45 and unexpectedly pregnant - GP less than helpful, am I harsh?

[StandFirm]

Bit of a shock this morning! We truly thought this was not on the cards and we had been very careful (well, obviously not enough). I can't take hormonal contraception and frankly pregnancies are always complicated for me. DH is older than me as well making this whole thing is even more of a surprise. Irony was that I had an appointment booked to discuss sterilisation as my cycles were always extremely reliable up until now but I've been worried about perimenopause making that method unreliable. Nature got me first.
Beyond the practicalities - I work for myself so on the one hand I have autonomy, on the other it's brutal chasing up clients at the best of times - I am really concerned about the health risks to the baby of course but also to my own health. We still have a young child (elder two are adults, one of whom is self-sufficient) so I have that to consider. I don't want to be reckless with my health and so I went to the GP to get the facts. All I got was 'it's your choice'. Not what I was asking! I need to know the likelihood of miscarrying (again, I did once after our third, and I was younger) and the full facts on the implications on my own health. Again, all I got was: things can go well, no one can tell anything and no one will tell you to terminate because you're 45. That was not my question. I'm clear it's my choice, but I thought his job was to give me the medical facts. Is there a reason why he would have been so unhelpful? I got out of the appointment absolutely none the wiser and just as anxious as before. I've self-referred to my local maternity but are GPs not qualified to give pregnancy facts? He didn't even test to make sure it was correct.

I guess the gp can’t give you an answer. A midwife may be more useful to answer. I think the only thing you can do is firstly consider how you want your life to be going forward. If you move forward with the pregnancy take a day at a time. I think most people would be equally shocked and take time to make the decision.

Another GP voice to say we’re not trained in early pregnancy counselling, beyond a very rough approximation of miscarriage and downs risk by age. It’s possible the GP thought you were there to ask for referral for a termination and was a bit wrong-footed when you wanted stats which he didn’t feel equipped to provide.
I don’t think it’s reasonable to expect the GP to assess your individualised risk. By age you have about a 50% risk, it’s not reasonable to expect a generalist to guesstimate a number factoring your previous miscarriage, advanced age of father, possibly conceived at a non ideal time in your cycle.
Also you’re aware of the pregnancy at a time most women wouldn’t know they’re pregnant - lots of estimations of miscarriage risk don’t take into account losses around 4 weeks as historically women would not know they were pregnant as early as we do now. You will see a midwife and an obstetrician in due course if the pregnancy continues. I know it’s not what you want to hear but if you want more expertise sooner I think you’re really looking at private obstetrician territory.
I really do appreciate the feeling of wanting to be in control. Tommy’s is a good resource I have signposted patients towards since having my own pregnancies you might find it helpful.

How did it all turn out in the end?? Or are you pregnant still?

@tipsyfairyhichichic hopefully doctors are using a specialist medical AI program for which they pay a subscription, if there is such a thing. We use one in my industry (accounting). Just typing something into a free AI thing and hoping for an accurate response would result in any old nonsense.

A third c section could also come with risks which will be elevated due to your age. Being brutally honest I would not want to be recovering from a section at 45 especially with other DC.

@StandFirm I was much older than average in my last pregnancy. I had a terrible first pregnancy so I called my GP and she was lovely but also non committal. I’m not sure what I expected really, obviously she couldn’t decide for me.

I ultimately had the Panorama test- really thorough genetic test which you can do at 9 weeks and it’s accurate. It gets sent to America but I got the results back within about 10 days. All was well and baby was born without any conditions (as predicted).

Sounds like a really tough time for you OP. I understand your frustration, I would be the same as you need to make a balanced decision and in order to do that you need fact and details. I was absolutely recommended never to get pregnant again after my last child, due to c section complications. However our last child ( a surprise ) has Autism and life is a very hard slog on a daily basis and I’m still a bit younger than you and I am wreaked. I worry who will support my child as I age and they will likely still have support needs. Recently a friend of mine with 3 kids including teenagers said she was considering a fourth and honestly I was like why would you take the risk, stats associated with additional needs are higher for older mothers. I say this gently as life could look very different than anticipated for you. there are so many factors that could result in a risk to yourself and the baby and ultimately your wider family unit. I hope you get some sound advice and able to navigate this in partnership with your husband.

OP, in all honesty, you're being unreasonable. I know this is a stressful time and it's a choice you need to make as soon as possible, but no GP is going to be able to consult their crystal ball and tell you how likely you are to have a 'healthy' baby. (My second, born at 38, is severely autistic but very robust and healthy...) This isn't a GP's job, as others have said you will get a better risk level just by doing some googling, and in any case everyone's risk levels are different. There are so many variables.

From what you've said, if your work life is this busy, do you have room in your life for a new baby anyway? I don't imagine that doing your job while pregnant is going to be dangerous for your unborn child (how many women have to continue very stressful or busy jobs while pregnant??) but will you be able to just stop when the baby's born?

You will be consultant led so they take extra care, extra appointments and sometimes extra scans.
My mum had my brother when she was 44.5, he's hard work, he has High functioning autism and ADHD... but so do i and she had me when she was just about to turn 19! So i dont think age is as much of a factor as they make out. Most of my siblings and nieces and nephews are diagnosed one or both too.
When my brother was born i was 24/25. He is now 13 🙂 I am the oldest of us 5 and he's the youngest. The only thing that it did mean is that shes not been able to be the grandma ide hoped she'd be to my kids, as my brother takes up alot of her time and attention. Unrelated i guess but he got diagnosed with type 1 diabetes at the beginning of this year and thats been a whirlwind to contend with with a teen.

Its a hard one to weigh up really, if i was in your position i dont know what ide do tbh. I dont think i could have an abortion but at the same time personally ive already ended up with 3 c sections and the last 2 times, theres been complications.
You dont say if you are generally in good shape health wise? Thats definitely a factor and also what about previous pregnancies/births? Like how did they go? My pregnancies were generally smooth but the births went diabolically 😥. If you're one of those people that breeze through it all then that would make me want to say go for it if you feel like you want to. At the end of the day nobody has a crystal ball unfortunately. My heart would love more but my mind and body say TF no!! And im just turned 38 😆. My youngest is about to be 3.

Get another GP. He's hopeless..

Sorry for not responding sooner. I didn't mention how things turned out because I wouldn't want to upset you. Unfortunately we had some bad news at the 12 week scan and I was being quite stubborn. I miscarried spontaneously at fourteen weeks after some horrific bleeding and was quite unwell. I'd had three miscarriages in my twenties and they had been very straightforward in comparison.

Up until 14 weeks I hadn't felt that my age made a difference to my health in pregnancy. I'd had hypertension and gestational diabetes in my full term pregnancies. They hadn't recurred in those14 weeks. I had the usual morning sickness and fatigue, but I don't think I felt much older or less fit than I did in my 30s. I think it's being a Mum to a teenager in my 60s that I would find really hard. I would also have been providing a lot of hands on elder care at a time when my daughter would have been quite small.

Get an OBGYN?
I don't think the OP is in America.

A friend of mine found herself unexpectedly pregnant at 45, when she’d just started her nursing degree, as her children were independent. She was prepared to give up nursing and have the baby, but unfortunately it was found to have problems incompatible with life, so she had an abortion. She was so upset when her milk came in.

Sometimes, I feel as though GPs are damned if they do, damned if they don't.
They're castigated if presenting too much medical info and not appearing human enough, then vilified for not presenting enough stats.
Someone said above they don't refer to geriatric pregnancies anymore: they absolutely do. I had my DC in 2018 and it absolutely was referred to as a geriatric pregnancy.
From my experience as a 39 year old - then - who had twins with a Dad in their 50s (twins are now 7 and Dad is 60): don't.

the GP is right. It is your decision from here on
Do your blood tests, all this and good luck

If you want an opinion, I wouldn’t do it if I were you. If my children were mid 20s and husband even older.

But over the next few weeks you may find the decision is out of your hands.

Unfortunately, because the society we live in has become so litigious, your GP will have had to give you information in the most neutral way possible. There are so many variables to what you’re asking that there are few straight answer - they simply couldn’t win.

The facts are out there, but only you can make the decisions - your GP can’t safely counsel you through this in a 10 minute appointment.

No, you're not harsh—you're just overwhelmed and need support

@RafaFan You're rather naive.
GPs have been using google for years.

Look at all the posers here who said the GP would have had to do some research before he could answer OP re. her risks.

What do you think he'd use?

AI is very sophisticated. Amazingly, the content is provided through AI accessing medical research and everything out there on the web.
It's often more reliable than an out of date GP.

Midwife here: unfortunately healthcare professionals are between a rock and a hard place when it comes to situations like these. If you want hard facts, you can look up the statistics or you could ask your NHS trust or pay privately for the Harmony test to get a realistic expectation of some major congenital conditions. But you can’t test for everything, no one can. Unfortunately, a child with a mum in her late 40s and her dad in mid-late 50s has a very high chance of some conditions. Some women will want to hear this, others won’t. Google will give you many facts if you stick to reputable papers (NICE, RCOG). Just be aware you might not like what you read and not everything is predictable/forseeable. In the end, everyone takes a chance when having a child, it’s just some people play a riskier game than others and you have to consider what your appetite for risk is. Good luck.

If you want an example of misogyny in women’s health provision then all the posters telling op she should have used ChatGPT or Google instead of ‘waisting’ the time of an actual healthcare professional is a shining one.

It might be fair to say something like, check if the GP surgery has a family planning drop in or contact the early pregnancy team. But really, the GP should be able to offer general advice about things like this.

I realise your pregnancy was a shock, but your GP can't advise you to continue the pregnancy or not. You know the chance of Downs etc at your age, it is your call. I suspect your GP may feel it's not appropriate for him to help you make the decision.

If he said there was a high chance of sever disability, you could terminate and discover there were no abnormalities - is it his fault then?

It sound as though you're looking for a reason to terminate on medical grounds. I totally understand this - I had an unplanned pregnancy, and keeping or terminating was a huge decision for me, and I'm pro-choice.

You don't need an excuese to terminate other than you don't want to add to your family. I think you should speak to a pregnancy counsellor.

It’s not just the health risks, what sort of life do you want. You have done quite a bit of motherhood. It’s never over as such but do you fancy having a 10 year old at 55?

The vasectomy part i dont understand why he didnt already have it done if they were done having kids and OP cant take contraceptives. My hubby put himself forward after our last baby, ive done my bit of taking hormones etc and he didnt want any more kids. It was the logical route.

My mum had my brother at 44 and i was 24. He was planned but she had 13 miscarriages in a row (all before 12 weeks) before he hung in there and made it so obviously she aged in the process and was older than she had hoped she would be. Things happen out of human control sometimes.