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Unplanned pregnancies in the over-40s are at a record high. Are women getting their facts wrong?

When Charlotte, 43, found she was pregnant it came as a bolt from the blue. Already the mother of three teenage children, she had considered her child-bearing years to be behind her. "It took me seven weeks to realise I might be pregnant. It hadn't entered my mind, as my periods had been irregular for some time and I'd assumed it was the onset of menopause."

The assumption is that once we have reached adulthood, and certainly once we are in settled relationships, we are past the point of conceiving by mistake. But, according to fpa (formerly the Family Planning Association), unplanned pregnancies in the late-thirties to forties age group are at a record high. In fact, last year the percentage of pregnancies terminated in women over 40 equalled that in 19-year-olds. Although this figure includes terminations carried out for medical reasons, it suggests a startlingly high number of accidental pregnancies.

An accidental pregnancy brings with it agonising dilemmas, whether you are 19 or 39. For those who decide on a termination, there are extra issues to address. For an older woman who has not yet had children, this may mean making the final, often painful decision that she isn't ever going to. For those who have had families and who do not want, or, for medical reasons, may not be able, to start again, it can bring up other intense feelings.

Clare Burgh, for example, who conceived unexpectedly at the age of 39, having decided against having children after an early diagnosis of infertility, describes the anxieties older women feel about the health risks of a later pregnancy, both to the child and the mother. "I made the decision that, at my age, I wouldn't be able to go through with the pregnancy if there were any kind of chromosomal abnormalities," she says. Fortunately for Clare, there weren't, and her son Christopher, now four, is a healthy little boy. But there is a significant risk of abnormalities in children of older parents, who have to consider whether they want to be caring for a needy child into their own later life, a consideration made more difficult if the child is unplanned.

"Even if she is very certain that a termination is the right thing to do, the emotions are less cut-and-dried than they might be for a young woman who finds herself pregnant and is unambiguous about not being able to fit a baby into her life yet," says Ann Furedi, chief executive of the British Pregnancy Advisory Service.

So why are intelligent, mature women getting pregnant by accident? The answer, seemingly, is down to a great deal of confusion about our likelihood of conceiving as we get older.

The publication, in 2001, of Sylvia Ann Hewlett's Baby Hunger, in which she warns young women that if they wait to have babies until they are over 35 they are risking age-related infertility, seems to have convinced many women that conception after a certain age is virtually impossible without medical intervention. Although Hewlett's intention was to give women the "sobering facts" about fertility, so that they can better plan their lives to include children if they want them, the focus on infertility seems to have muddied the waters for women who are not planning to get pregnant.

Moreover, a plethora of articles in the press followed the book with alarming statistics about declining fertility, statingthat the conception rate drops to a mere two per cent after the age of 40. "We read so much about declining fertility rates, it is understandable that older women may become complacent about contraception," says Furedi. Angela Reynolds, helpline manager at fpa, continues: "This two per cent figure relates to the fertility rate, which measures the number of births within an age group. There is a steep decline in births to women over the age of 40 due to a number of factors, including a higher take-up of sterilisation, and the fact that many pregnancies are not carried to term. The drop in birth rate does not simply reflect a woman's declining ability to conceive."

There is, of course, evidence that the quality and number of eggs produced by women drops off as we get older. But the decline in fecundity (the medical term used to describe a woman's individual potential to conceive) may not be quite as cataclysmic as some of these reports have suggested.

Records going back to 1930 of women who have given birth in their forties suggest that it is far more common for women who have already had children to conceive at that age than women trying to conceive for the first time. It would follow that effective birth control is even more important for older women who have already had their families.

But surveys carried out by fpa repeatedly show that younger women have a much higher level of knowledge about where to get hold of, and how to use, contraceptives - including emergency contraception - than older women, who may be relying on information they gleaned early in their sex lives.

Reynolds urges women to make use of the fpa website to update their contraceptive knowledge, or to visit their GP to talk through the options as they get older. If you have already fallen pregnant, it can also be helpful to talk through the implications with a professional before making any firm decisions. Furedi says that it may be easier to self-refer to one of the BPAS clinics than to go to a GP, especially if he or she has been the family doctor. "Although the vast majority of GPs are sympathetic, women are often afraid of being lectured," she says.

"The idea that a mature, educated woman may get pregnant accidentally tends to be outside the public imagination. But 20 per cent of all abortions are to married women. These women often feel humiliated because they think they should know better, but if they knew how common this problem was, the stigma might disappear."

www.fpa.org.uk; the British Pregnancy Advisory Service Helpline (0845-730 4030)