What's wrong with having a baby at 65?

Stories about postmenopausal mothers are usually pitched as the last ditch efforts to have a child by women who turned their backs on motherhood at an earlier, more appropriate age. Such women are considered selfish, and such pregnancies unnatural. Typically, commentators cite welfare of the child issues and the increased medical risks as justification for their unease. At first glance, the news this week (also reported in BioNews 798) that 65-year-old Annegret Raunigk - a mother of 13 children, who is now expecting quadruplets - would appear to be more of the same, if not even more freakish. Yet on closer examination, one realises that the unique aspects of this case suggest that we need to question the rhetoric that postmenopausal motherhood is always unacceptable.

A Royal College of Obstetrics and Gynaecology expert study group (Bewley, Ledger & Nikolaou, 2009) found that almost all pregnancy complications that increase with age (and none lessen). Specifically, older women are at increased risk for haemorrhage from placenta praevia, high blood pressure, gestational diabetes and abnormal labour patterns. Postmenopausal mothers are thus typically criticised for putting themselves and their child at undue medical risk. While this is a legitimate criticism of motherhood at this age, in this case it is not Annegret's age per se that is increasing her obstetric risk, but the fact that she is having quads. Any pregnancy involving multiples is at higher risk of obstetric risks and can expect to be under increased medical scrutiny. If anything, criticism based on medical risk in this case, should be reserved for the cowboy tactics of the clinic that implanted multiple embryos.

Postmenopausal mothers are often accused of having selfish reasons for having a child. In this case Annegret's currently youngest child wanted a younger sibling. While this may raise eyebrows (wouldn't a pony have been easier?) Tizzard (2001) highlights that for the rest of us, the reasons we give for having a child are actually hard to justify. Some common reasons include: because it happened; because everyone else has children; because you would not be fulfilled as an adult if you don't have children; because a child will bring happiness into your life; because you want someone to carry on your name/genes/business - none of which, as Cutas (2007) points out, are particularly high-minded, and some of which are even questionable. Curiously, we are not so quick to pass judgement when conception happens in the private sphere.

The critique of postmenopausal mothers that is hardest to defend is that of the welfare of the child. Such concerns usually fall under two categories: the type of childhood the child can expect to have, and the increased likelihood of losing their mother at an early age. Again, in this case, it is not that straightforward. As the mother of 13 other children, and a grandmother of seven, these quads will not only have each other for company, but will be born into a large and probably loving family. Rather than a lonely and unhappy childhood, these babies are most likely to have an abundance of love, care and companionship, both during their mother's lifetime, and long after she has died. It may not be conventional, but we know from extensive research on other 'new family forms' - lesbian mothers, gay fathers, and children born via gamete donation - that it is the quality of the relationships within the family that matters, rather than the composition (Golombok, 2000).

Despite arguments that postmenopausal motherhood does not necessarily spell disaster, people will continue to treat such developments as socially threatening and dangerous - another example of modern science gone awry. Such pessimism is unsupported given that we have no scientific data investigating the quality of parenting provided by postmenopausal mothers nor the developmental outcomes of their children. And so, as Pennings (2013) has noted, the paucity of empirical evidence leaves this group of women open to prejudice and wild assumption. It may also be wise to remember that other new family forms were also at one point in the not-so-distant past considered 'unnatural'. Postmenopausal motherhood may be complicated, but until we have actual data on the outcomes in such families, the case of Annegret Raunigk suggests that we are in no position to moralise.