A State of ShockIt might have been embarrassing to walk through the lobby of the ob-gyn clinic crying, but Andrea Garduno was too unsettled to care. Anyway, she knew the entire staff at the El Paso clinic from her days working there as a student nurse. They were almost as surprised as she to learn that at 43, after sending two daughters off to college, she was pregnant again. Garduno had just one ovary and, thinking pregnancy was not a big risk at her age, had been using only contraceptive foam. ("It might as well have been Reddi-Wip," she says now.) The office manager put her arm around her shoulders and said, "Andie, don’t worry. I have a friend who went through this, and her daughter just graduated from Stanford, with honors. And she’s told me that this daughter has been the biggest blessing of her life."Garduno would find those words reassuring in the months ahead, but for the moment, she was focused on how to break the news to her husband. He was a urologist and she, his surgical nurse. When she reached the operating room, he was performing a needle biopsy on a patient’s prostate gland. "I leaned over and said, ‘I want you to know that I’m six weeks pregnant,’" Garduno recalls. "And he just got this look on his face."The shock of accidental pregnancy in women over 40 is far more common than you might expect. True, fertility declines with age: Only 15 in every 1,000 women over 40 become pregnant, compared with about 170 in 1,000 women in their 20s. But the fact is, slightly more than half of pregnancies in older women are unintended, according to the Alan Guttmacher Institute, a reproductive-health research center in New York City. Only teenagers and women 20-24 have higher rates of unintended pregnancies. And like teenagers, we tend to assume — or at least vaguely hope — that pregnancy won’t happen to us.What Do We Do Now?An unexpected late pregnancy can lead to great joy, of course. Garduno’s daughter Italia was born in November of 1991. "I went full-term, and let me tell you, my old boobs even kicked in and I was able to breastfeed for 13 months," Garduno says. "I was born in ’47 and I’ve said I was like an old ’47 Buick. They don’t make ‘em like that any more." Italia is now a beautiful, dark-haired eighth-grader. To her parents, she is the center of the universe.But for a majority of women, joy is not part of the picture. A whopping 65 percent of unintended pregnancies in women over 40 end in abortion — the highest percentage for any age group, according to statistics compiled by the Guttmacher Institute for 1994, the most recent year for which the data have been analyzed. "A lot of women in the older reproductive age groups indicate that they’ve completed their childbearing and don’t want to start over again," says Lawrence B. Finer, PhD, a research director at the Guttmacher Institute.Then there are the women who have never had children and feel too old to start — like Lori (who asked that only her first name be used). She found herself pregnant at 44 after nearly 20 years of marriage. She’d been using a diaphragm ("Obviously, less than perfectly"), but had never had a scare or been late. "I just figured I wasn’t going to get pregnant," the executive at a nonprofit organization says. Lori and her husband, a college administrator, had never really discussed having kids, and both felt torn about whether to go forward with the pregnancy. Her ob-gyn told her to think hard about it, because, "This could be your last chance to have a child."The doctor suggested an ultrasound to determine viability. "While my physician was completely impartial, she did say something during the scan that was hard for us to hear," remembers Lori. "She said, ‘It’s a healthy fetus,’ and then offered us a look at the screen." Lori and her husband looked, and felt even more conflicted. "My husband’s point of view was, ‘This happened, so why don’t we see it through?’" says Lori. She was less certain.Lori had been pregnant once before, in graduate school, but, "Because I barely knew the guy and wanted to finish school, it was pretty straightforward to decide to have an abortion," she says. "I didn’t even tell him what I was doing." This time, the decision was more complicated.