ObjectiveThe study aims to describe older women's self-reported pregnancy-related symptoms, health and use of antenatal services by parity. Study designThe data were collected in a national survey of women who gave birth in one week in England in 2006. A random sample of 4800 participants was drawn via birth registration by the Office for National Statistics. Women were contacted at three months postpartum and a 63% response rate was achieved. Older women's (35 years or more, n=692) experience of pregnancy-related symptoms and use of antenatal services were compared with those of younger women (<25 years n=336 and 25–34 years, n=1957) using logistic regression (odds ratios (ORs) and 95% confidence intervals (CI)) and adjusting for available confounding factors such as ethnicity, marital status, deprivation and education. ResultsThe older women had fewer antenatal visits, overnight stays in hospital, and pregnancy-related symptoms than women aged <25 years. Overall, the most common symptoms were nausea 68%, heartburn 62%, and backache 51%. Symptom prevalence varied with age and parity. Compared with women aged <25 years older women were less likely to have vomiting (adjusted OR, 95% CI: 0.49, 0.35-0.70), backache (0.42, 0.32–0.55), and to experience depression (0.58, 0.37–0.90) and more likely to have haemorrhoids (1.81, 1.31–2.47). Compared with women aged 25–34 years they were less likely to have vomiting (0.76, 0.58–0.99) but more likely to have varicose veins (1.39, 1.03–1.88), haemorrhoids (1.60, 1.31–1.96), carpal tunnel syndrome (1.34, 1.03–1.75), and stress incontinence (1.35, 1.05–1.45). ConclusionSubstantial numbers of women reported pregnancy-related symptoms likely to cause discomfort and affect daily life. Older women used antenatal health care less and experienced fewer symptoms but those reported were of the type that are more likely to persist after pregnancy, with the exception of depression, which was most commonly reported by the youngest women.