AIBU to worry about my sister’s pregnancy risks at 46?

[Nordicdaydream]

My sister is pregnant (24 weeks). She is 46 and conceived naturally. She’s had quite a few miscarriages in the past and has one son already who is 6.
I am concerned at the risks once she gets further along. They are monitoring her with growth scans and she’s had a regular appointments but they offered her the glucose test for gestational diabetes and she’s refused it. She also refused the NIPT Down syndrome test.

I suppose I’ve been researching and worried for both her and the baby as I know things are more likely to be complicated at this age.

Has anyone else had a natural pregnancy around this age? And were there complications?

She's a grown adult who is capable of making her own informed decisions about her health.

Being pregnant doesn't make your health decisions open for public scrutiny and judgement.

She will likely have perfectly reasonable reasons why she has made these decisions. She is not obliged to justify them to you. It is not for you to judge her for doing it 'wrong'. There is no wrong here. There is a way that is right for her.

Basically butt out. It's none of your business.

My lovely aunt had 5 children, the last (and perfectly healthy) at age 46. Back in the old days it was common to keep conceiving until the body was finished.
So obviously that's not to say that nothing could go wrong, but it's really not as big of a deal as it sounds.
However, I'd certainly encourage her to do the routine medical tests such as gestational diabetes.

I had my third baby the week I turned 44. Everything went very well. Conceived naturally. I am healthy and on no medications, no smoking or alcohol etc.
I did not decline any tests at all, I attended all my NHS appointments, and had cons-led hospital delivery.
I hope all goes well for your sister. Have you offered to support her with going to appointments or exploring why declining glucose test ? Declining glucose test seems crazy to me. Unmanaged gestational diabetes is dangerous, it’s much safer to know if you have it and manage it.

I had DC2 (natural conception) at 45. I was offered the glucose/GD test purely due to my age - I took it but all was normal and had no complications in the pregnancy. DC2 arrived perfectly healthy. I can understand the worry, but it is her risk to take and it is more likely than not that all is fine. I've known mums who were 10 + years younger than me have children born with issues despite being low risk - it's always a gamble regardless of age. Best of luck to your sister, hope all goes well.

She’s a fool to refuse the glucose test. I had no symptoms whatsoever but was booked in and they discovered GD and it didn’t go away after my son was born I now have type 1 diabetes.
As for the other tests I had both children in my 40s and after the nuchal fold measurements were normal we declined any further tests. A relative got pregnant at 40 and did have an amniocentesis but it couldn’t pick up that her DD was profoundly autistic.
I do have a friend who had a surprise pregnancy at 46 and her son is now a healthy 23 year old!

I have a friend who was born when his mum was 46. He’s 40 and she’s a reasonably sprightly 86. He wasn't a surprise baby, she just desperately wanted another when all her
kids were grown! Anyway, I knew her very well, she’s lovely, he has always been healthy had a perfectly lovely upbringing.

I also have a friend who just had her 2nd at 44. She had an emergency c section,
but it went well - all parties are fine.

A friend had her one and only at 47 with no problems. My 3x great grandmother had seven babies between 40 and 50. All were fine. I'm descended from the one born at 50.

I had a natural pregnancy at 46. Absolutely no complications at all. Just put your 'worrying' energy into being supportive, because it's her body, her pregnancy and her medical choices.

Glucose test - they will check her urine for sugar anyway so this refusal is not a great risk
NIPT - if she knows she wouldn't terminate then again, no issue here. She will have the 20 week scan which will check baby's heart etc so NIPT wouldn't really add much value here
Age - 46 is not 76, if she's overall healthy then she will be absolutely fine. Plenty of women give birth at this age and the main risk here is miscarriages rather than something happening to her

Refusing the blood glucose test is unconscionable. Fair play if Downs wouldn't change her mind about keeping the baby, although I'd argue you'd do better to be prepared to deal with the other health issues it brings ahead of time (e.g. heart problems) so that you could actually care for them and keep them well... But refusing the blood glucose test is neglectful.

I have a friend with a large number of children who had her youngest at 47.

The pregnancy was no harder than her previous ones, although each one had been difficult in some way. She had gestational diabetes with the youngest 4 or 5 and pre term deliveries with all but her second.

The baby is now 5 & apart from a developmental delay, which three of his older siblings also have, he’s healthy.

her the glucose test for gestational diabetes and she’s refused it.

I had that as Dad was diabetic - so don't get why that test would be refused - it is a bit of a pain fasting and waiting round so is it a logistical issue?

I did know one mother she had 4 post 40 - and last but one she had gestational diabetes with - she blamed her diet - wasn't there for any previous 6 pg or last one.

Over 40 NHS apparently does like to offer - but maybe she look at her risk factors and decided not worth it - I assume her MW will have advised her.

Not wanting NIPT Down syndrome test - well is she is aware of risks and won't abort what ever not sure it would be helpful.

I've known mother's this old - most with no issues depsite may of them having had IVF which also increase some risks I belive.

I had people telling me they were worried about our choices round my pg - never helpful. She pg an adult and with access to medical care - your worrying changes nothing.

There’s some utter shite on this thread from multiple posters about the GTT.
It’s not a fucking safeguarding risk to not want to needlessly fill your body with sugar until you vomit and shit yourself at the same time. It’s a nasty archaic test and shouldn’t be routine. It was pushed on me as routine with both PGs and I wish I’d been brave enough to refuse it.

Women have agency over their bodies and are not vessels for babies FFS. If she gets symptoms or has risk factors that’s a different matter.

I also refused NIPT with DC1 (and it wasn’t even available in the country where I had DC2) which horrified the consultant. Some of them are obsessed with it.

This is what this forum is for, it’s anonymous and people can be concerned about family members and seek support! That’s not judgmental

Her baby, her business 🤷‍♀️

Risks of Down’s and similar and also miscarriage increase with maternal age. My friend (late 20s) has old parents (they were mid-late 40s when she was born), similar age to my grandparents. She was born prem and has issues with some organs. I worry about losing my grandparents to old age and she’s worrying about her parents.

Yiu are right to be worried because the risks are much bigger at that age. However worrying won’t change anything.

The bit that would bother me would be the refusing screening. If she has a disabled child, what is her plan for the child if something happens to her (your sister?) It would not be fair if you were expected to pick up and look after them, unless you wanted to. That is 100% not something I would want to have to contend with. But I’m not sure there’s any way to broach that without causing great offence.
Could you perhaps gently encourage her to attend the screenings? The risk of Downs is far higher with age.

How amazing for her, she must be thrilled. Lovely for you to be concerned. As she’s over 40 she’ll have a consultant led birth and they won’t let her go over 40 weeks due to increased risk of still birth. I was 42 when I gave birth and induced at 38 weeks. I had very good care. In short the NHS will absolutely know the risks and support her

Is she being offered NIPT because routine screening came back high risk? The NHS doesn’t routinely offer NIPT unless there’s risk factors or high risk on combined screening. Or maybe she’s abroad. Did she decline the whole lot, including checking for trisomy 13 and 18? These two (compared to downs) have much higher risks, including risks that you won’t carry the pregnancy to its end (ie risk baby isn’t born alive). Those are not things I’d necessarily think not knowing would be helpful.

Re the Geststional diabetes - age is a risk factor, so is ethnicity, bmi, family history, etc. there’s probably more. Not everyone has a horrid experience of it, I did not find mine particularly difficult or unpleasant. They only do morning appointments for this and it was simple enough for me to get the drink down. But there is a lot of fearmongering and “fake science” going around about these things.

is she engaging in the rest of her routine care?

I didn't have the test for Downs Syndrome as it had a small risk to it and I would have kept the baby anyway so it seemed pointless having it (I was slightly younger that the age you have stated but it still wouldn't have made any difference). There is a risk to all pregnancies but I don't think that worrying about it will make it any better.

I had a baby at 44, and sailed through the pregnancy compared to my pregnancy at 33.

Absolutely this. How awful. Especially if she’s been through miscarriages. Can’t you just be happy for her?! I’ve had numerous family and friends have babies between 45 and 50 with zero issues.

Not unreasonable to have concerns but make sure she doesn't know you're worrying, last thing you want is to cause her to get anxious. The fact she conceived naturally is a great sign and shows she's physically fit enough to conceive and be pregnant at 46. If she is generally fit and healthy there is no reason she can't have a healthy pregnancy and birth. She's not old. She may not want the downs syndrome test because it doesn't make a difference to her if baby has it or not. I'd encourage her to have the gestational diabetes tests as that's important for any pregnant woman and the baby.

She's concerned for her sister because she cares... Why is that unreasonable?? as long as she doesn't pass any anxiety on to her.

You must have had a different version to me. I just had to drink Lucozade & walk round the hospital. No shitting or vomiting involved!