Jewish World Review Nov. 18, 2002/ 13 Kislev, 5763
The researchers have concluded that there's no reason - no medical reason - why a woman in her 60s and maybe even beyond can't get pregnant if she wants to, and can find a young woman willing to contribute an egg. This is reverse noblesse oblige of the sisterhood.
The researchers, reporting in the Journal of the American Medical Association (JAMA), studied 77 pregnant postmenopausal women between the ages of 50 and 63 and concluded that age is no barrier to pregnancy. Of the 61 babies born to these women, 31 were "singletons," 24 were twins and 6 were triplets. Is this growing old gracefully, or what?
With a bit of irony, no doubt unintended, this issue of JAMA, devoted to the clinical science of aging, includes an editorial about how human cells grow old: "Use It or Lose It: Activity May Be the Best Treatment for Aging."
Presumably this does not refer to activity in the womb, but we can't be sure.
"Cognitive and emotional function," concludes JAMA, "is vital to independence, productivity, and quality of life." Having a baby in the seventh (or even eighth) decade of life may not be the kind of productivity that offers independence, but it suggests imaginative scenarios.
As ever-older women give birth, costs could be halved in a nursing home or an assisted-living facility with a "twofer," with both elder care and daycare offered at the same place. Mother and child could sup on strained peas and carrots together. The elderly mommy could take baby for free with her senior airline discount. The pressure would be on Congress to revise Social Security to include preschool benefits with retirement. Should maternity be included in Medicare? Nancy Pelosi and Tom Daschle, are you listening?
"Sex after Sixty," a popular book title a few decades ago, can be updated as "Pregnancy after Sixty," although sex has nothing to do with these pregnancies. Other suggested best-selling titles might be "How I Went to My Son's High School Graduation on My Walker," "Why My Daughter's Kindergarten Classmates Call Me Great-Granny" and "Enjoying Retirement as a Full-time Mommy."
One participant in the JAMA study finds gray humor from another perspective. "We're having our own grandkids," says Marilyn Nolen, 55, who became pregnant with twins. "We just skipped having kids."
Of course, there's some fine print here. (Isn't there always?) Most of the births were delivered by Caesarean section, more than in most in-vitro births, and several women developed gestational diabetes and mild or severe preeclampsia. Preeclampsia is characterized by high blood pressure, swelling, weight gain, headaches and changes in vision. Rates for this condition in this study were 35 percent, almost double that in younger pregnant women. Gestational diabetes makes the baby exceedingly vulnerable for other problems, such as breathing problems and fractures. But none of these severe effects prevent the researchers from concluding that, as long as the pregnancy is carefully monitored, "there does not appear to be any definitive medical reason for excluding these women from attempting pregnancy on the basis of age alone."
And here come the lawyers. Dr. Richard Paulson, who led the research team at the University of Southern California, argues that refusing to help these women get pregnant is age discrimination: "Not only do I not have a problem in allowing (women over 50) to become pregnant, I would have an ethical problem in denying them."
Dr. Faustus might conclude that this is making his pact with technology.
So might some of Dr. Paulson's real-life colleagues. Many fertility clinics will not treat women over 50. An ethics committee of the American Society of Reproductive Medicine concludes that assisting a woman to get pregnant in her 50s and 60s is not unethical but should be discouraged.
In-vitro pregnancy has become a boon for younger women who might not otherwise be able to give birth, but the real constraints of age, it seems to me, should count for more than simply a desire to have a child. Nature has good reasons for bestowing children on women when they're young and energetic. Common sense tells us that there are certain things scientists can't measure in their brave new world. There is something decidedly narcissistic in seeking a baby in the sunset years. A "child-lift" at 60 isn't quite the same thing as a face-lift.
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