please!! advice for my worried friend who is 20 weeks pregnant.

[mrsfossil]

I have a friend who is 20 wks pregnant and will be 40 in jan. Her consultant has just told her that she must now take asprin and they said she must be induced at 39 wks. All because of her age, because of the risk of still birth at 40? she has no medical probs, is a very slim size 10 and her baby is ok. She doesn't want to take the asprin and after having an induction with her 1st (very healthy baby) doesn't want an induction this time. I told her that she should get a 2nd opinion but her husband said that she must listen to the doc.

Ultimately it is her body and she has the right to follow or refuse medical advice.
What are he reasons for not wanting to take the aspirin?
There are plenty of women on here who have been taking it for various reasons throughout their pregnancies, I myself was on 50mg daily until 3 weeks due to raised BMI.

I take 75 mg soluble aspirin every day since I was 12 weeks and the consultant told me to. I'm 42 and 26+3.

I also have been told that I will only go to 39 weeks and then be induced.

I'm just taking the advice of the consultant.

I can understand the asprin if you have a problem with your blood, but if everything is normal then why thin your blood more. Doesn't it increase the risk of placenta abruption. She hasn't been given a good reason to be induced other than her age. But induction does increase chance of instrumental birth and/or C-section. Wouldn't that be very risky with very thin blood? Is there any way she could talk to someone else independly?

I wouldn't be concerned by the aspirin advice as this is now prescribed to those with risk factors for high blood pressure which can cause problems. I am on 75mg aspirin due to my age (41) and as I am carrying twins. As it is such a low dose the risks are tiny and the benefits to mother and baby far outweigh the risks in my view. However, there is more (official) information about this here: www.nice.org.uk/newsroom/news/HypertensionInPregnancy.jsp. I would be more concerned by the induction. Personally I would ask to discuss this further with a consultant as to what the risk actually is so she can make an informed decision. However, ultimately no one (not even her husband) can force her to have a procedure she is uncomfortable with. However, with all the facts she can then decide what is best for her and her baby. It also seems advice about inductions due to maternal age varies around the country. This is not something that was suggested to me aged 41 so I'm not sure where this advice is coming from as it's certainly not nationwide.

Why doesn't she want to take the aspirin? It's good for you.

Also, unfortunately the risk of stillbirth does go up with age, so her consultant is being very sensible. I think she should follow his/her advice.

Hi, I keep reading threads about women who will be 40 at due date and who are being offered (told) early induction.

I will be 40 & 3 mths when I'm due but have not heard a whisper of this.

I have a midwife appt tomorrow so am going to raise it, but it would be very helpful if you could tell me what health trust your friend is under?

Is it only recommended if you have other high risk indicators?

Regards placenta abruption my understanding is that high blood pressure which the aspirin is prescribed to prevent is more likely to cause placenta abruption than the aspirin itself. It's important to remember this is very low dose aspirin so the normal risks about taking aspirin in pregnancy do not necessarily apply. Personally in your friend's case as she is worried about this, and the induction I think the best thing would be to discuss the aspirin with her midwife, and ask for a referral to a different consultant to discuss the induction more thoroughly, including an outline of risks and benefits.

I'd also be unconcerned about the aspirin but very bothered about the suggested induction. I agree with jammie that she needs to discuss this further and that she can refuse any medical treatment she doesn't want.

thanks ladies, I will encourage her to ask questions. She hasn't got high blood pressure, or any other pregnancy problems. The consultant is just concerned that she will be 40??? she is under Birmingham health authority.

I'm on 150mg aspirin daily & due an early induction as per consultant advice as I lost my last baby at term due to a placenta that was dead.

This will be a huge part of the reason why the consultant is stating these as being required as there is research to say the older you are as a pregnant mum that the less the placenta can hold on for near the end no matter if you are a marathon runner or a couch potato.

It's up to your friend but I cannot fathom a reason why saying no to this advice is a good idea. Believe me!

What's the big deal- why doesnt she want to be induced? she'll probably end up induced at 41 weeks anyway- i would far rather be induced at 39 rather than 41!
also, not sure why she's so anti the aspirin either.
i think she needs to listen to the experts.
But, that said, a 2nd opinion is ALWAYS a good idea.

FWIW my 'very healthy very slim' friend who's 41 is having an elective section- she's just not taking any chances, and i think if i was that age i would to.

Why would your friend ignore the advice, it is not worth the risk.

I had my DS 4 weeks ago and had a c section at 39 weeks due to my age 42, I was also told to take aspirin which I must admit I didn't take as my previous pregnancies were fine and I'm fit and healthy so didn't see the need as the consultant admitted it was just a general thing for over forties and I had never had any previous issues.

I self-prescribed baby aspirin due to reading some research papers linking my crazy high bHCG levels at my NT screening with potential placenta issues later on.. and that there were better outcomes for those who took aspirin.

I told my consultant he just shrugged and said "if you like". It was really not an issue. There are such negligible reasons to not do it.. yes, there is the tiny increased risk of placental abruption but it seems there are other reasons for that not related to the actual aspirin.

Generally I think they like you to stop at 36 weeks or something though due to potential clotting issues at delivery.

I lost DC2 at 27 weeks and have been prescribed aspirin for this pregnancy to ensure the blood flow to the placenta is as healthy as possible.

The consultants know their field and will have seen many pregnancies with many different outcomes- I like tsw cannot imagine going against the advice of the consultant. It is just not worth it. I have sadly seen first hand that consultants want our babies to be healthy and born safely just as much as we do, their recommendations for medication/induction are not taken lightly.

I had my first baby the week I was 41, so the same age as your friend, and my second at 43. I was seen by a very experienced consultant at a top London teaching hospital and neither time was I told to take aspirin. Dd2 is now 6, so there may be new research out there, but really, 40 isn't ancient, she shouldn't need to be medicated unless something is actually wrong. Does she have a history of miscarriage or sticky blood?

I will be 40 plus 2 months when sproglet is born and no one has mentioned aspirin to me, or induction at 39 weeks .
I've had two previous children and never had blood pressure problems hopefully I won't this time either.

hellymelly the aspirin advice is based on NICE guidelines that came in in 2010 so after your DD2 was born.

strongecoffee You need two moderate risk factors to be advised to take aspirin so e.g over 40 and first pregnancy or over 40 and multiple pregnancy etc. It is listed on page 7 of the guidance here: www.nice.org.uk/nicemedia/live/13098/50416/50416.pdf if anyone is interested

Your friend doesn't need to do anything the consultant says - it's her pregnancy.

However, as others have indicated there are very good evidence based reasons for inductions at term - they help prevent still birth in older women. She needs to talk to her consultant about getting information about this - risks & benefits.

Not sure about the aspirin - I am 19w and 40 in January - but age is my only risk factor so don't think it would apply to me.