Menopause? No - pregnant!

Generic picture of contraceptive pill

Generic picture of contraceptive pill

Published Apr 16, 2012

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London - Hazel Nicholson approached what she thought was the onset of menopause not with dread, but a sense of optimism. Having raised two children, she was all too familiar with the relentless, often unappreciated drudgery of motherhood.

With her reproductive system winding down, she was looking forward to a long-awaited opportunity to relax. So it came as something of a surprise to discover that her three months of missed periods were not, in fact, due to the menopause, but an altogether unplanned pregnancy.

“I was shocked and devastated, and broke down in tears when my doctor told me,” says Hazel.

“My children were in their teens. I could see light at the end of the long tunnel of parenthood. Another baby was the last thing I wanted, and my first thought was to terminate the pregnancy.”

Hazel, now 45, is far from the only woman of her age to encounter an unexpected pregnancy. Recent statistics from the Department of Health revealed that the number of abortions in women over 40 has risen by a third in the past decade, with 8,000 choosing to terminate a pregnancy in 2010 alone.

Countless more went on to have their babies, as shown by a study last month which revealed that the birth rate among the over-40s has doubled over the past two decades.

Some scientists believe this is because modern women over 40 are more fertile than middle-aged women of previous generations - a change due to natural selection. They say that of the women who wait to try for a baby, only those genetically predisposed to longer-lasting fertility will be able to conceive. This gene is passed on to their children, who in turn can have babies later in life.

Of course, the availability of IVF has also increased older motherhood. But there are many more women - such as Hazel - who fall pregnant after mistakenly believing they are no longer fertile.

“Women in their 40s whose period patterns start to change often assume they don’t need contraception,” says Heather Currie, gynaecologist at Dumfries and Galloway Hospital and founder of the Menopause Matters website. “But pregnancy at that age can be a disaster. Many women aren’t prepared for childbearing or a baby. There is also a greater risk of complications such as Down’s syndrome and pre-eclampsia.”

These were all factors that Hazel, already mother to Becky, 19, and Connor, 15, had to take into consideration. Ultimately, she decided the risks and sacrifices were worth it, and her daughter, Libby, is now three.

“I’ve been amazed by how much I love late-life motherhood,” Hazel says. “But I have since had a contraceptive implant fitted - this is definitely my last child.”

Hazel, from Aldershot, Hants, had believed for a decade prior to falling pregnant that she was approaching the menopause. “Since the age of 33, my periods had become increasingly intermittent,” she explains. “They would be up to two months apart and were often very light.”

Given her family history, her conviction was understandable. Early menopause is said to run in families, and as her mother went through the change at 46 and her grandmother was only 35, she assumed by her mid-30s that her fertile years were behind her.

She viewed the process as a new beginning rather than the end of her youth.

“It meant freedom from my dreaded monthly cycle and worries about contraception,” she says.

She’d had both Becky and Connor while in her 20s with her first husband, Ivor, and had endured a difficult time during their early years.

“Ivor was in the Navy and was away for months at a time. I was constantly in tears after Becky was born. Looking back, I’m sure I had post-natal depression,” she says.

Hazel returned to her job as a classroom assistant within weeks of both births, so eager was she for adult company.

‘” occasionally felt guilty at missing pivotal moments, such as Becky’s first steps, but I craved mature conversation,” she says.

Hazel and Ivor continued to grow apart and divorced in 2004. Six months later, she met her new partner, Adam, a plumber who, at 32, is 13 years her junior.

“Being younger, Adam was desperate to have children, but I was adamant my baby days were behind me,” she says.

“Becky, Connor and I had become a unit and I didn’t want to jeopardise that with a new baby. Anyway, at 37 I felt sure I couldn’t conceive. Adam and I used condoms at first, but over the years an unplanned pregnancy wasn’t a concern.”

It was only when, at 42, Hazel realised she hadn’t had a period for three months, and was feeling increasingly tired, that she visited her GP. She nonchalantly took a pregnancy test, only to be horrified when it came back positive.

“My breasts had been sore, but I hadn’t put on weight or had any cravings,” she says. “Adam was thrilled, although to my enduring shame I barely let him show it. We spent eight hours discussing the pros and cons of keeping our baby.

“The list of negatives was endless: no more freedom, no more lazy lunches. Would there be complications because of my age? The only positive was that the baby was the product of our love. For that reason alone, we decided to go ahead.”

Although all tests for complications came back negative, Hazel cried constantly during her pregnancy.

The children, especially Becky, could barely hide their disdain. “She asked me if I’d ever heard of contraception,” says Hazel. “She was embarrassed and not exactly thrilled. I was mortified.”

It was only five months into her pregnancy that Hazel’s shock turned to acceptance and, slowly, anticipation. “Adam came home with baby magazines and sleep-suits, and his enthusiasm proved infectious,” she explains. “Becky and Connor eventually got used to the idea, and I slowly allowed myself to believe that a baby might be a good thing.”

When Libby was born in December 2008, the whole family was thrilled. And Hazel, who gave up her job to look after her daughter, has been surprised by how much she has enjoyed her second chance at motherhood.

“I take Libby ice-skating, swimming and to ballet,” she says. “I feel more confident than when Becky and Connor were little, and am finding it more rewarding.”

But she admits there are also downsides. “I have been mistaken for Libby’s grandmother at toddler groups,” she says. “I hate to think of Libby being bullied for having an older mom. I’ve tried to explain to her, but she doesn’t understand. To her, I’m like any other mommy, which pleases me. And her big brother and sister adore her.”

Of course, not all such unplanned pregnancies have such a happy ending. As Dr Paula Franklin, medical director of nationwide abortion centres Marie Stopes International, says: “We see a number of women with unplanned pregnancies who tell us they thought they were menopausal.”

Lizzie Richards, 42, was one of them - but unlike Hazel, she couldn’t bear to go through with her pregnancy. She had a termination in January after discovering she was six weeks pregnant.

“We were careless one night after several glasses of wine, which is how it must have happened,” says Lizzie. “My periods were still reasonably regular, but I never believed I was likely to conceive at my age.

“When my period was late, it took five positive pregnancy tests to convince me I was expecting. I was horrified, ashamed and, as a grown woman, felt stupid that I’d allowed myself to get into this situation.”

She and her partner, Justin - who are both nurses, and already have two children, Poppy, 17, and Barnaby, 11 - agreed that another baby was not on the agenda.

“I had just got my life back,’”say Lizzie, from Chelmsford, Essex. “I’d spent so many years clock-watching, being back for 3pm every afternoon to pick up the children from school.

“As they grew more independent, Justin and I had planned to make the next few years about us - about sleeping in at the weekend and going to restaurants.

“The idea of being a new mom filled me with dread. Justin would have supported me had I decided to keep the baby, but he, too, felt abortion was the best decision.” The following day, Lizzie made an appointment at the Marie Stopes clinic in Buckhurst Hill, Essex, for a termination.

“How had I, a professional woman, been so stupid?” she asks. “As a nurse, I felt I should have known better.”

Lizzie decided to have a surgical termination under sedation and Justin went with her for moral support. “After we arrived at the clinic, the hour or so waiting was the worst part,” recalls Lizzie.

“I was surprised to see several other older, smart, professional women like myself there. The nurses could see how much I was beating myself up about my decision and were very friendly.”

Lizzie adds: “I can’t pretend I wasn’t scared - I’d never had surgery before, and it felt quite surreal. But although I had period-type pains afterwards, it didn’t hurt. While I was at the clinic, I had a coil fitted so it wouldn’t happen again.”

She was free to go home after just three hours, her relief mingled with sadness. “I took the week off work to recover, and for several weeks I felt tired, detached and withdrawn,” she says.

“I knew I wasn’t alone: a friend of the same age has also had a termination and I’ve heard of other acquaintances who have experienced unwanted pregnancies.

“Justin has been hugely supportive and after two months, I am ready to move on.

“But I am going to be more careful about contraception from now on. I’ve realised that stories about losing your fertility in your 40s are not true for everyone.”

So how can the problem be addressed? As there is no definitive test for menopause, the answer is, with difficulty. Current NHS guidance is for women who think they are menopausal to continue using contraception until they haven’t had a period for two years, if they are under 50, and one year if they are over 50.

It is advice few women appear to be following, as a recent survey by Menopause Matters shows. It revealed that 27 percent of pre-menopausal, 32 percent of peri-menopausal and 40 percent of post-menopausal women used no contraception at all.

Sarah Munro, 44, a barrister, took a laid-back approach to birth control and has a five-week-old son, Monty, as a result. Incredibly, she was almost six months pregnant before she realised she was expecting.

“Looking back, of course, it sounds ridiculous but it just didn’t occur to me that I could be pregnant,” she says.

Already a mother to Ben, now 13, from her first marriage, Sarah, from Stanford on Soar, Notts, was 37 when she met her husband Luther, 43, a pub landlord.

“I remembered clearly how difficult motherhood could be. I hadn’t enjoyed pregnancy the first time round - I felt sick and permanently lethargic - and was sure I didn’t want another baby. Luther was disappointed, but he loved Ben like his own son and agreed to sacrifice fatherhood for me.” The couple married in May 2008, when Sarah was 40. After the wedding, she softened her approach.

“I decided that while I wouldn’t actively try to get pregnant, I wouldn’t insist on contraception,” she says. “I felt I owed it to Luther at least to try.

“In my mind, I was too old to fall pregnant anyway, and with every passing month I felt my chances of conceiving had diminished.” Last May, when Sarah’s periods stopped, she assumed she was going through an early menopause. Like Hazel, she was pragmatic about it. “I couldn’t see anything to be gained from being upset about nature unfolding,” she says.

As the weeks passed, she grew increasingly emotional. “I was working on a harrowing case at work and was flat-out with the demands of motherhood, so I assumed tiredness and menopausal hormones were responsible for my tearfulness,” she says.

Her GP agreed with her theory, while also suggesting he prescribe her a course of anti-depressants. “I didn’t want to be on medication and, thankfully, refused,” she says.

Slowly, she put on weight - another symptom of the menopause. “I had plenty of energy, and none of the nausea or tiredness I’d had first time round,” she says.

Reality only dawned on her last October when she attended a cousin’s wedding. “The silver shift dress I’d bought just ten days earlier was already straining at the seams,” she says.

“After the wedding breakfast, which I’d barely touched, my stomach felt hard and bloated. It occurred to Luther and me that - even at 44 - I could still be pregnant.’

Sarah bought a pregnancy test the following Monday. “I knew even before the red line emerged that it would be positive,” she says. “I felt utterly stupid for not realising before, but as the shock subsided I was delighted and, needless to say, so was Luther.”

Yet her excitement was mixed with anxiety. “I’d been drinking alcohol throughout my pregnancy and hadn’t taken folic acid. I’d left it too late to have any of the tests for Down’s syndrome or other deformities more common in babies of older moms. I was worried sick about my child’s health and had only three months to prepare for new motherhood.”

Fortunately, Monty arrived healthily at the beginning of February. “This pregnancy was so different from the last one,” she says. “I felt fit enough to work until the end, and was in court an hour before my waters broke.”

Sarah is currently battling the sleep-deprivation common to any new mom - and coming to terms with how parenting has changed over the past 13 years. “Advice on weaning and the MMR jab are all completely different,” she says.

“I probably do get more tired doing the night feeds, and I am aware that I’ll be the oldest mom in the playground. But in many ways I’m enjoying motherhood more now. Luther and Ben are a brilliant help, and I’m more confident and established in my career, so I have time to enjoy my baby.”

And like so many other women her age, Sarah has also had a wake-up call - just because she is old enough to go through the menopause doesn’t mean she is too old to fall pregnant. - Daily Mail

* Some names have been changed.

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