From PEOPLE Magazine Click to enlarge
Pat Anthony had a mad, beautiful idea. She didn't tell anyone what it was. She just got into her Mercedes one morning in August 1986 and set out for Johannesburg, 230 miles away. She had plenty of time to think as she drove. Two years earlier, her daughter, Karen, had nearly bled to death giving birth to her only child, a son, and her uterus had been removed. Now Karen, 25, and her husband, Alcino, 33, desperately wanted more children. Recently they had begun talking about adopting a child, or even hiring a surrogate mother. That alarmed Pat.

"An outsider, however close, might have wanted to keep the babies," she explains now, "and that would have been dreadful."

In Johannesburg, Pat had an appointment with a gynecologist. She had driven more than three hours to ask if her mad idea might work. Would it be possible, she wanted to know, to remove eggs from Karen's ovaries and fertilize them with Alcino's sperm? It would be a test-tube baby, with one crucial difference: Instead of placing the fertilized embryo in the mother's womb—since Karen no longer had one—could it be implanted in her own uterus? And could she, soon to be 48 and already a grandmother, carry that fetus and give birth to her own grandchild?

The doctor replied that such a procedure was physiologically possible, though unprecedented and possibly risky to Pat. Soon afterward Pat got back in her car and drove home to the farming town of Tzaneen, in the northern Transvaal, where she and her husband, Raymond, 48, live in an apartment above the gift shop he owns. When she got there, Karen was walking up the front steps.

"I've got something very important to tell you," Pat called out. Then she hesitated. "But I'll tell you tomorrow."

"You can't do this to me, Mum," Karen protested. "You must tell me now."

As she outlined it at the time, Pat's plan was visionary, though compared with what actually happened, it seems almost modest: Earlier this month she gave birth by cesarean section to not one but three small, healthy babies—David (5 lbs., 8 ozs.), Jose (4 lbs., 15 ozs.) and Paula (3 lbs., 9 ozs.). That made her not only the first woman to give birth to her own grandchildren but also the first surrogate mother to produce in vitro, or test-tube, triplets. The claims of medical firsts, and all the talk of religious and ethical dilemmas stirred by her surrogacy agreement, were of scant interest to Pat, who was simply absorbed in the joyful outcome, a gift of love and life to her daughter and son-in-law. "When I first heard the babies cry, it was just beautiful," she says. "I felt like any other happy granny whose daughter has just had a child."

Perhaps no lesser motive than a mother's love could have made Pat Anthony do what she did. She had not been strapped to a maternity ward gurney since 1964, when she delivered her second child, Colin, now a university student. Colin's birth had been so agonizing that Pat, a slim, small-boned woman just 4'11" tall, had sworn to her husband that she would never willingly endure anything like it again. Though she and Raymond are Roman Catholics, they had no more children.

Problems with childbirth also afflicted Karen and her husband, Alcino Ferreira-Jorge. The ordeal of giving birth to Alcino Jr. three years ago cost Karen not only her uterus, but nearly her life. She required 17 pints of blood in transfusion. "At first when Karen came home from the hospital she didn't believe the truth," Pat says. "It didn't sink in that there would only ever be one child for them." When it did, the knowledge tormented Karen and Alcino, a refrigeration engineer who had left his native Angola in 1975.

"When Alcino Jr. was little," Karen says, "I couldn't be at peace because I knew if anything happened to him, there could be no more children. At night, if he even coughed in his sleep, we would jump out of bed terrified for him." Work only reminded her of her predicament, since Karen runs aerobics classes for pregnant women. Her inability to bear children became an obsession that swept up the whole family. "I think children are part of married life, a vitally important part," says Pat, "and Karen was going to be denied that." When the talk turned to surrogacy, Pat conceived her plan. What she had not been willing to suffer for her own sake or her husband's, she determined to do for her daughter.

At lunch the day after Pat volunteered her services, Raymond and the rest of the family embraced the plan. Pat vowed to give up her three-pack-a-day cigarette habit—a promise she kept. Early last January, after giving Karen drugs to stimulate her ovaries, infertility specialists at Johannesburg's Park Lane Clinic removed 11 of her eggs and combined them in vitro with Alcino's sperm. After 48 hours, four fertilized eggs were surgically implanted in Pat's uterus. Pat was determined that the eggs would survive ("I lay still for four hours after the eggs were placed in me," she says), but privately doctors were less than optimistic. Says Dr. Joel Bernstein of Vita Lab, the Johannesburg infertility clinic that oversaw the procedure: "We rated the chances of the implant working at just over nought percent"—in other words, slim to none. "We believed her age was against her," says Bernstein. He sent the family home to wait, and maybe to pray.

Pat's body quickly gave some signals that sent her spirits leaping. "I knew I was pregnant a few days after the implants and well before any scan," she says. "I felt queasy almost immediately, just like many pregnant women. I put on 12 pounds in three weeks."

A month after the implants—on her 48th birthday—Pat underwent her first sonogram. When the probe was pressed against Pat's abdomen, the machine detected two viable fetuses. The doctors, Pat recalls, "were very, very excited. The nursing sister went to the door to call in Karen and Alcino. Then the doctors noticed a third baby on the scan. Everyone started shouting and shaking hands and kissing each other."

The family's parish priest, Fr. Sean Laffan, had promised to baptize the babies and says he will stand by the commitment despite the disapproval of church superiors. In March, when Pat was in her third month, the Vatican decreed all forms of artificial procreation to be "morally illicit." When reports of Pat's remarkable pregnancy appeared in newspapers around the world last April, the family suddenly found itself embroiled in controversy. To escape the unwanted attention, Pat moved to Johannesburg, where she lived in a secluded house at the end of a cul-de-sac.

Pat remained healthy throughout her pregnancy. So did the babies. But on a Tuesday 16 days before her October 14 due date, a sonogram indicated that one of the babies "was beginning to lag behind the [others]," says Dr. Cecil Michelow, head of the Vita Lab team. "We didn't want the smallest baby to start deteriorating, and Pat was getting tired, so we decided to go ahead" with the cesarean operation.

Pat received an epidural injection, blocking sensation below her waist. She told the delivery room doctors, "If I make my daughter happy, then I will be happy too." Under hospital regulations, Karen was admitted to the delivery room, but Alcino was left to pace outside. Just before the operation Pat waved to him through the door. "Very soon you will be a father again," she called.

Pat had attended prenatal clinic and, naturally, wore maternity clothes, but she had insisted from the beginning that she had only grandmotherly feelings toward the three babies growing inside her. Even two days before the birth, she had said, "I can feel them kicking inside me, and I just laugh. I don't feel any strong maternal instincts or urges. I am doing this because my daughter, not me, was desperate for children and unhappy because of it."

In the delivery room, Pat was surrounded by a team of 14 doctors and nurses. Karen took her hand and gently squeezed it. At 6:10 a.m. Karen heard what she described as "a husky little cry," as doctors lifted out the first of her triplets. Karen and Alcino had not known what the sex of their children would be, but they were ready with names as needed. The first child was a boy, David. Then came a softer cry, and Jose was born.

Karen had always wanted a girl, and now Pat whispered to her that she hoped she would get her wish. "We were both crying with joy when Paula entered the world," Karen recalls. "I had always wanted a little girl, and this was my very last chance."

At about 6:30, Alcino looked up and there was Karen, "running, in her gown and mask, out of the theater and straight into my arms," he says. "I just burst into tears."

While gazing up at the masked faces and blinding lights, and shaking off the drowsiness induced by painkilling drugs, Pat had still managed to share with her daughter the wonder of giving birth. "I was very close to Karen," she recalls. "I kept urging her to listen for their cries." Dealing with an event and with emotions no man before him had experienced, Pat's husband was a picture of blissful pride. "My heart burst when I saw the babies wheeled out of the [operating] theater," Raymond said. "If there is proof of a mother loving her daughter, then this is it."

For nine months, Karen had been taking hormones to stimulate lactation. She had even been practicing on friends' babies. Though Paula was initially placed in an incubator, all three babies began breast-feeding within hours of their birth.

Back in Tzaneen, reaction to the births was generally favorable. "It is fantastic—there will be a lot of champagne drunk in this town tonight," declared Mayor Johan Van Vuuren. "From a Christian and ethical point of view, I know that some ministers in this town do have problems with it, but everybody has great respect for Mrs. Anthony and for the love she has shown her daughter." Father Laffan announced that he still intended to baptize the children, despite a harsh statement from the Rev. Hyacinth Ennis, a lecturer at St. John Vianney Seminary in Pretoria. "There's no distinction to be made between surrogate pregnancies carried out for money and those carried out for love," Father Ennis said. "It's simply wrong to have a rent-a-womb system of parenting."

Pat and her family were hardly contrite. "No one should dare to criticize us," said Raymond. "We have been given three healthy children against all the odds, and surely that is God's will."

Dr. Bernstein, who had excitedly raised the babies over his head before he handed them over to Karen, agreed completely. "We feel that what Pat Anthony has done for Karen is the acceptable face of surrogacy," he said. "There was no payment, no commercialism. It was an act of pure love."

For the South African government, the situation is not so simple. Surrogacy is legal if not undertaken for money, but Justice Minister Kobie Coetsee announced that the triplets would be considered Pat and Raymond's until Karen and Alcino, the genetic parents, formally adopted them. The humorous possibilities were not lost on the local press. The Johannesburg Sterran a front-page cartoon in which one tiny triplet quipped to another, "Legally, I could be your uncle."

For the Anthonys, the legal implications of the birth were secondary to the fact that it was behind them. Three days after the delivery, Raymond drove to a Catholic church to offer a prayer of thanks, and a proud Alcino was talking of how the triplets would one day be told of their remarkable birth. "I don't think it will be much of a problem," he said, "because if you think about it, really very little has happened." Pat agrees: "I never thought I was doing anything really different, just what anyone would do for a daughter deprived of having children." For once, Pat Anthony sounded as if she weren't seeing things very clearly.

  • Contributors:
  • Sue Reid.