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.

What are my personal risks of developing pre-eclampsia, DVT, gestational diabetes and of course, i know about the 10 week genetic test to screen certain conditions. DH is in his 50s

They’re not specialists and won’t be going through your medical history ti work out specialist advice on a geriatric pregnancy. The most you’ll get is generic stats, but even that isn’t their job.

All the information is available online through the NHS or pregnancy charities. Make the decision on that. No one can guess how your pregnancy will go.

@standfirm 50’s that gives a 10 year window so I am guessing he is nearer 60 than 50.

Answer this if you could guarantee a healthy baby and pregnancy do you both want this baby?

Then I wonder why I got an appointment in the first place because it was a waste of time. I made it clear that I wanted to discuss this very question. Never mind.

He would and I am genuinely on the fence.

Which is why I don't want to make an emotional decision. I want it to be as rational as possible.

If health is guaranteed (hypothetically) why are you on the fence? What are your reasons?

I suppose I'm in shock. I can't answer that today. It just feels off this time but it could be down to a number of things.

I totally understand why you wanted to get more personalized and holistic information from your GP than just googling it. And he should have been able to give you some basic information and outline the most common/serious outcomes.

However, there are so many risk factors involved in pregnancy and so many potential complications for both mother and baby (some common, some very rare and massively varying in severity) that it’s almost impossible for him to give you anything more than a brief overview in a 10 minute appointment.

If you decide to continue the pregnancy then you’re like to be referred to an obstetrician who can answer your questions in more detail (although they still won’t be able to offer any guarantees). You can also have the NIPT screening from 10 weeks which is pretty accurate at picking up some generic conditions (although it doesn’t test for everything).

I know it’s a tough decision and you want as much information as possible to help make your choice, so I understand why you felt frustrated.

For the kind of information you want the GP really isn’t the best place and I agree with others you could find a lot of this out online. If you wanted specific information on every potential risk personally measured that is a private healthcare thing- not something a GP would do in a 10 minute appointment.

@StandFirm you do need to remember that abortion is one of the few areas in health that family dr‘s can conscientiously object to facilitating ( they should direct you to another dr if so) .If you go purely by stats rather a lot of us might

choose not to try and conceive in our 40’s… but then many of us would not have our children! I have previously worked in a community area with a GP whose own beliefs meant they avoided things to do with DNR orders which caused issues as I worked for a hospice!. Not saying that this is why in this instance but I can imagine GP’s need to be very careful of not saying anything that may sway your decision either way. Often the best thing to do is an e-consultation…write down exactly what questions you need answered, this gives a dr time to respond. You don’t need to have stats , or indeed justify your reasons, to back up a decision to choose to abort an unplanned pregnancy in your mid 40’s (if that’s what psychologically is on your mind.) Sending hugs, I’m sure it’s been a big shock.

@ByBlueLion and @MumbleJumble123 thank you both for your kind considered response

I was wondering this reading your previous, I think it sounds like you're understandably in shock, and you're trying to get some "facts" so you can control the situation and make the right decision.

All anyone can tell you is that there is an increased risk of xyz, and some statistics, not what will happen to you. The GP doesn't have the answers you're looking for. If the GP had given you hard stats about all the possible outcomes ie 1:4 chance of X happening, are you in a better position to make a decision? They absolutely can't be seen to be influencing your decision at this point, surely that isn't ethical.

Sleep on it. I think this is going to have to be a heart decision rather than a head one, and you'll have at accept that if you go ahead this is going to be one you can't control.

Yes, that is right: information is power. Even if he couldn't tell me that's what would happen to me, I was after hard truths so to speak.

Unfortunately, nobody can tell you that. Of course the odds are more stacked against you but nobody can tell you which way it will go. Even a professional can only give you the odds, which obviously will not be in your favour as much as somebody maybe 10 years younger, but there are risks at any age of pregnancy. The bottom line is whether you want to take the risk or not.

If he couldn’t give the answer, he should have steered you to somewhere with those stats. Check if you can find anything on NHS or NICE and then move to major hospital MFM sites. Don’t ask ChatGPT or do a blind google

But you are hardly ever going to get 'hard truths' in a medical diagnosis situation. All medics can do is give you probabilities based on previous similar situations.

I have a duty to my other kids first and foremost. It's about them too. Just like I wouldn't pick up a really dangerous hobby, my priority is to be looking after them and to look after myself (so that I can look after them). I am really having a bad case of health anxiety here.

Any HCP can only advise you of the risks , they will not really be able to tell you definitively what will happen, they can obviously look at your past medical history and look at statistics but they will never say, it will or won't be ok.
My mum had a consultation for an operation and the surgeon (obviously) wouldn't say it would definitely be successful, it was all just about possible risk and possible outcomes.

I don't think you could expect anything else from your GP. The doctor won't know how likely you are to miscarry. You presumably know how fit and healthy you are and, most of all, how capable you feel about doing the parenting stuff from scratch all over again. Nobody can really advise you about this. What does your husband think?

I'm sorry this has happened, can understand it is a shock. I wish you good luck whatever you decide.

I would still call that hard truths - even if they're not absolutes. I understand how stats work. He did not give me ANY info at all.

Sorry OP I can’t give you facts, but I can empathise as I was in your situation at age 46, meaning I would have been 47 when I gave birth. And had what I considered at the time to be an equally unhelpful experience with a GP.
I think unless it’s happened to you personally it’s hard to understand the level of shock and indecision about how to proceed that this can cause at our age. Wider external agency support / research is lacking here I feel. I remember desperately scouring the internet for help or answers.
We have 1 dc (complications in pregnancy but all fine now) and previous to that I’d had 1 miscarriage.
I’m fit and healthy, but for us we decided not to go ahead with the pregnancy because of the higher risks of having a child with needs we couldn’t cope with & the knock-on effect of that to our lives & family as it is now, of jeopardising my future health (also take into account advancing years, menopause etc which can turn things upside down), & the financial impacts. This decision was probably also coloured for us by a very scary and negative experience we had when I was pregnant with our dc.
It was one of the hardest decisions we’ve ever made but looking back on events that have happened in our lives since and taking into consideration how tired I sometimes feel aged 48 with a 6 year old, and how I appreciate having some level of my own life back now that baby / toddler years are over, it was the right one for us.
All the best for however this proceeds for you x

My experience is that gps don’t really get involved in anything pregnancy related these days. You would be better off referring yourself to a midwife and seeing if you can get answers that way. I had a pre-booking appointment at 6 weeks for my latest pregnancy.

I would look into a NIPT test, you’ll have to pay but will give you more reassurance than the NHS combined screening which is almost bound to come out high chance given your age.

Yes, and that's what I was after. Nothing more.

I think that's a conversation more appropriate to be had with your midwife after your scan to be honest.

Book a private scan. Pay for a genetic test (can't remember what they're called but I had it i think at 9 or 10 weeks). Take it from there.