Does being over 40 automatically make you high risk?

[TheBightyMoosh]

I'm currently 36 weeks (with my second pregnancy) and 41 yrs old - I have been under consultant care this time partially because I had high BP with my last pregnancy, but mainly because of my age.

I have been told that I will be induced on (or around) my due date, because of increased risk. But the thought of this is just terrifying me. Obviously I don't want to put my baby in ANY danger, but I would really hope that I could let things take their natural course. An induction will mean that I can't use the birth centre, and will probably mean a lot more monitoring, and I feel it would mean a lot less control.

I don't know what my question here is really, I suppose I am just looking for reassurance that my age isn't going to count against me in trying to acheive a much more natural birth, or at least one where I can be more active in and more in control. I am getting really stressed out with the whole thing. Any advice on how to approach my consultants would be much appreciated.

That is silly. Induction carries its own risks. You still have the right to decide for yourself which risks you are prepared to accept. Have you got a supportive midwife? Did you go over dates with your first? The estimated due date is only an estimate, after all.

My maternity notes mention being 35 and over as a risk factor all by itself.

Bottom line is that, generally speaking, they shouldn't be telling you you have to do anything. They should be getting your consent. If you don't want to be induced, don't consent.

Have you written down a birth plan and could that form the basis of a discussion with your consultant?

I know, it's crazy, isn't it?

My midwife is pretty good, but I get the feeling she would encourage me to go along with whatever the consultants recommend. I think I just need the confidence to put my foot down and insist on doing it my way- while being as safe as possible. I haven't done a birth plan yet - that's a great idea. I'm seeing my m/w next week, so I'll work one up before then.

Thanks for your help.

It's worth seeing what the NICE guidelines say about age and risk factors. You should also ask what the risk relates to exactly - how is your BP this time?

I found that well meaning MWs and consultants confused different risks - so said high risk but when pressed, they couldn't come up with much. I think they're being cautious, which is fair enough but you should question!

Do you have any other risk factors apart from high bp and age? I had high bp with my first at 39. I'll be 41.5 when I have number 2 and I've been given the choice between vbac and cs (had cs last time). I certainly haven't been told that I will definately be induced. Oh, and I had gallbladder surgery just before I conceived and that's not bothering them either way!

I guess what I'm saying is to find out if there are other reasons for being induced. High bp and age doesn't seem to be enough to me! Good luck.

I'm only at 18wks but am 41 and have been told the same thing. I started a thread about it here which might help give you some confidence that induction isn't automatically imposed across the country based on age alone. Obviously if there are other factors, it may be a different story.

There aren't any NICE guidelines that I could find relating to age and early induction. My registrar said there was a slight increase in risk of the placenta failing which is why they would want to do it, but I can't find any research to support that based on age alone. (If anyone knows where it is, can you point me towards it?)

What the articles I found seem to say is that it's difficult to determine if you are likely to suffer from placental failure. They can do some monitoring, but from what I've read, there's no fail safe way of knowing, hence I guess why they are keen to induce.

Did they offer you growth scans to check all is ok? I think they can also check blood flow to the baby.

I would tell the MW your concerns and hopefully you'll have an ally. I'm planning on doing the same - I don't want an induction unless it's absolutely necessary. If something crops up that changes that risk, I'll take another view but in the meantime they can back off!