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Older first-time mums - advised to have a Caesarean?

(36 Posts)
Marama Sun 31-Aug-14 09:27:21

I'm about 11 weeks along (I think - scan on 8 September when I'll know for sure) and this is my first baby. I'm also an older mum at 43.

I've just read an article about Claire Sweeney, who's my age, about to have her first baby and it said that she was advised to have a C-section because of her age.

Has that been your experience?

I'm not totally against having a C-section, but I would prefer to have a vaginal delivery. I'm going to research my options more, but I would love to know others' experience.

Yika Sun 31-Aug-14 09:31:50

I had my DD at 43 (first baby). C-section was never mentioned. I had a pretty easy pregnancy and normal birth.

AnguaResurgam Sun 31-Aug-14 09:33:20

I don't know anyone who was advised to have a C-section solely because of maternal age.

(I found myself wondering if the woman interviewed gave that answer to an impertinent question just to fob off, because it sounds so unlikely).

squizita Sun 31-Aug-14 09:33:44

Bear in mind a celebrity who feels the need to justify there cesarean (as people might judge) may well not want to tell the whole country her gynie issues in detail so this "just my age" might be a neat "subject closed" type comment. grin My hospital labour ward and MLU accepts women in their early 40s, I know some, for vaginally birth.

micah Sun 31-Aug-14 09:34:03

Rubbish.

Ask your m/w, but plenty of my friends have had 1st vaginal births in their late 30's/early 40's with no problem.

Although my mil insists my I needed a section because I was "too old" to have my first baby vaginally- I was 33! So I wonder if it's one of those old wives tale type thing that seems to be spread by the older generation/ when you were old having a baby at 25!

Marama Sun 31-Aug-14 09:36:46

Thanks, guys, that's good to know. Yes, on reflection, she probably did want to shut down any more questions!

Foxeym Sun 31-Aug-14 09:44:32

No, I had DC3 last year at 42 and the only reason I had a CS was because I'd had an EMCS with DD1 and 2. I was told that you are not allowed to go over 39 weeks though when you are over 40 so I would have been induced at 39 weeks if a CS hasn't been planned

Marama Sun 31-Aug-14 09:46:20

Thanks, Foxeym, that's interesting to know. I'm putting together a list of questions to ask my consultant after the scan, so the induction at 39 weeks is something that I'll bring up.

Kimaroo Sun 31-Aug-14 09:47:19

Dd1 is 23 and I was 35 when I had her. A woman in the ward who was 36 was advised to have a CS because she was over 35! Seems incredible now that that was considered 'old'.

Taura Sun 31-Aug-14 10:38:00

I am 41 and recently had a chat with an Obs anaesthetist, and one if the things she was glad to hear is that I am not "too posh to push" i.e. She didn't even mention anything about it being better to go for a CS because of my age - quite the opposite.

RedToothBrush Sun 31-Aug-14 11:10:29

I've just read an article about Claire Sweeney, who's my age, about to have her first baby and it said that she was advised to have a C-section because of her age.

For various reasons I think it is highly unlikely she was advised this in quite the way its been suggested. Remember it is perfectly possible that she has underlying health issues, which would make it a better option for her too. I strongly suspect that there is more to this than meets the eye...

In terms of whether older first time mothers should be advised like this, there is a debate.

Statistically, the older you get the more likely you are to end up with an assisted birth of some description (instrumental, EMCS or ELCS). At one point www.birthchoiceuk.com had some good statistics which focused on women over 35 only. But they were really hidden away and a pain in the backside to find at the time and the site has subsequently changed. I think it worked out that only 1/3 of women ended up with an unassisted birth.

The reasons behind this are pretty complex - older women are more likely to have more complex medical histories, more likely to have a higher BMI and more likely to be less fit than other age groups, so the figures can be somewhat misleading.

In other words, if you are fit and healthy then there is often very little reason why you should be advised to have an ELCS and it can be more a reflection of other social issues, rather than indicative of women over a certain age.

Imho, I think I would be considering what my overall health was and what my individual preferences were rather than being swayed by what a celebrity has said. If you want a VB then that should be a key part of your thinking.

I think you have to look at the risks of a planned VB which includes the possibility of an EMCS or an instrumental delivery versus a planned CS (statistics often lump CS together and separate instrumental deliveries and EMCS from unassisted VBs which has certain merits, but also is fundamentally flawed in its own right too). These are perhaps the most helpful stats out there - but like I say need to be understood in terms of their weaknesses. It is very easy to get sucked into looking into various stats on the whole, but again you need to properly understand what you are looking at rather than taking them at face value.

All in all, I believe there is a stronger case for first time mothers over 40 to be given free choice over what type of birth they have than other groups - as much as anything else, because they are less likely to have more children (and therefore do not have to consider the risks of subsequent CS). But this should be a choice rather than advice unless there is a particular reason behind it.

Marama Sun 31-Aug-14 12:03:21

Thanks, RedToothBrush for your really thoughtful response. Think I should mention that I wasn't really swayed by what a celebrity said, really it was something I hadn't come across before and I wanted to see what other women's experiences were.

All of your post will be really helpful for future research and thank you so much for taking the time to respond. I do have a high BMI, but I'm quite fit and healthy otherwise, and - when all's said and done - I want whatever's best for me and my baby. I would prefer to have a VD, but would not be upset if I have to have a CS. I do want to do as much research as I can, but I've been putting it off a little as I didn't want to jinx it!

The statistics on unassisted birth for the over 35s are really interesting, and something that I'll bring up at my consultant's appointment when I have my dating scan on the 8th.

wawabear Sun 31-Aug-14 12:04:35

A friend of mine had both her children into her forties and both were vaginal births.

My mum was 40 when she had me and that was a vaginal birth and my grandma was 45 when she had my uncle in 1948 and that was a vaginal birth.

I think it very much depends on the individual and any problems experienced during the pregnancy.

squizita Sun 31-Aug-14 14:25:32

I am 36 and was advised to use the MLU because basically I'm no less physically likely to have a straightforward VB than someone in their 20s, and they felt it would be less stressful for me and a newer nicer facility.
Basically it's to do with issues that can crop up when you're older that skews the data, not age itself (e.g. blood pressure, physical strength, back and pelvis issues...). E.g. more older mums have pre-eclampsia (for which and epidural is often advised and thus they might need assistance) but if your BP is normal that won't be an issue.
So do ask your consultant but you may well get a very reassuring answer!

ohthegoats Sun 31-Aug-14 15:12:55

I've never heard anything like that, and I've been consultant led at 40 years old. I think it's a shame that someone in the public eye gave a bullshit reason instead of just saying 'for medical reasons' to shut the question down. Will make other older mothers question it now.

RedToothBrush Sun 31-Aug-14 15:18:13

I think it's a shame that someone in the public eye gave a bullshit reason instead of just saying 'for medical reasons' to shut the question down. Will make other older mothers question it now.

I think saying she was advised is the same as saying for medical reasons tbh. I think thats a slightly unfair criticism.

Its not celebrities responsibility how anyone else gives birth. Its up to the medical profession to convey the message through the media with evidence and research.

ohthegoats Sun 31-Aug-14 15:49:45

But she is specifically quoted as having said it's about being an older mother, rather than just 'advised'. I know it's not up to celebrities to do anything at all, but if they get interviewed about being pregnant, and choose to do that (they could have said no questions about it, or just gone private on something that's private), then they do have a responsibility to not chuck a random untrue comment in there. Unless it was the journalist of course, which I wouldn't be surprised by.

dolicapax Sun 31-Aug-14 16:00:02

Is she having her baby at a private hospital? I've heard CS are often encouraged over VB because they are worried about being sued if there are complications during a VB. Cost isn't an issue as obviously you are paying for the service.

Marama Sun 31-Aug-14 16:02:48

ohthegoats - I'm the OP, and I probably phrased that the wrong way. I don't think in context of the interview that that's what she was saying - it did feel to me like she said it - as others upthread have suggested - as a way of fobbing off the question.

Perhaps as a first-timer it worried me a little - which is why I jumped on here and asked for others' experiences.

I certainly do not feel that celebs have a responsibility to anyone's state of health but their own. I agree with RedToothBrush that it's the medical profession who should convey the message. We could argue until we're blue in the face whether celebs should be responsible for the things they say or not, but at the end of the day it's up to each of us, in conjunction with our doctors and midwives, to choose the right plan of action to take.

Marama Sun 31-Aug-14 16:04:49

dolicapax the answer to that is I don't know! I'm not actually a 'fan' of Claire Sweeney, and I can't remember how I even found out that she was pregnant in the first place.

SofiaAmes Sun 31-Aug-14 16:06:15

I had my 2 at 37 and 39. I had an emergency cs (after 40 hours of labor) with my first and a VBAC (and a post partum haemmorage and extremely painful tearing) with my second. If I had it to do over again (and my advice to all older mums) is to have an elective CS. By the way, not only was a CS not offered to me, but it was made pretty clear that it would not be available to me without a major fight.

Marama Sun 31-Aug-14 16:08:50

Oh no, SofiaAmes, I'm sorry that you went through that.

scarletforya Sun 31-Aug-14 16:17:50

I had DD at 42 and induction was attempted at 39 weeks. It didn't work thankfully and I was able to have a caesarean. This is what I wanted all along! I went private and so did a few other women I know at my age and it was the same routine with us all. So I think induction at 39 weeks due to maternal age is a bit of a white lie consultants use to allow them do what amounts to elective sections. (Providing the induction fails!)

It's more or less done with a wink and a nod here in Ireland as we don't have the NHS thing where you can choose an elective section.

I didn't want an exhausting labour with pain at all at my age and I'm really glad I didn't have to go through that.

RedToothBrush Sun 31-Aug-14 16:47:00

dolicapax Sun 31-Aug-14 16:00:02
Is she having her baby at a private hospital? I've heard CS are often encouraged over VB because they are worried about being sued if there are complications during a VB. Cost isn't an issue as obviously you are paying for the service.

No. Liverpool Women's which does not have a private maternity wing.

RedToothBrush Sun 31-Aug-14 16:49:02

BTW, the cost argument is bollocks anyway. Especially for a group of women who are more likely to suffer complications.

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