait, it kind of is). Then, their surprise pregnancy led to his life’s work, creating the modern field of obstetrics in the U.K.
I digress. Let me know in the comments if you’d enjoy some fan fiction in the future about the true origin of the term “geriatric pregnancy.”
“Elderly primigravida” wasn’t just used in olden times, though. In 1958, the Council of the International Federation of Obstetricians and Gynaecologists first used “elderly primigravida” to refer to women over 35 having their first pregnancy, and it stuck for several decades. And as recently as 1990, Robert Resnik, M.D. published research about the phenomenon that is older moms, reinforcing the risk narrative.
The Number 35 + the Fertility Cliff
Once “elderly” was normalized, the next obsession became the number 35. In the 1970s, long before Aaliyah declared “age ain’t nothing but a number,” the medical community fixated on the number 35. Many researchers have since questioned whether age-gating pregnancy has been helpful or harmful. To call attention to risks associated with later-in-life pregnancy, they created the concept of the “fertility cliff.”
By the 1970s, testing for genetic abnormalities was almost routine, increasing anxiety around maternal age and risk. Fear and misunderstandings (particularly about Down Syndrome) led to conclusions about pregnancy after 35. Starting in the 1970s, researchers almost routinely began referring to the age 35 as a cliff, a time of abrupt change in fertility and in pregnancy risk. Pop culture, of course, never got the update that the cut-off at 35 was partly based on outdated data from amniocentesis risk thresholds.
Cue the biological clock ticking.
Anyone remember that weird dancing phantom baby on Ally McBeal?
While some risk factors do increase with giving birth over the age of 35, there are also benefits. The British Medical Journal, for example, found that “increasing maternal age was associated with improved health and development for children up to 5 years of age.”
All of this fixation on the number 35, did, in some ways, help accelerate reproductive assistive technology. It also created a threshold and the concept of “advanced maternal age.”
Advanced Maternal Age and Failure-Framing
Tracing the term “advanced maternal age” through history also yielded interesting findings. Although very few medical journals actually use the term “geriatric pregnancy,” it seems more colloquial; there’s a general consensus that “geriatric pregnancy” is outdated. It’s now preferred to say: “advanced maternal age.”
That phrase caught on like wildfire in the mid-70s in the medical journals after a researcher at Johns Hopkins, Jack Rary, published an article in 1974 that named “advanced maternal age” as a “leading indication for amniocentesis.”
In fact, the term “advanced maternal age” may have been coined much earlier by a Harvard neurologist, Herbert Barry in 1945.
Whenever it was first used, the term is often misunderstood. “Advanced maternal age” may be preferred to “geriatric pregnancy.” But it still stems from what I’ll call failure-framing language used by clinicians and society to describe what it’s like to have a child later in life.
If you’re pregnant and over 35, you’re immediately defined in negative connotations, as if you’re overcoming potential failure. Consider these phrases (still frequently used):
- Incompetent cervix
- Hostile uterus
- High-risk
- Barren
- Delayed pregnancy – who defines “delayed” and in relation to what?
Is “advanced maternal age” really any better?
What about “very advanced?” Oh yeah. You hadn’t heard? Apparently, the added description is used “to better differentiate between those who have more recently crossed the AMA threshold and those who are pregnant much later in life.”
These labels and failure-framing negative connotations can increase worry and stress for those trying to conceive or expecting.
If the questions people ask on Google are any indication …
- Is it safe to get pregnant after 35?
- What are the risks of having a baby after 40?
- Will my baby be okay during a geriatric pregnancy?
Only recently have major institutions begun to acknowledge how damaging this framing can be. As recently as August 2022, the American College of Obstetricians and Gynecologists announced their new, preferred language will be: “pregnancy at 35 years or older.”
How about we lead not with the mom’s age, but instead, stay focused on positive support and encouragement for a healthy pregnancy.
Hope for the Future: “Just Pregnancy”
A century after “elderly primigravida” was all the rage, we might finally be moving into a new era. When one in five first-time parents is over 35 years of age, it seems like it’s no longer in vogue to act surprised about the “rare phenomenon” that is advanced maternal age.
Thankfully, the prenatal medical community is making a shift toward personalized risk assessment, where, instead of blanket risk categorization due to age, clinicians are being trained to treat each patient individually.
Imagine that.
Researchers have also found that, despite the added worry about their status of being “at risk,” pregnant women over 35 also experience positive feelings throughout pregnancy, recommending that caregivers thoughtfully use a holistic approach to sharing information that doesn’t cause added anxiety.
Again, imagine that.
We can do our part to help the medical community move along faster by focusing on the positive aspects of later-in-life pregnancy and parenthood. In other words, let’s drop the “age.” We’re empowered. We’re excelling. We’re simply advanced and we’re maternal.
The Saga of “Geriatric Pregnancy”
And there you have it. The good, the bad, and the downright infuriating saga of the term “geriatric pregnancy.”
While we don’t really know who coined that term, we can trace the origins back to “elderly primigravida,” either from Nixon in 1920/30s Britain or Waters and Wager (if you’re U.S.-centric) in the fifties. And “advanced maternal age” sprang up as early as 1945 from Barry in Boston.
As frustrating as it can be to be labeled “geriatric,” “high-risk,” or even “elderly” during pregnancy—especially if your only risk factor is your age—there were some positive unintended consequences from all this attention on our aging gestational efforts. Would creating a family with reproductive assistive technology be possible if not for increased attention, research, and funding? Maybe.
We can all agree that advancements like freezing your eggs could have come with far less pejorative terms. Let’s retire “advanced maternal age” and “geriatric pregnancy.”
Let’s call it what it is: just pregnancy.
You can put my age where it belongs on my medical chart – next to my date of birth.
Now that you know the full story, you have my full permission to channel your inner-Aaron Sorkin the next time the topic comes up.
“Who invented geriatric pregnancy?”
In the immortal words of President Andrew Shepherd: “Let’s take him out back and beat the sh*t out of him.”
As always, Advanced Maternal © is for entertainment purposes only. We are not experts. Please contact a medical or mental health professional if you need help.
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