Women's freedom of choice is fine, but don't forget the children

Published on Friday 5 May 2006 01:35

THE average age of women requesting assisted reproduction technology (ART) in the UK is 34, according to a recent report from the Human Fertilisation and Embryology Authority.

Social and economic changes have resulted in more women choosing to delay parenthood and subsequently seeking treatment for infertility.

ART requests from women over 50 are infrequent but usually hit the headlines partly because of the immediate and long-term risks to elderly mothers and their babies, and partly because of the implications for health and social services.

Often, women who become older mothers stress that they are healthier and fitter than are many younger women.

Yet their ageing eggs result in increased risks of chromosomal abnormalities in the offspring.

They typically find it harder to conceive, and are more likely to experience subsequent pregnancy loss. They also face an increased risk of problems such as diabetes, high blood pressure, heart problems, deep vein thrombosis and operative delivery. Post-menopausal women need hormone replacement regimens to make their wombs receptive to eggs donated by younger women.

Most of the public are uncertain about the notion of people becoming parents for the first time in their fifties or sixties. There was universal condemnation of Adriana Iliescu when she gave birth at the age of 66.

Many older mothers stress that they have the energy of much younger women and are well equipped to cope with active babies and toddlers.

They often emphasise the contentment they have achieved in their careers or relationships in the belief that this will make them better mothers. They largely ignore the greater likelihood of dying before their children reach maturity and the near impossibility of providing the child with grandparents or contemporary siblings.

This may be a serious problem, as research in developmental psychology suggests young people continue to need their parents' emotional as well as financial support, and that grandparents have a useful role to play in childhood development.

A recent TV programme about Britain's oldest parents showed children coping with adults assuming their parents were their grandparents, and one having to "be independent" lest her parents died.

Although this seems unfair in a society which places a value on childhood per se, it has to be contrasted with children in developing countries who often have to fend for themselves and younger siblings at a very young age.

Women can become mothers in their sixties only with the help of extensive medical resources and, importantly, at the expense of a young woman prepared to put her body through the traumatic and possibly dangerous process of egg donation.

The shortage of donors in the UK means many go abroad and reports suggest poor women in Eastern Europe are being exploited by foreign clinics.

Most women pay only for their ART treatment. However, it is left to the taxpayer to pick up the tab for any emergency care needed and for the long-term physical and emotional care of the children conceived.

Economic concerns about a progressively ageing population in Scotland mean that increasing fertility in any age group should be encouraged, and recent studies have suggested that families benefit financially if women postpone childbearing.

Any debate on older mothers should take into account the circumstances of each individual case.

In allowing women the freedom of reproductive choice, ART should not prejudice the long-term welfare of the unborn child.