What’s wrong with elderly women giving birth?

A 59-year-old plans to have a baby through IVF and dissenting voices can be heard everywhere from the newspapers to the office watercooler. But is there really any reason why we should have a problem with the idea, asks medical ethicist Daniel Sokol.

Imagine walking past a poster on the street. It shows a mother and baby. The mother, however, is old enough to be the baby’s grandmother.
The initial reaction of many passers-by, upon being told that this grey-haired and wrinkled woman is the mother, would be one of revulsion. There is something deeply unnatural about the image.

These are the thoughts that many have had in response to the news that Susan Tollefsen, who became a mother at 57, is now considering IVF treatment again at the age of 59.

But is there a rational basis for concern?

The “yuck” response is not uncommon in the face of new things. It is an internal red flag, telling us in an indistinct way that something is amiss. At times, that something is perfectly reasonable.

The disgust we feel at the recent torture of two young boys by brothers aged only 11 and 12 is underpinned by solid reasons. Yet, often, our “yuck” response is nothing but the external manifestation of ignorance or prejudice.

This is apparent by looking at history. Pain-relieving chloroform in the 19th Century, heart transplantation (involving a donor and recipient of different races), homosexuality, and in vitro fertilisation in the 20th Century, were all met with initial cries of disgust.

The birth of the first “test tube” baby, Louise Brown, in 1978 was deemed immoral by, among others, the Vatican and Nobel laureate James Watson. “I am not a wizard or a Frankenstein,” said Dr Patrick Steptoe, the gynaecologist involved in the creation of Louise Brown.

These examples show that what society considers morally permissible evolves with time. They also point to the need to dissect our gut reactions.

Greater risk

In one sense, the computer screen in front of you is unnatural. It is the product of man’s ingenuity. So too is an umbrella. Distinguishing the natural from the unnatural is not an easy task.

Can we say that keeping people alive on life support or resuscitating them when they would otherwise have died is natural, but that enabling an older woman to conceive a child is not?

Both are trying to “remedy” the natural ravages of ageing. If we accept that both can be viewed as unnatural, we must appeal to something else to justify treating them differently.

Assisted reproduction, like virtually all medical procedures, carries a risk of harm. The treatment, usually requiring several cycles of IVF, is hard on women emotionally and physically. At 60, the impact is likely to be greater than at 30.

Yet, in a liberal democracy, individuals are to a large extent allowed to incur even significant risk as long as this does not harm others.