"a rather worrying trend of births to [older] women"

[TheFourYearOldDrankAllTheMilk]

So say "experts" quoted by the Guardian.

https://www.theguardian.com/society/2025/sep/11/more-than-half-of-uk-births-now-involve-medical-intervention-audit-finds

What a crock of nonsense. Women have been having babies into their forties since God was a lad. That there are more interventions is down to doctors getting involved where a midwife wouldn't.

Just to give myself as an example. So far this pregnancy I've been told I am high risk because I have

Rhumatoid arthritis (I don't and never have, so that came as a surprise)
Had a small baby (previous kid was 7lb 7)
High blood pressure (BP is consistently 117/75 or thereabouts)
Liver disease (news to me)
Obesity (bmi of 30.3. Not exactly in the Roly Polies, to be fair)

And that I am old. I'm 41.

I live in an area with no midwife-led unit within a sensible distance (it was closed down; I understand it failed some inspections) so there will be doctors nearby when I give birth, and I'm not a hippy so if I do require intervention I will accept it, but they have been trying to book me in for an induction since I was barely mid-way through this pregnancy.

I am immensely grateful that the doctors are keeping an eye on me, but honestly it has taken some sorting out of all of the mistakes on my record.

Now, to read an article that lazily quotes "experts" and informs the public that British mothers are struggling with an unassisted, vaginal birth because they are old and fat is a slap in the face. Perhaps what they ought to be doing is writing articles encouraging women to empower themselves against intervention, like extolling the virtues of practices such as perineal preparation. [Buy an Epi-no, ladies, do it!]

I won't even comment on the fact that the journalist, described as their health policy editor, no less, feels the need to clarify that a caesarean section is a birth "in which the baby is delivered during an operation". OK, yes I will. Who exactly has this article been written for, four year olds‽

Already women in the west are pushed towards delaying or not having children, largely because of the need to establish a career to pay for the massive jump in house prices compared to even as recently as the 1990s. Let's make them feel even more shit about themselves if they dare to have a child over the age of 40.

Please do better, The Guardian.

This. Before the pill was available, late pregnancies were common. My dm had babies at 38, 42 and 44, and miscarriages at 40 and 45. That was in the 50s and early 60s

Its really pretty rare for someone to need a hysterectomy after a PPH. It isnt unusual for some midwives never to care for someone that goes on to need one for those reasons. It depends where you work.

Most in the hospital are stopped by the drugs that midwives carry to homebirths as well as prediction of who is at increased risk which comes with clinical knowledge and lived experience. The woman may need further care in theatre but they are out of danger. Very few people need literal life saving care in theatre. What they need in theatre is repair and complete removal of all placental tissue.

I take it you are a midwife?

I can’t comment from a medical point of view, but as a patient I was very reassured to be losing 2.9l of blood in theatre, with a big medical team around me, and all the facilities they could possibly need to deal with it.

@EarlGreywithLemon I'm sorry you went through that, it sounds absolutely terrifying. Glad you had a medical team you felt confident in x

I had a baby at 42. Came on due date, easy natural birth. The day before I was in the gym doing body combat. I appreciate that there are increased risks. They didn’t apply to me and I’m thankful for that. None of this is to say I wasn’t anxious. I’m 56 now, he’s 14. He also has autism. I’ve come across a lot of older parents who have had autistic children.

That’s very kind, thank you - it sounds like the same happened to you, so I’m so sorry. X

Luckily everyone was so calm and looked like they knew exactly what they were doing, so it wasn’t traumatic. I had the baby with me the whole time too. I think I would have felt very scared bleeding out at home and being whisked away in an ambulance though.

@EarlGreywithLemon thank you, but to be honest mine was much less serious, do technically a major PPG but not the same. Mine was only slightly over 1L and from the notes and the debrief it sounds like it was mostly due to my labia tearing. For various reasons I suspect it wouldn't have happened if I'd stayed at home, but either way it was under control pretty quickly.
The only thing I found traumatic about the birth was what the midwives in hospital did to me after I transferred, but that's another story x

You wouldn't have lost it in theatre. You'd have lost that in the room where they'd have stopped the active bleeding and taken you to theatre.

I did lose it in theatre.

My daughter’s heart rate was showing decelerations and I had some bleeding, I was taken to theatre, they got her out and then I had the PPH. The doctor at the time, and then the consultant at the debrief said it was likely I was having a placental abruption.

I’m so sorry to hear that. Xx

Okay i missed this, an abruption isnt a PPH, it is an APH. PPH means "post partum haemorrhage", or "after birth haemorrhage", an APH is a before birth haemorrhage. Your daughter wasn't born yet so it was an APH.

Abruptions and similar haemorrhages are often picked up on intermittent ausculation and basic palpation and transferred accordingly. In labour ward, we may take longer to recognise that there is a theatre worthy bleed than if at home or in the birth centre because we would recommend tranfer as soon as we felt something was wrong to get you on a CTG. In labour ward, you'd already be on a CTG, we wouldn't be as hands on with you, and we would likely take longer to see that you have symptoms of abruption. Why? Because people are stressed in Labour ward, yheg are of hugher risk and the machines don't always work properly, and so we are used to seeing abnormal CTGs.

We are not used to hearing weird heart rhythms at home. We are not used to the type of hard tummy one has once abrupting.

There's every chance that the first midwife who would have come to assess you at home would have felt a hard tummy, heard an abnormal heartbeat, and transferred you in from then.

The trend for later first time motherhood is a new one. Pre reliable contraception, women had babies until they couldn’t any more. My grandmother had three babies in her forties, and that was back in the fifties and sixties.

@LoftyRobin you sound like you have lots of experience and I'm always interested to learn general information, procedures, statistics etc about pregnancy and birth, so thank you.
But no amount of experience can tell you what happened to a particular woman in a particular situation given only a few basic facts and it's frankly irresponsible to pretend otherwise. Not to mention dismissive to pretend you know better than she does what happened to her.

I thought the significant factor was if it was your first child as an older mother, women have been having subsequent babies after 40 for ever. Also the increased risk of chromosomal abnormalities, but this risk can now be managed with nipt, abnormalities scans (which are mindblowingly detailed now and if necessary/ wanted TFMR.

This isn't OP first baby, so it does seem that she is attracting a lot of drama for a normal natural life event.

@LoftyRobin the theatre team called it a PPH - both my husband and I heard them call it out at the time. The order was - heart beat decelerations started - decelerations didn’t improve - taken to theatre - as we were taken to theatre the midwife noticed some bleeding - daughter out - team called out PPH - PPH treated, while I was holding my daughter.

I understand that you’re very pro home birth, which is totally within your rights. But that really wasn’t my experience of the labour ward at all. I had a midwife with me at all times, and she was paying pretty close attention. The doctor came in as soon as the CTG started showing decelerations. He scanned me twice to figure out the baby’s position. We had a discussion with the doctor and agreed to let me push for a bit. The decelerations didn’t improve so the doctor came in again. We had another discussion to agree the way forward - I asked for a C section, but the baby was very low so the risks were explained to me. I agreed to try instrumental while being prepped for section just in case. Etc. They were extremely hands on and I felt very very well looked after. It felt like a very well oiled machine.
In fact, reading through my notes at the debrief, the consultant said the team had done extremely well to spot the early signs and prevent a dangerous situation from developing. She asked me if I wanted them to receive a special commendation for it, which I did. I am extremely grateful to them for how good - and kind- they were, and I said so to her at the debrief.

I am pro women giving birth where they want. They said it wrong or you understood it wrong. You cant have a PPH when youre still pregnant
You can have an APH which becomes a PPH after birth and an APH is a risk factor for a PPH. It's important that you understand exactly what happened. You can request an obstetric debrief at any time to find out.

As I have already said - the PPH was called after my daughter was already born, though a small bit of bleeding was noticed as we were making our way to theatre. I was holding my daughter when my husband and I heard the team call “PPH, PPH” and watched the blood loss volume going up on the theatre white board to 2.9l. The doctor said afterwards “we think you were having a placental abruption”.

I did have an obstetric debrief with a consultant, and she reiterated both points: abruption, PPH. She said that due to the team’s vigilance with the CTG and decision to get our daughter out right away it was caught early - certainly before our daughter was affected.

I have since had two pregnancies (both ELCS) and both points were discussed at length with the consultants and anaesthetists when planning for said sections. As you probably know, once you’ve had an abruption you are more likely to have another than the general population. So we chose earlier delivery to the ensure I did not go into labour naturally, having balanced the pros and cons each way.

I don’t think three consultants, one doctor and two anaesthetic consultants are likely to have been using the wrong terminology, or misunderstood what happened.