Oscar-Winner Hilary Swank’s Pregnancy at 52 Highlights the Realities and Risks of Late-In-Life Motherhood

A million-in-one chance for the "Million Dollar Baby"?

Oscar-winning actress Hilary Swank recently announced she is expecting her third baby, due later in December, adding her name to the growing list of women who have experienced pregnancy during the complex transition into menopause.

While the 52-year-old actress is certainly not the final woman to carry a child while approaching what is traditionally known as "The Change," medical experts are using the high-profile announcement to break down what everyday people need to know about the biological possibilities, medical realities, and inherent health risks associated with late-in-life pregnancies.

The average age of menopause in the United States falls between 51 and 52 years old. Meanwhile, perimenopause—the transitional phase filled with hormonal shifts that leads up to full menopause—typically begins in a woman’s 40s.

Swank, who is already a mother to 3-year-old twins, joins several other prominent women who have become pregnant during the perimenopausal window. However, medical data shows that natural conception and successful live births drop off drastically as a woman’s age increases.

According to data compiled by the National Center for Health Statistics, there were only 840 registered births from women aged 50 and older in 2017. This resulted in a sparse birth rate of just 0.8 births per 1,000 women aged 50 to 54.

Despite these exceptionally low statistical odds, pregnancy during the menopausal transition remains entirely possible—occurring either through natural conception or assisted reproductive technologies such as in vitro fertilization (IVF), though both paths come with notable medical caveats, according to Dr. Natasha Spencer, an obstetrician and gynecologist at Orlando Health Physician Associates.

"If a woman is experiencing ovulation/cycling, although irregularly and/or sporadic, it is always possible to achieve pregnancy naturally — however, with a lower probability," Spencer told The Post.

"Moreover, older women experience an increased rate of early pregnancy loss, both trisomic and euploid, primarily due to a decline in egg quality."

Spencer also noted that physiological changes in uterine and hormonal function play a substantial role in these early pregnancy losses, with many incidents occurring between six and 14 weeks of gestation.

For older women looking to expand their families, assisted reproductive technologies like IVF can provide additional pathways and opportunities for pregnancy. However, preprocedural factors can heavily influence overall success rates. These variables include female age, the specific type of infertility diagnosis, and the patient’s past reproductive and obstetric history, Spencer explained.

While younger women are certainly vulnerable to many of the same pregnancy complications as older women, the statistical odds increase significantly when advanced age and other overlapping health factors are introduced into the equation.

Carrying multiple fetuses—as Swank did with her twins—a history of complicated past pregnancies, and underlying health conditions such as chronic high blood pressure or diabetes can all elevate the chances of experiencing complications throughout the gestation period.

Furthermore, these medical complications can pose serious health risks for both the mother and the developing child.

Older expectant mothers face elevated risks for early pregnancy losses, ectopic pregnancies, placenta previa—a condition where the placenta partially or completely blocks the baby’s exit in the uterus—protracted labor, and severe maternal morbidity and mortality.

"Some fetal/neonatal risks include chromosomal and gene abnormalities, congenital malformations, low birth weight and preterm births and perinatal mortality," Spencer added.

However, medical professionals emphasize a strict biological milestone: once the transition to menopause is fully complete—defined as experiencing no menstrual cycle for a minimum of 12 consecutive months, accompanied by classic symptoms like hot flashes and night sweats—natural pregnancy is no longer possible because the ovaries no longer contain viable eggs.

Even so, there remains a window for perimenopausal or fully menopausal women to carry a child "through assisted reproductive technologies via egg donors or embryos created by them earlier in life," Spencer noted.

Beyond the medical considerations, statistics and clinical observations suggest there may be distinct psychological and developmental benefits to experiencing pregnancy and parenting later in life.

"Most women of advanced age will ultimately have good pregnancy outcomes and are able to cope with the physical and emotional stresses of pregnancy and parenting better," Spencer explained, pointing to the emotional maturity and stability often found in older parents.

"Increasing maternal age may also be associated with improved health and development for young children."