Women giving birth in their 30s, and on into their 40s, is quickly becoming the new norm in the United States; in fact, the birth rate for women age 35-39 grew more in 2014 than any other age group.

According to a June 17 report from the National Center for Health Statistics, the birth rate for teens and women in their early 20s both hit record lows in 2014. However, the number of births for women in their early 30s grew by 4 percent and the number of births for women in their late 30s grew by 5 percent.

With many factors at play, such as women simply waiting longer to settle down with eyes on education, careers, home buying, and so on, as well as a medical environment that allows them to do so without sacrificing the possibility of having a family, experts say the patients walking into obstetrics units and birth centers today are quite different than those of decades ago—calling for designs that answer to an older, more sophisticated patient population.

“They’re more educated and planning their babies more. These generations are saying ‘I can have a child at 40, and I’m OK with that,’ and they’re going to shop around,” says Kirsten Waltz, managing principal of Steffian Bradley (Enfield, Conn.), who advises spaces should be designed to be more classic than trendy.

But beyond aesthetics, preparing for an older patient population requires designs that support some specific services and operational models that they'll be seeking.

For starters, while many won't need access to high-acuity spaces such as NICUs, some slightly more complex medical protocols like an IV line may be used, says Katherine Todd, clinical nursing director, Family Birth Center and perinatal services at Park Nicollet’s Methodist Hospital, who guided the hospital’s renovation of its 40,000-square-foot Family Birth Center in St. Louis Park, Minn. To that end, the Family Birth Center was designed with easy transition areas in labor and delivery rooms so moms can use birthing tubs and a shower—even with an IV pole by their side.

And then for others, with age comes complications—in becoming pregnant and during pregnancy—necessitating environments that include comprehensive care. Alena Sakalouski, leader for women’s health at HDR (Minneapolis), says those environments should support programming that includes prenatal (including high-risk obstetrics) and fetal care as well as fertility treatment.

Age and some fertility treatments also increase the likelihood that women may conceive multiples, requiring quick access from labor and delivery to NICUs for premature births (which are more common with multiples), high-risk antepartum space, and patient rooms and other areas that can accommodate multiple infant warmers.

“We talk a lot about twin and triplet rooms and how we design those,” says Anita Linney-Isaacson, principal and senior vice president at HKS (Dallas), of how the firm is responding to the increasing age of expectant mothers. “If the mother has twins or triplets, she’s going to want to be close to all of them, and so do you design rooms for twins or do you design rooms to be able to expand?” One tactic taken by HKS was to provide larger twin rooms with enough gases to potentially expand for triplets and another is to design single rooms that are connected so that by sliding a door, rooms can be expanded to accommodate those families.

At the new WakeMed North Family Health & Women’s Hospital in Raleigh, N.C., opened in May and designed by BBH Design, Thomas Cavender, vice president of facilities and construction at WakeMed, says the hospital’s maternal fetal medicine group was bolstered to answer more high-risk births, so physicians were engaged in the design of the space to make sure it was right.

The facility includes six Level 3 NICU rooms and is set up with gasses to accommodate twins and triplets. An infant resuscitation room is located between two C-section rooms and is set up as a Level 4 NICU. “We really took a lot of input from the staff and from the physicians on the unique needs of that 38-year-old first-time mom, and that population is growing,” he says.

Jennifer Kovacs Silvis is executive editor of Healthcare Design. She can be reached at jennifer.silvis@emeraldexpo.com

For more on the latest trends in designing birth centers and obstetrics units, see "Little Things: Designing For Labor, Delivery, And Beyond."