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Previous study has shown that in the United States, most maternal deaths and severe obstetric complications due to chronic disease are potentially preventable through improved medical care before conception. Many women who need assisted reproductive technology (ART) because of infertility are older than the average pregnant woman. Risks for such chronic diseases as obesity, diabetes mellitus, chronic hypertension, cardiovascular disease (CVD), and malignancy greatly increase with maternal age. Chronic illness increases the risk of the in vitro fertilization (IVF) procedure and is also associated with increased obstetric risk and even death. The objective of this review is to outline the potential risks for older women who undergo ART procedures and pregnancy and to characterize guidelines for evaluation before enrollment in ART programs. A PubMed search revealed that very few studies have related to pre-ART medical evaluation. Therefore, we suggest a pre-ART medical assessment, comparable to the recommendations of the American Heart Association before noncompetitive physical activity and the American Society of Anesthesiologists before elective surgery. This assessment should include a thorough medical questionnaire and medical examination. Further evaluation and treatment should follow to ensure the safety of ART procedures and of ensuing pregnancies.

Objective To evaluate the consequences of COVID‐19 pandemic restrictions on the postpartum course. Methods A retrospective cross‐sectional study compared women who gave birth between March and April 2020 (first wave), between July to September 2020 (second wave), and a matched historical cohort throughout 2017–2019 (groups A, B, and C, respectively). Primary outcomes were postpartum length of stay (LOS), presentations to the emergency department (ED), and readmissions 30 days or longer after discharge. Following Bonferroni correction, p < 0.016 was considered statistically significant. Results In total, 3377 women were included: 640, 914, and 1823 in groups A, B, and C, respectively. LOS after birth (both vaginal and cesarean) was shorter in groups A and B compared to the control group (2.28 ± 1.01 and 2.25 ± 0.93 vs 2.55 ± 1.10 days, p < 0.001). Rates of ED presentations 30 days after discharge were higher in groups C and B compared to group A (6.63% and 6.45% vs 3.12%, p = 0.006). Rates of readmissions 30 days after discharge were 0.78%, 1.42%, and 1.09% (groups A, B, and C, respectively), demonstrating no statistical difference (p = 0.408). Conclusion During the COVID‐19 pandemic, there was a reduction or no change in rates of ED presentations and readmissions, despite the shortened LOS after delivery. A shift in policy regarding the postpartum LOS could be considered.