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 was almost 45 when i had my only child - I declined all tests apart from the usual scans as I knew I wouldn’t terminate. I was very fortunate that all was fine. I have had no problems coping despite my age and being a solo parent. I wish you well whatever decision you make

They probably can’t give you a personalised risk for things like pre-eclampsia, but they can help you mitigate the risk. I’m 42 (nearly 43) and currently pregnant with 2 MCs in the last 3 years behind me. When I called up the community MW to chase up my booking appt I was immediately given a prescription for baby aspirin and high strength folic acid, which I think are to combat risk of pre-eclampsia. I already have a daughter with Down’s syndrome (conceived when I was 32) so I was parachuted straight to the NIPT without needing to have the Combined Test result first - and it came back low chance for everything. They still anted me to have the Combined Test though because it also tests Papp A levels, which if low can be a pre-eclampsia risk. I’ve also been told I’ll have extra growth scans and will be offered an induction if I go past 40 weeks, so rest assured, dinosaurs like us are well monitored.

Health wise this pregnancy has been a breeze so far! No nausea, just tiredness!

Just to add I’m 13 weeks, so one trimester down!

We don't

Another GP isn’t the answer, read posts from GPs on the thread. They can’t give personalised risk and it will only be as robust as info easily accessible anyway.

The op can look to better sources of info, which have been mentioned.

Not what you’re asking but there’s no way I’d have a baby at 45 with a father in his 50s. Your health may be fine now - mine was - but I developed health issues around age 49 which would have severely impacted my ability to to parent a young child effectively. I also think your DH is far too old.

But hopefully, as medical professionals, you recognise when something AI comes up with is wrong. The layman would not necessarily know.

I KNOW the free AI responses that come up when you type a query into Google get things wrong, from tests I have done on it based on my field of expertise. This was in response to receiving some total nonsense in an assignment from a student.

This is the point I was making - that Dr Google and AI are not reliable sources of information, if the reader doesn't have the expertise to interpret it.

Apart from anything else, in the OP's case, a human interaction with a relevant professional, which the GP could help her find, would be much more helpful than random, often contradictory, "facts" pulled up by Google.

You can't let it drop can you?

The things the OP wanted to know were easily available online and for example on maternity sites like Tommy or even the NHS.

True. But I still think a GP who has more empathy would be better. Reminds me of years ago when I saw a male GP for advice about menstrual problems. I remember sitting there wondering why I'd even bothered to make rhe appointment as he clearly had no clue about menstruation from the way he was talking. GPs can't di everything. I do get that. But I always think a really skilled GP can make you feel a bit better after the appointment even if they can't solve the problem.

I get it I'm younger but there are certain things in my history that my odds for various scenarios that put me at higher risk.
The risk of postpartum psychosis is 1 in 1000 but because of my history for me it's 1 in 2. Due to family history, despite no other risk factors for clotting, I'm at risk of a stroke or heart attack in the post partum period.
If I was to find myself pregnant at 45 I'd want to know what my age would add to those risks and if there's anything else I need to consider. Unfortunately it's not the GP that can give you the answers
I'm under 2 obstetricians one for my mental health and one for management of risks associated with medication I take and my family history. I had appointments with them to get an understanding of the risks in this pregnancy, what tests they can run and what I need to consider. Even they didn't have all the answers on the day of the appointment. My family history of clotting is interesting so she wasn't sure what could be done in pregnancy or afterwards to mitigate this risk so went away to discuss it with other professionals. They have come back with there's no monitoring in pregnancy that could determine my post partum risk so the plan is to watch and see but it has been noted that it's a risk for me.

Medicine is so much more nuanced than the stats and it is so frustrating especially when you are trying to make these huge decisions. I'd try to make contact with the midwife early and get a referral for obstetrics to discuss your pregnancy and your history so you can gather as much information as possible.

My nan had her youngest at 45. My uncles girlfriend was actually pregnant at the same time although she terminated so very much a sliding doors moment between being a new parent Vs new grandmother. There's 21 years between my auntie and my dad and she's 5 years older than me and 2 years younger than my sister. We grew up as a blended generation family and for us it worked my auntie was more of a cousin to me. My nan did at times struggle with juggling the role of parent and grandmother but my parents supported her as they had a child of similar age going through similar things - they were even at the same school!

@tipsyfairyhichichic whatever...I wasn't even replying to you. If you would be happy making such an important, potentially life-changing decision based on stuff you read on websites good for you. As another poster said, in real life it's much more nuanced, no two cases are the same. I have been there, and there was no way I would have got all the information I needed to make an informed decision from websites. I was lucky enough to be able to access the right support.

Which was? A test?

By the sound of it OP works, she pays her National insurance contributions, she has every right to see a GP (if & when she can get an appointment).
I get they’re ‘general’ and may not of been able to give her the information she needed but at least show some empathy and guide and refer her to places or people that may help with facts.

The GP doesn’t specialise in obstetrics so they likely don’t know the facts. As a high risk pregnancy you will be under a consultant who can discuss all this with you but you would generally see them a little later in pregnancy 12 weeks + depending on individual risk factors.

Me too.. lasted less than a week.

I had my first via ICSI at 40. My second was a happy accident at 42. I'm not sure how much higher your risks are 3 years older. The pregnancy with my second was actualyy much easier than the first even though im older. However, the eldest has suspected autism and I wouldn't be surprised if the youngest has it too.

Realistically, you need to decide if you want another baby and if you are prepared to the the risk. You have other kids. If something happened to you would potentially putting them in a caring role.

TBH, I worry about dying and leaving my kids. I have a heart condition and some other health issues. I worry about making it to see the children reach adulthood this has been compounded several recent deaths in my friendship group. I've lost 3 friends this year they were all under 50 and all died of natural causes.

You might be healthy as an ox and wealthy enough to provide for a child in event of your death. When I had my kids I wasn't even considering that. If I die my kids won't have a pot to piss in and will have to rely on the love and kindness of relatives.

NIPT tests are great in these scenarios. Get one privately as soon as you can. Think the earliest is around 10 and

10 weeks

I took a little break from posting yesterday and am actually feeling much calmer now that the initial shock has worn off. I do need to weigh the pros and cons. This is not the first time I've had a pregnancy in less than ideal circumstances. My first was conceived at 19 when I was at uni and everyone was telling me I was throwing my life away. My gut back then was 100% to ignore them and I'm so glad because although it was very hard and we were skint and I didn't sleep for years, I look back on those years with so much fondness - and things did work out well for us. The challenges were different- this time it's not about material considerations. Sure, I'm self employed, which comes with a lack of protection but at the same time I don't have a boss who could shaft me when I'm on mat leave! It's also up to me to do as much or as little with the clients who've known me decades in my industry. It's so competitive right now, I'd rather not step back and let others steal the business but I'll cross that bridge when I get to it. DH is in work, in a stable position (as good as this gets) and he's already said he would switch to a four or even three-day week so we could spread the load. It would be less money overall but much kinder on us all. As for the older kids, our eldest DD is 18 and still some way from being financially self-sufficient but our 25 year old has started a good career and if anything were to happen to us, he would hopefully be in a position to provide that safety net. However, I don't want to put him in that situation without getting his take. I am wondering how we could have that conversation with him without sounding like we're foisting the decision onto him (we're not) but it would be good to know what he thinks as he has a stake in this (his sisters too but they are much younger, especially the little one). As before, my main concern remains the health risks for the baby and myself. I have already booked the early genetic scan. I think I need to 'relax' until then. And possibly nature will decide for us as it did last time - which was heartbreaking. I guess I'm more prepared for and accepting of that outcome this time around.
The snip for one of us is a high priority as well!
Thanks again for all the thoughtful responses.

Just want to say good luck, I'm in the same boat as you though this is our first baby after many gruelling years of treatment. People on MN can be so quick to say don't do it, etc but the baby is here, comments like that are so unhelpful.

Best of luck to you too!

Also, in terms of the lifestyle: my entire adult life I've worked and raised a family. I actually like being a mum. Even though I work hard, I also have a very nurturing streak. It's a lifestyle that I'm not worried about taking into my retirement - however I do realise that this has relied on me having vast amounts of energy (and again, we're back to the health question: will this last another 18 years or so)

When I requested a NIPT through my midwife (because I imagine that a combination of my age and history means that a high chance combined test would be pretty much guaranteed) and was referred to the screening midwife team they booked me in for an early scan so they could guarantee they took the test at the right time, so that ended up being a nice bonus - and huge relief, both at that scan (8+5) and my 12 week scan to see a little baby and a heartbeat. I am starting to believe it more now, particularly as we’ve told the kids, and we’re starting to think forward more to the actual baby rather than thinking the worst…

You’d be hugely unreasonable to seek any views/promises from your eldest DC about supporting a possible future sibling (with or without additional needs)!

I agree with this!! If you can’t afford another child it’s not a good idea.