What it's like being pregnant at 45.
GO DIRECTLY TO THE LABOUR WARD. DO NOT GO TO THE BIRTH CENTRE. DO NOT PASS GO, DO NOT COLLECT £200. That's just a flavour of how I felt about the advice I received during my pregnancy.
So... according to the pregnancy universe, any pregnant woman over the age of 35 is considered 'geriatric' so, pregnant with my first baby (but not my first pregnancy) at 44-45 years of age (cue gasp), I wondered whether there was a 'really geriatric' box I could tick.
Before getting pregnant (knowing I was undertaking donor conception) I considered myself to be at my fittest. I ran three times a week, barely drank, didn't smoke, ate well and was vigilant about taking my pre-conception vitamins. So, when I finally got the good news that I was pregnant, I decided that I would continue my efforts to stay healthy; I was no spring chicken and pregnancy is, well....., it's hard!
I'm lucky - I have good genes - so people are surprised when I tell them my age. And it was no different for every midwife and consultant I saw. "I was expecting a much older-looking woman" said one consultant who was preparing to review my latest scan. Throughout my pregnancy, I'd had all the routine tests (and more) and, every time, my results were "very good" - no sign of gestational diabetes, bloodwork all looking great etc. etc. I was presenting in line with a much younger woman; AND as soon as I hit the second trimester, I was feeling fine and full of beans. So WHY THEN, did I have the same conversation over and over again about my 'advanced maternal age'? It was like every medic ignored the person they saw in front of them and just talked to my age on paper. I knew that a home birth would be an absolute no-no for me and, to be honest, I felt it was a step too far for me anyway. But my maternity hospital has a state-of-the-art birth centre - complete with pools and every birthing gadget designed to make having a baby as zen-like as possible. I wanted that!
From my very first midwife appointment I was told that due to my advanced maternal age I was considered high risk. I would, most likely, be advised to give birth in the labour ward and that I would 100% need to be induced at 40 weeks as there's a higher risk of going full term at my age, because the placenta in older women can be less effective. Being induced meant the only option was going to the labour ward - whereas if I went into labour naturally, I'd have a shout at being accepted into the Birth Centre. "OK, I get that", I said at every appointment, "but can we see how my pregnancy progresses and how I am before making any decisions?".
At pregnancy yoga and NCT classes (talking of which, I was worried I'd be twice the age of my NCT cohort - yes I am the oldest but it doesn't matter - we are all first-time mums which is plenty in common!), it was drummed into us all - we have the power to choose how we give birth. When I shared my updates each week, regarding how I was being advised and how I felt that no-one was listening to me, it was always greeted with the same response: "don't let anyone push you into something you don't want"... "you tell them how you want to give birth and let them help you achieve it". Easier said than done but I was determined that I wanted to have some say in my birth choices. So, at every appointment, I continued to fight the good fight.
I'm lucky in that, because of my ancientness, I had scans and consultant reviews every 4 weeks of my pregnancy (yay for being ancient as it was so reassuring to see baby regularly!) and, at each review, we had the same conversation. Some of the consultants were more open to the Birth Centre option for me - but all of them agreed that I should be induced early. I stood firm - I wanted to see how things progressed before committing to anything.
Then, at my 36 week scan, there was a concern that baby was already huge. It was measuring above average and was already an estimated weight of 6lb 13oz. OUCH!! So, at that review appointment, the nice doctor explained to me that, given baby's weight, they would like to induce at 39 weeks. Again, I explained that I didn't want to be induced if I could avoid it - but I understood the risks (and was a bit freaked out by baby's size!) so would take the advice I was given. The consultant was extremely understanding (although made a very barbed comment... "what you hear at NCT and other places is one thing but they are not medical experts...") and he agreed a compromise: he booked me in for a sweep at 38 weeks to see if we could help labour start naturally - but, if it didn't, I would come in for induction at 39 weeks. He also advised me to adapt my birth plan - to request that if I was induced, I wanted as 'unmedicalised' an experience as possible and that any interventions would be discussed with me to give me clear pros/cons to inform my decisions. "OK, it's a deal" said I - feeling that finally someone was listening to me - but also accepting that the doctors are medical experts and, ultimately, the health and wellbeing of my baby was my number one priority.
As it happened, my waters broke at dead on 37 weeks - but contractions didn't start naturally - so I was induced in the labour ward. I laugh now as I look back on the experience. As we were driving to the hospital, I was busy scribbling on my birth plan "I'd like an unmedicalised experience"..... as it happened, I ended up having an extremely medicalised experience! I went straight on the hormone drip. Twelve hours later, I was only 1cm and in a lot of pain - I'd been resisting the epidural, but now it was time... "fetch the anaesthetist" I shrieked! When it was time to push (after 21 hours!) I was determined to give birth on all fours... (as all the advice I'd received said that ones pelvis is wider in this position vs. lying down) but baby's heart rate had been dangerously low during labour, and the heart rate monitor wouldn't stay on when I got on all fours... so I was back to my original reclining position! Baby still didn't want to come out and now Baby's heart rate was dangerously high. After 22.5 hours labour, the doctor came to see me. "We need to get this baby out ASAP. We've considered a C-section but we think you'll be fine with an assisted delivery". THE DREADED FORCEPS. "Oh, and do we have your permission to do an episiotomy?" THE DREADED SNIP 'N' STITCH!!!! I'm not proud, all I wanted at this point was my baby alive and well in my arms - I'd have said yes to anything! And, after one final push, baby George was born.
Did it matter that I was 45? Well, yes and no. I was healthy. Baby was healthy.
Throughout my pregnancy I had done everything possible to keep myself in good shape - although it was a struggle. I found it uncomfortable to run after about 8 weeks, so I stopped. A keen hiker, I continued to do long country walks and brisk commute walks until about 32 weeks. But, into the third trimester, I found myself to be fully exhausted - moreso than reported by my much younger pregnant chums who seemed to have way more energy and mobility than me. Suddenly I had started to feel my age. But... I was having a big baby. Carrying that load around would have exhausted anyone!!!
In hospital, I got extra care due to my age - and thank heavens for it; I considered myself to be very lucky to have extra scans and appointments that younger women don't get. And, when I delivered Baby, I got a lovely private post-natal room, free of charge for 'high risk' women. I didn't have to slum it in the post-natal ward! And, now that I'm a new mum, baby is 9 weeks old as I write, I don't feel any more or less exhausted or ancient than my NCT friends - some of whom are a good 15 years younger than me.
If I were to advise any woman in her 40s thinking about getting pregnant, I would say this:
1. Be as fit and healthy as you can be while trying to get pregnant - set yourself up for success!
2. Fight the good fight with health professionals to get what you want - but not at the expense of sound medical judgement. Being labelled as 'geriatric' can automatically narrow your options - but remind anyone reviewing your case to judge you based on your test results and medical history. Find a balance that's right for you
3. See how things go! There's no need to make decisions there and then - keep the conversation going until late pregnancy - and see how you feel
When I became pregnant this time around, I felt in my heart that it was my last shout. Worried about being so old that pregnancy would be unbearable (and worrying about being 60 when my child turns 15), I felt that it was a one-time experience. But, it was fine. And I feel great. So... let's talk again in a year's time to see whether I'm up for going again. Who knows 😊
Thanks for reading!
Before getting pregnant (knowing I was undertaking donor conception) I considered myself to be at my fittest. I ran three times a week, barely drank, didn't smoke, ate well and was vigilant about taking my pre-conception vitamins. So, when I finally got the good news that I was pregnant, I decided that I would continue my efforts to stay healthy; I was no spring chicken and pregnancy is, well....., it's hard!
I'm lucky - I have good genes - so people are surprised when I tell them my age. And it was no different for every midwife and consultant I saw. "I was expecting a much older-looking woman" said one consultant who was preparing to review my latest scan. Throughout my pregnancy, I'd had all the routine tests (and more) and, every time, my results were "very good" - no sign of gestational diabetes, bloodwork all looking great etc. etc. I was presenting in line with a much younger woman; AND as soon as I hit the second trimester, I was feeling fine and full of beans. So WHY THEN, did I have the same conversation over and over again about my 'advanced maternal age'? It was like every medic ignored the person they saw in front of them and just talked to my age on paper. I knew that a home birth would be an absolute no-no for me and, to be honest, I felt it was a step too far for me anyway. But my maternity hospital has a state-of-the-art birth centre - complete with pools and every birthing gadget designed to make having a baby as zen-like as possible. I wanted that!
At pregnancy yoga and NCT classes (talking of which, I was worried I'd be twice the age of my NCT cohort - yes I am the oldest but it doesn't matter - we are all first-time mums which is plenty in common!), it was drummed into us all - we have the power to choose how we give birth. When I shared my updates each week, regarding how I was being advised and how I felt that no-one was listening to me, it was always greeted with the same response: "don't let anyone push you into something you don't want"... "you tell them how you want to give birth and let them help you achieve it". Easier said than done but I was determined that I wanted to have some say in my birth choices. So, at every appointment, I continued to fight the good fight.
I'm lucky in that, because of my ancientness, I had scans and consultant reviews every 4 weeks of my pregnancy (yay for being ancient as it was so reassuring to see baby regularly!) and, at each review, we had the same conversation. Some of the consultants were more open to the Birth Centre option for me - but all of them agreed that I should be induced early. I stood firm - I wanted to see how things progressed before committing to anything.
Then, at my 36 week scan, there was a concern that baby was already huge. It was measuring above average and was already an estimated weight of 6lb 13oz. OUCH!! So, at that review appointment, the nice doctor explained to me that, given baby's weight, they would like to induce at 39 weeks. Again, I explained that I didn't want to be induced if I could avoid it - but I understood the risks (and was a bit freaked out by baby's size!) so would take the advice I was given. The consultant was extremely understanding (although made a very barbed comment... "what you hear at NCT and other places is one thing but they are not medical experts...") and he agreed a compromise: he booked me in for a sweep at 38 weeks to see if we could help labour start naturally - but, if it didn't, I would come in for induction at 39 weeks. He also advised me to adapt my birth plan - to request that if I was induced, I wanted as 'unmedicalised' an experience as possible and that any interventions would be discussed with me to give me clear pros/cons to inform my decisions. "OK, it's a deal" said I - feeling that finally someone was listening to me - but also accepting that the doctors are medical experts and, ultimately, the health and wellbeing of my baby was my number one priority.
As it happened, my waters broke at dead on 37 weeks - but contractions didn't start naturally - so I was induced in the labour ward. I laugh now as I look back on the experience. As we were driving to the hospital, I was busy scribbling on my birth plan "I'd like an unmedicalised experience"..... as it happened, I ended up having an extremely medicalised experience! I went straight on the hormone drip. Twelve hours later, I was only 1cm and in a lot of pain - I'd been resisting the epidural, but now it was time... "fetch the anaesthetist" I shrieked! When it was time to push (after 21 hours!) I was determined to give birth on all fours... (as all the advice I'd received said that ones pelvis is wider in this position vs. lying down) but baby's heart rate had been dangerously low during labour, and the heart rate monitor wouldn't stay on when I got on all fours... so I was back to my original reclining position! Baby still didn't want to come out and now Baby's heart rate was dangerously high. After 22.5 hours labour, the doctor came to see me. "We need to get this baby out ASAP. We've considered a C-section but we think you'll be fine with an assisted delivery". THE DREADED FORCEPS. "Oh, and do we have your permission to do an episiotomy?" THE DREADED SNIP 'N' STITCH!!!! I'm not proud, all I wanted at this point was my baby alive and well in my arms - I'd have said yes to anything! And, after one final push, baby George was born.
Did it matter that I was 45? Well, yes and no. I was healthy. Baby was healthy.
Throughout my pregnancy I had done everything possible to keep myself in good shape - although it was a struggle. I found it uncomfortable to run after about 8 weeks, so I stopped. A keen hiker, I continued to do long country walks and brisk commute walks until about 32 weeks. But, into the third trimester, I found myself to be fully exhausted - moreso than reported by my much younger pregnant chums who seemed to have way more energy and mobility than me. Suddenly I had started to feel my age. But... I was having a big baby. Carrying that load around would have exhausted anyone!!!
In hospital, I got extra care due to my age - and thank heavens for it; I considered myself to be very lucky to have extra scans and appointments that younger women don't get. And, when I delivered Baby, I got a lovely private post-natal room, free of charge for 'high risk' women. I didn't have to slum it in the post-natal ward! And, now that I'm a new mum, baby is 9 weeks old as I write, I don't feel any more or less exhausted or ancient than my NCT friends - some of whom are a good 15 years younger than me.
If I were to advise any woman in her 40s thinking about getting pregnant, I would say this:
1. Be as fit and healthy as you can be while trying to get pregnant - set yourself up for success!
2. Fight the good fight with health professionals to get what you want - but not at the expense of sound medical judgement. Being labelled as 'geriatric' can automatically narrow your options - but remind anyone reviewing your case to judge you based on your test results and medical history. Find a balance that's right for you
3. See how things go! There's no need to make decisions there and then - keep the conversation going until late pregnancy - and see how you feel
When I became pregnant this time around, I felt in my heart that it was my last shout. Worried about being so old that pregnancy would be unbearable (and worrying about being 60 when my child turns 15), I felt that it was a one-time experience. But, it was fine. And I feel great. So... let's talk again in a year's time to see whether I'm up for going again. Who knows 😊
Thanks for reading!
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