How Old is Too Old to Give Birth?
by Elisa All

The recent revelation of the identity of the world's oldest birth mother sparks questions about the practical and ethical considerations of giving birth to a child so late in life.

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When many women her age are anticipating the birth of their first grandchild, California resident Arceli Keh, age 63, gave birth for the first time in 1997 to a daughter named Cynthia. The Associated Press reported that Keh and her husband, Isagani, a carpenter, spent at least $50,000 on in vitro fertilization treatments that eventually led to Cynthia's conception and birth. "I wasn't trying to make history," Keh told The Express, a British newspaper. "I just wanted a baby."

Married for 16 years, the Kehs -- who emigrated from the Philippines -- have no other children. As reported in The Express, the couple lives in Highland, Calif., 60 miles east of Los Angeles. "We are far from wealthy," Mrs. Keh said. "We are working people. I only retired to have my baby."

"I wasn't trying to make history, I just wanted a baby." - Arceli Keh

The Kehs utilized the University of Southern California's Program for Assisted Reproduction, which allows women up to age 55 to participate. Mrs. Keh hid her age until she was 13 weeks pregnant. "Our age doesn't matter," she said. "We feel young at heart and we love our child. Isn't that what counts?"

That, it seems, depends on who you ask. Cristina L.H. Traina, assistant professor of religious ethics at Northwestern University, wrote in the Chicago Tribune: "Wanting a baby is essential, but is it enough? In the field of ethics, it matters deeply why we want something. We must be sensitive to the grief that follows on the disappointment of an intense wish to conceive. Still, contemporary philosophers remind us to ask whether, when we are 'desperate' to be pregnant, we have healthy reasons."

Among 25-year-old mothers, the incidence is one in 1,250 births. Among 35-year-old mothers, the incidence increases to one in every 378 births, and by age 45 it is one of every 30. Source: Mayo Clinic

According to the Mayo Clinic, fertility rates remain relatively stable until the early 30s, and then they decrease to very low levels by the early 40s. Peak fertility occurs between the ages of 20 to 24. In women aged 30 to 35, fertility is 15 to 20 percent less than maximum. In women aged 35 to 39, the decrease is 25 to 50 percent. In women 40 to 45, there is a 95 percent decrease in fertility.

Mayo reports that the risk of miscarriage increases after age 35, and it further increases after 40. The increasing risk is primarily caused by chromosomal abnormalities in the fetus. There are higher risks of having a baby with low birth weight, premature labor or chromosomal abnormalities such as Down syndrome. Among 25-year-old mothers, the incidence is one in 1,250 births. Among 35-year-old mothers, the incidence increases to one in every 378 births, and by age 45 it is one of every 30. Consequently, amniocentesis is usually offered to women older than 35 to test for Down syndrome. Older women also have a somewhat higher risk of gestational diabetes, pre-eclampsia, and placenta previa. Aside from the medical issues surrounding giving birth later, there are practical ones. In the book Mothers and Daughters, Elsa Malmud, who gave birth to a hearing-impaired daughter at age 44 and another daughter at age 51, found that her family was unsupportive of her late decision to become a mother. Also, Malmud regrets that she won't be around to be with the girls throughout most of their lives or help them with any grandchildren.

Despite these issues and the fact that other kids think she's her children's grandmother rather than their mother, she isn't sorry she waited. "I've done a lot of things I wanted," she said. "I've traveled, had a career and made sure my marriage would last before having children." As for Mrs. Keh, parenting expert Adele Faber had this to say in USA Today: "Kids are exhausting, and if she has the energy to cope, that's wonderful for her. God bless her, and God help her."

Looking for more about this story?	An interview with Mrs Keh's physician on PBS' NewsHour