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.

Women have been having babies in their 40s since time began, because they can.
There are some extremely know it all posters here.
Go with the flow. What will be will be.
Many women have healthy babies well into their 40s, me included.
You are entitled to Maternity services via GP the same as younger women.
Talk it through with your DH.

Why be so sarcastic?

Women have been having babies in their 40s since time began, because they can.

And because if you get pregnant and carry to term it is within your natural childbearing age.

We have much better health and maternity care now, too. Mothers of 45 and their babies are probably at much less risk now than a 24 year old mother 100 years ago.

But now, it is about choice, so I would go with what you must want to do, OP.

Thanks for this, Destiny123. I didn’t know that.
I’m not in the UK, test is done in most cases here.

No, of course not. But I’d hope they’d know how to find them/the right direction to point someone in.

I think you also need to consider the position your GP is in medicolegally.

All the general statistics (rates of miscarriage etc you could find online). Specific stats relating your medical history are trickier but again, not impossible to find (presuming you mean things like what is my risk of x condition/complication if I already have y). Problem is risk is a population measure and it’s incredibly difficult to apply it to an individual. Somebody always has to be the unlucky 1 in 10,000 just as we see people all the time who confound all risk stratification. An obstetrician might be better placed to advise but even then I imagine they’ll be reluctant to get into specifics.

Given the spina bifida case recently where a retired GP was successfully sued for not documenting that they’d advised folic acid supplementation in a consultation 30 odd years previously (despite the child/now adult ultimately having a form of the condition not related to folate deficiency) I can see why GPs are cautious about antenatal advice. They may be worried about a complaint that if they say 90% of people won’t have this condition and you’re then in the 10% that do you’ll complain/sue then claiming you’d have acted differently if not for their advice. Clinical practice has become increasingly defensive.

My husband is in his 50's. If we manage to have another child he has voluntarily agree to get the snip. Your husband should too.

I think the GP was wise to be neutral.

An unexpectedly pregnant older female who has had three successful pregnancies who visits a GP for advice is clearly considering her options whether to proceed or terminate. This puts him in an awkward position

I think you need to take a couple of days to process the information, get some advice and experiences from people here and use google to estimate the risks.

I got pregnant unexpectedly at almost 43. I miscarried at 15 weeks and it was awful. No one knows the risk of an individual to miscarriage but on age it's quite high at your age. The further along you get the worse the miscarriage is. After you have told people you are pregnant it's dreadful having to tell them you miscarriied. Only you and your DH can decide if you want this baby or not. Good luck either way but if you don't want it an early abortion would be less distressing.

I don't think GPS really deal with pregnancies. When I was first pregnant I went to see my GP and he assumed I did want to keep it. When I made it clear I did he referred me to the midwife. The second time I went straight to the midwife!

Not read whole thread but I think you want the GP to decide for you- which they can't do. This could be a desperately wanted miracle late in life baby and they would be massively insensitive to tell you to terminate.

You need to decide what you want to do. I'm sure whatever you do will be what is best for you and your family.

Id see a woman GP OP.

This would be exactly my advice. It might feel like you’re jumping the gun to go to a service that offers terminations but it’s their bread and butter to offer consultation and counselling around unplanned pregnancy. I have a friend who had a surprise baby at 45 and all was and is well but the anxiety of being older is also definitely present.

Also, just to say (in case it’s what you want to hear please discard if not!) not wanting another baby is ample reason to terminate alone. It feels a bit like you’re looking for a reason to justify your ambivalence… wishing you well with whatever conclusion you come to x

Maternity is the correct place to go, though. You need to talk to a midwife and an obstetrician.

A GP is a general practitioner, they won't be able to pull these statistics out of thin air unless they have a special interest - some do, but not all.

He sent you to the right place - contact the maternity service.

I don’t think this is helpful, the odd aren’t stacked against older mothers, yes there is a higher risk of miscarriage c 40/50% but that isn’t the odds stacked against you, that would be a 70% chance of miscarrying.

1 in 30 risk of DS isn’t the odds stacked against you, it’s a risk of roughly 3% of DS which means 97% chance of no DS. Yes it’s higher than if she was younger.

there are higher risks as you age but it’s not a forgone conclusion

As a 44 year old first time mum, I was told they don't use the term geriatric anymore, if that helps at all :-)
My midwife told me that some results might mean more tests because age is part of the calculations, but her experience was that all pregnancies have risks and age alone isn't as big a factor. Thankfully my son, now 3, is healthy. I did have (diet controlled) gestational diabetes but I was prone to that due to pcos, so that might not have been age related in my case. When we were close to due date, they kept a close eye on my fluids, and let me go past my due date initially before inducing
Good luck with whatever you decide.

Thank you.
I'm enjoying reading positive examples. And glad to hear 'geriatric' is no longer in use haha.

Thanks to everyone who's contributed to this thread. It's made a difficult day a little easier to navigate.

There was a thread not so long ago where a concerned mum was shredded for using google instead of going to see her GP. You can’t win on MN.

Best of luck OP.
I have two friends with very geriatric pregnancies (48 and 49) and both had the lovely boys they wanted (not entirely without complications - but those weren't age related). These were both people without children before.
Also have friends who felt they couldn't go through with it - people with children.
This seems to make a difference.
I hope you are able to consider and come to terms with whatever choice you make. Best wishes.

I am 60 with teens. I love them to bits but I wouldn't recommend it and nor would my friends.
We are all fit and healthy but we are old.
Our children are thankfully well, healthy and great kids, but still think we are too old.

I didn't think that when I was 45.
Your husband is a lot older than mine was too.
Things can change so quickly.
I wouldn't risk it.
Focus on the children you have.

Yes, that is definitely a point of view I'm considering.
Part of the shock was precisely thinking about my eldest (25) and his longterm partner (26) recently discussing children. I've basically been switching to grandma mode! And somehow this situation makes me feel I'd be stealing energy away from my role as their supportive nan...

You will find a huge difference between being pregnant at 20 and 45.

If your pregnancy doesn't go ahead, FGS get your contraception sorted.

I assume you were using the 'rhythm method' which is an accident waiting to happen.

@StandFirm I don’t know if anyone has mentioned Tommys which has a lot of research based information on pregnancy and a helpline as well if you want to discuss your situation. They won’t have all the answers because nobody does but it’s an excellent resource.

Best wishes

I was 41 when I had my daughter, the risk of down syndrome was 1 in 65, 1 in 2 after the nuchal fold scan at 13 weeks. Health wise I had a back issue which pregnancy really didn't help but other than that it was ok, she's 18 now all good.