In recent years， China’s fertility policy has undergone significant changes， resulting in an increase in the number of advanced maternal age pregnant women， which has become a new challenge in the field of maternal and child health. Based on the theory of risk culture， through in?depth and supplementary interviews with advanced maternal age pregnant women with three births， the results showed that the fertility risk awareness of advanced maternal age pregnant women gradually decreased， and they were willing to take biomedical risks to give birth to a third child under the dual influence of fertility culture and medical culture. Therefore， the risk cultural theory is helpful to clarify the cultural reasons behind the risks of advanced maternal age pregnant women， and explore the subjective and objective factors influencing the risk perception of them， so as to provide better medical care services for this group.