I totally understand why people scoff at the term "geriatric pregnancy." I do. I get it. But why it makes people so upset is worth examining.
Geriatrics is the branch of healthcare that deals with problems and risks associated with aging. It stems directly from the science of gerontology, which is the study of the aging process and all of its aspects—social and biologic.
It's not a term used by old-fashioned sexists to make women feel bad about themselves. It's literally a medical, clinical term. And, unfortunately, reproductive biology hasn't evolved along with society. Though it's extremely common for women in their mid-late thirties to conceive and carry children, pregnancies do have an increased risk for certain complications when a birth parent is 35 or older. Some of these complications are higher rates of miscarriage, genetic disorders, and certain pregnancy complications like high blood pressure or gestational diabetes.
Of course there should be a clinical term for that, because an "advanced maternal age" presents a serious health risk to the already serious health condition of pregnancy. Speaking of which, "advanced maternal age," now the more commonly used term, is not any different or better than the term "geriatric," but at least puts into perspective that the advanced age of the pregnant person is in relation to reproduction only.
The decline in fertility that happens with an advanced maternal age means the quality and quantity of the eggs in our ovaries decreases. While getting pregnant after 35 years of age is hardly impossible, it does mean that there is a notable, rapid decline in our fertility at this age and beyond. This puts pregnant people at an increased risk for complications.
We may not be considered "geriatric" at 35+, but our ovaries are.
So why are so many people offended by the use of "geriatric pregnancy?"
The simple answer: ageism.
"Geriatric" is only an insult if you find the concept of getting older offensive. And while I'm not here to tell anyone how to feel about getting older, ageism has wide-ranging, negative consequences for people's health and well-being.
And with the insulting way society as a whole treats women as they age—from upholding impossible beauty standards to discrimination in the workplace—it's no wonder so many of us can be put off by even normal terms used to describe the aging process.
According to the World Health Organization (WHO), ageism can change how we view ourselves, can erode solidarity between generations, can devalue or limit our ability to benefit from what younger and older populations can contribute, and can impact our health, longevity and well-being while also having far-reaching economic consequences.
Ageism is associated with earlier death (by 7.5 years), poorer physical and mental health, and slower recovery from disability in older age. In the United States, one in every seven dollars spent on healthcare every year for the eight most expensive conditions was due to ageism ($ 63 billion total).
Every single person on earth has certain biases, and psychologists believe we're all ageist in varying degrees. It's worth asking ourselves why the term "geriatric" leaves such a sour taste in our mouths. Why do we associate growing older with such hostility? It's a privilege to grow older, after all.
Ageism—in healthcare especially—is a prejudice that not only harms older patients in general, but it's a detriment against our future selves, too. Someday, if we're lucky enough, we'll all be older adults. The ageism that we perpetuate now in no way helps us when we're in our seventies and eighties and deserve quality care.
The American Geriatrics Society (AGS) aims to educate people about the harm found in ageism so we can combat it together.
"We all are supported by and able to contribute to communities where ageism, ableism, classism, homophobia, racism, sexism, xenophobia, and other forms of bias and discrimination no longer impact healthcare access, quality, and outcomes for older adults and their caregivers," the AGS states.
You may not like being considered "old" as a pregnant person, and you don't have to. But we need to educate ourselves on the concept of ageism—specifically in relation to the term "geriatric"—before we decide how to feel about it.
For those struggling with infertility, a lot of emphasis is placed on the age of 35—and that can feel so stressful. It can absolutely feel dispiriting with so much significance surrounding the age threshold for pregnancy. Those feelings are absolutely valid.
However, it's not obstetrics that has to catch up to the times when using phrases like "geriatric pregnancy" or "advanced maternal age." It's evolution. Which, unfortunately, isn't likely to happen anytime soon. It's 100% OK to feel frustrated by this. It's not OK to use those feelings as permission to perpetuate ageism, which can harm everyone—old, young, pregnant, and non-pregnant.