The Ethics of Septuagenarian Pregnancy

Is it unethical for a woman to get pregnant after a certain age?  And if so, who should decide, based on which criteria, what the age cut-off should be?

We talked last month about how women in their 50′s and 60′s have recently carried-out successful pregnancies through the use of donor eggs.  I told you about the world’s oldest first-time mother, Rajo Devi Lohan, who gave birth at age 70.  Now, at age 72 with an 18-month-old, Lohan is on her death bed, the Daily News reports, purportedly due to lingering complications of her pregnancy. 

As one might imagine, there is little to no discussion of the ethics of Septuagenarian pregnancy available on the Internet, since its occurrence – thus far – is very rare.  About a year ago, bioethicist Jacob M. Appel wrote a carefully-worded piece for The Huffington Post on the topic, in which he says, “Finding a careful balance between personal autonomy and the public welfare is often a considerable challenge. Fortunately, in the cases of sexagenarian and septuagenarian mothers, the private benefit is obvious–and the social harm, if any, is rather hazy. If women choose to have children into their sixties and seventies, we should make sure that they are informed of any potential health risks entailed. And then we should do what we always do when devoted parents give birth: We should offer them our congratulations and our best wishes.”

In Lohan’s case, however, she says, “The doctor never warned me it was dangerous to have a baby at my age.”  While I find it extremely hard to believe that a) her doctor didn’t warn her about the potential complications of a huge medical procedure like IVF using donor eggs and b) she didn’t have some inherent understanding that women don’t really get pregnant at 70 years old and therefore it was probably, uh, a bit risky, I don’t entirely trust her doctor, either.

The Daily News says, “Her doctor, Anurag Bishnoi, denied there was any connection between her pregnancy and her illness and instead emphasized how important (her daughter) Naveen’s birth had been for Lohan. “She does not have to face the stigma of being barren,” he said.”

I feel fortunate that I haven’t had to deal with the multiple effects being barren can have on a woman who wants children.  However, do I think it’s wise to aid a woman who is theoretically old enough to be a great-grandmother in having a baby for the first time so she doesn’t have to deal with the stigma?  Absolutely not.  What about the stigma of dying of old-age before your child’s second birthday?

While I sympathize with Lohan when she says, “I dreamed about having a child all my life,” it bothers me to hear her say, “It does not matter to me that I am ill, because at least I lived long enough to become a mother.”  Sure, you lived long enough to become a mother, but who is going to take care of your infant daughter now?  Your 73-year-old husband?  As it stands, her 60-year-old sister, Omi, has moved in to take care of the child.

It seems strange to me that bioethics should have to be involved here at all; one would think common sense would rule the day.  At 70, I imagine most women would think to themselves, well, I always wanted to be a mother, but that ship has sailed.  But I do understand how passion can sometimes lead us down thorny paths in life, and how only after the fact you learn, as I said yesterday, that just because you can do something doesn’t mean you should.

Lohan seems to be at peace with her decision, and I’m happy that a younger family member – albeit still older than most moms – is able to take care of little Naveen.  (The story would be particularly tragic if she became a ward of the state.)

Several European nations have toyed with the idea of capping the age for IVF treatment, among them France, Italy and the United Kingdom.  But in 2005, age restrictions on IVF were withdrawn in the UK.  There are no age restrictions in place in the United States, though many fertility clinics – and individual doctors – have restrictions of their own.

Bioethicist Appel warns that placing age restrictions on IVF treatment for women promotes a double standard.  He says, “Our society has long accepted, even acclaimed, fatherhood in later mid-life. An occasional eyebrow may rise when Tony Randall fathers children in his upper seventies, but a man who becomes a dad at fifty-five or even sixty usually receives a proverbial cigar–not a lecture on social responsibility.”  I understand his concern, and I agree that because of greater life-expectancy, becoming a first-time parent into one’s early 50s is okay.  But I do feel a child deserves – barring any unforeseen accidents or illness – the chance to be raised by their parents until they’re at least 18. 

Of course an 18-year-old mother could get hit by a bus tomorrow, but a 70-year-old mother is much less likely to live to watch her child graduate from high school.  The question here is intention.  Every pregnancy is both a bit selfish and altruistic, but to what degree?  Lohan got pregnant to quell her own desires, but what about her child’s right to know her mother?

Maybe I’m taking this all too seriously, and life is just a foolish game, humans are just a spec of dust on the Earth’s overall history, blah blah blah.  Maybe my “concerns about later-life mothering may reflect (a) heightened expectation that children know their parents, and even grandparents, into adulthood, rather than any universal or socially-essential norm,” as Appel suggests.  But I don’t know.  If, as a society, we try to discourage teenage pregnancy – on one end of the age spectrum – why shouldn’t we also discourage pregnancy after menopause?  Appel thinks it’s a bad idea to use menopause as an age cut-off for motherhood, because naturalist theory argues against the use of IVF overall.  But there has to be a way of acknowledging that while IVF and donor eggs are a good idea for some, they are not best used for all.

Photo: Passion of Bilwa

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