Turning Back the Clock
Last spring in Rome, using sperm from Jennifer's 45-year-old fiancé (who became her husband in November), Dr. Severino Antinori, a reproductive specialist, fertilized four eggs donated by a young Italian woman and implanted them in Jennifer's uterus, which he had earlier regenerated from the effects of menopause with hormone therapy. Hailed as one of the oldest women ever to give birth, Jennifer was described by one friend as being "ecstatically happy."
Most other people seemed more shocked than delighted. Few had dreamed that postmenopausal women could be capable of giving birth. Yet in recent years, without much fanfare, scores of women old enough to be grandmothers have done just that—most of them in Europe, but a growing number in the U.S. as well. And if there is anything miraculous to the procedure, it is its relative simplicity. In essence, Antinori, 48, and other scientists have discovered that once the uterus is reconditioned with hormone treatments and donor eggs are found, doctors can use much the same in vitro fertilization methods they do for younger women who experience difficulty getting pregnant. Given the opportunity to help Jennifer and others, asked Antinori, who has helped facilitate 54 births in women over 50, "Who am I to play God and say that she should not have a chance?"
More and more, however, the bundles of joy are coming wrapped in controversy, especially in Britain, where the Jennifer F. case has unleashed a fierce debate. Some medical ethicists argue that the prospect of women giving birth in their 50s and 60s raises a host of disturbing questions. "I don't believe any woman has an inalienable right to have a child. I am 73 and the thought of having a 14-year-old around appalls me," says Dame Mary Donaldson, former chairwoman of the British fertilization and embryology licensing authority. Adds Dr. Richard Marrs, director of the Center for Assisted Reproductive Medicine in Santa Monica: "Are we going to have children who are orphans at the age of 12 because their parents die of old age?"
Other experts contend that disqualifying women on the basis of age alone creates a double standard. In the wake of the controversy created by Jennifer's twins, Prof. Robert Edwards, one of the pioneers of IVF, complained, "If a man of 60 fathers a baby, then we buy him a drink and toast his health at the pub. But it is totally different with a woman of the same age. It's unfair."
And what of the women themselves? How have they fared in this brave old world? By and large, they seem delighted with their choice. For more than 20 years, Liliana Cantadori and her husband, Orlando, of Modena, Italy, had been trying to have a child. At the time of their marriage, in 1972, Liliana was already 41, 10 years older than her husband. After two miscarriages and repeated fertility treatments, they had all but given up hope of a baby. Then, in the early '80s, with the growing success of IVF, the Cantadoris once again went searching for a miracle. By this time Liliana was in her early 50s and had to lie about her age; the doctors would not consider helping any woman over 50. She was able to fool her doctors, in part because she had been taking hormones on her own for years and had not passed through menopause. There was also the issue of money. Liliana, who worked as a midwife in a hospital, says that she and her husband, a hospital porter, scrimped and saved and took out loans to pay for the treatments, which eventually cost $300,000.
In 1986 she turned up at Antinori's clinic in Rome; she was 55 but told people she was 45. After two years of trying, without success, she traveled to Bologna to consult with yet another specialist, Prof. Carlo Flamigni, telling him that she was 47. After three tries at IVF she got pregnant using donated eggs and her husband's sperm. "I knew the risks, and I knew that the baby could die, that I could die, that we both could die," she said. "But I did it anyway."
The pregnancy went smoothly until the seventh month, when Cantadori came down with severe hypertension (dangerously high blood pressure) and swelling and had to enter the hospital until she delivered. Nevertheless, on July 27, 1992, Andrea was born in excellent health at 6 lbs. 6 ozs.—thereby earning Liliana a place in the Guinness Book of Records as the oldest-ever birth mother. The cesarean section, however, took a severe toll on Liliana, who didn't admit to an angry Flamigni that she was 61 until after she got pregnant. "I thought I would die," she recalled. "They had trouble waking me up. If in pregnancy a 30-year-old loses her strength, imagine a 60-year-old."
These days those memories have largely faded. Now 18 months old. Andrea is doing well. "We give him the best steak," said Liliana. "He doesn't lack anything." On Jan. 1 she began receiving her pension, which provides a helpful supplement to Orlando's salary. Liliana has few-regrets about her decision. In fact, there are rumors in the Italian press that she is trying to get pregnant again. She admits that she would like another child, but as to whether she is actually trying she will say only. "It's a secret."
Likewise, for American country singer Jonie Mosby Mitchell the pleasures of late motherhood far outweigh the drawbacks, in March 1992 Mitchell, now 54, gave birth to a son, Morgan, using donor eggs from a 30-year-old woman, a procedure that cost a total of $20,000. "I feel wonderful," says Mitchell, whose husband Donnie, 47, supplied the sperm. "I probably feel better now than I did when I was younger, working in smoky bars."
Which is not to say that motherhood gels any easier after 50. Up each day at 5 a.m., Mitchell does chores in the morning before dropping Morgan off at day care. Then she puts in a half day of work at the country music club she and her ex-husband, Johnny Mosby, run in Ventura, Calif. Picking up Morgan in the afternoon, she heads home to prepare dinner. By 8:30 p.m. she's in bed and ready to start the cycle all over again. In contrast to most other older moms, Mitchell already had four children from her marriage to Mosby, which ended in 1977. But she and Donnie—who have an adopted daughter, Sydney, 5—were considering adopting another child when they learned about IVF "When you give birth you have more control over the situation," says Mitchell. "You're not dealing with attorneys or worrying about getting a phone call and losing the baby."
Mitchell says that most people she meets, once they get over the initial shock of mistaking her for Morgan's grandmother, express nothing but support. "Women will go, 'Hey, Jonie, right on!' " she says. "I have not heard one negative comment."
Indeed, as Mitchell sees it, about the only static has come from her own family. She says that her 29-year-old daughter, Lindy, was taken aback by the pregnancy. "She wasn't that wild about it, I'll admit," says Mitchell. If nothing else, Jonie thinks, she may have unintentionally stolen the spotlight when she had Morgan only 2½ months after Lindy gave birth to her own daughter, Natalie. Since then, Lindy and her mother have learned a new way of bonding and now share baby-sitting duties.
Given the profound jolt to the family structure that comes with late-life pregnancies, it is hardly surprising that relatives can be some of the sternest critics. As Jennifer F.'s brother told London's Daily Mail, "I think she has gone stark raving mad. She's going to be drawing child benefits at the same lime she draws her old-age pension." Her decision to have a baby so late in life, he added, was essentially selfish. "She's spent her whole life making money and now suddenly she's found that she's been making it for no purpose," he said. "She thinks children will provide a purpose. [But] no child deserves to be born to such an old mother. I honestly don't think she can have stopped to think about the future."
But one friend of Jennifer's was more sympathetic. "She had everything—a great job, a $900,000 house and a loving partner," the friend told the Daily Express. "The one thing she didn't have was children. She thought she had missed the boat."
In truth, the motivation of some of the older mothers can at times seem questionable, if quite understandable. One of Dr. Antinori's most celebrated current cases in Italy involves a farmer's wife named Rosanna Delia Corte, who will turn 63 next month. She is now three months pregnant, and thus a candidate to become the oldest woman ever to give birth. Della Corte began dreaming of having a baby after her only child, Riccardo, was killed in a motor-scooter accident in July 1990 at age 17. The fact that Rosanna is still mourning Riccardo, to whom she gave birth when she was 42, has led some critics to suggest that she is merely trying to re-create her lost offspring. (Before she decided to become pregnant, she and her husband, Mauro, first tried unsuccessfully to adopt.)
Rosanna, who was implanted with a donated egg fertilized by Mauro, 65, doesn't deny wanting to replace their lost son. "If I still had Riccardo I never would have done it," she told the Times of London. "I would so like to have another boy. I would so like to see the likeness of Riccardo again, but I will accept the child just as it comes." For his part, Antinori argues that a team of psychologists cleared Della Corte for his treatment. As for her ability to nurture her son into adulthood, he points out that her parents lived into their 90s. "If she stays in good condition," he says, "she'll live another 30 years."
Antinori's efforts have brought him considerable attention, not all of it flattering. Some critics have questioned whether he is more interested in fame than in his patients. One woman, who wishes to remain anonymous, says that four years ago, at the age of 36, she gave birth to triplets thanks to Antinori's treatment. According to the woman, who is a municipal employee, she agreed to do some promotional work for Antinori in return for his waiving part of her bill. She says she had no idea that a photographer would be present in the delivery room, or that photographs of her newborns would be sold to a string of newspapers and magazines. "He thinks he is a personality and that's all that matters," says the woman. "I would be afraid to send someone to him." Antinori staunchly denies that he is after publicity—or money. "My family is rich," says the doctor, who has two teenage daughters with his wife, Caterina, 43, a biologist. "I already had a Ferrari 20 years ago."
All the same, Antinori, who originally trained to be a veterinarian before going into gynecology, has displayed a gift for stirring up controversy. He once said that he had been present at the 1978 birth of Louise Brown, the world's first test-tube baby—a claim denied by the medical team that delivered the child. Last year he disclosed that he had been asked to treat Jane Fonda, now 56, who had recently married Ted Turner. Both Fonda and Turner promptly declared that wasn't so.
As the debate has grown over the propriety of impregnating older women, so too have calls for government-imposed age limits. In response, Antinori—whose fertility clinic in Rome is located a quarter mile from that staunch foe of IVF, the Vatican—vigorously defends the right of researchers to pursue their efforts unfettered by regulation. Even so, he does say that he personally considers 63 or 64 the outer limit. "The only important consideration," he says, "is the individual decision by the doctors and the couple."
In the end, of course, the symbolic importance of late-life pregnancies as a way to level the biological playing field will probably always be far greater than the number of women actually seeking the treatment. Yet for those few older women who do choose the option, the rewards of nurturing can seem as real as they are intangible—much as they do for younger couples. Two years ago, one of Antinori's patients, Giuseppina Maganuco, now 56, managed to have a baby after 20 years of trying. She sees her daughter, Anna Maria, as a godsend. "I don't care what people think," she says. "My house has been reborn." Mention the future—or the chance she will die while her daughter is still young—and she quickly changes the subject to the present. "I have wanted a baby all my life," she says. "All the love we can give, we are giving. I will give all I can until I die, and then after...I don't know."
GABRIELLE SAVERI in Rome, MARGARET WRIGHT and ELLIN STEIN in London, and NANCY MATSUMOTO in Los Angeles
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