x Abu Dhabi, UAESaturday 20 January 2018

Indian woman, 66, gives birth to triplets amid debate over ethic of elderly mothers

Critics say women are risking their lives; doctors argue they are fulfilling desires for an heir.

NEW DELHI // For centuries, being childless in India was a stigma so severe that it drove many women to suicide and gave men grounds to take another wife. Desperate would-be-mothers used to turn to tantrics, visit fertility shrines and take herbal remedies in the belief it would help them conceive.

In the past 20 years, however, they have increasingly been seeking in-vitro fertilisation (IVF) treatment from thousands of unregulated private clinics that have sprung up across the country. As a result, the issue now is that women who are old enough to be great grandmothers are risking their health by undergoing fertility treatment so as not to die without a child. The doctors who provide the treatment, mostly in the conservative northern states of Haryana and Uttar Pradesh, say they are helping women who feel it is their social and religious obligation to produce an heir.

Opponents argue that it is immoral for a doctor to encourage an elderly woman to risk her health to have a child who might be orphaned after a few years. The debate was highlighted yesterday when it emerged that Rajo Devi Lohan, who became the world's oldest mother when she gave birth at 70 in 2008, may be dying from complications as a result of the pregnancy. Last month, Bhateri Devi, 66, gave birth to triplets after receiving IVF treatment from a the same fertility clinic in Haryanawhere Ms Lohan gave birth.

Dr Anurag Bishnoi, who runs the clinic, said that he had already treated 100 post-menopausal women including Ms Devi and Ms Lohan and that the number seeking treatment is on the rise. "I feel it is morally right to help these women - there are no ethical problems," Dr Bishnoi said. "They don't need children to play with or to have fun. Their only reason is to have someone to carry on the family name to leave their property to."

Dr Bishnoi's clinic first checks the women for problems such as hypertension, heart disease and diabetes, then finds them egg donors and implants the fertilised ova in their wombs for US$2,000 (Dh7,346) each. He says that even though the eggs are donated - and sometimes the sperm, when the husband is infertile - the women still feel that the children are their own. "The law says if a baby comes from the uterus of a woman then that is her baby. The law does not recognise genetic maternity."

He rejects arguments that women over 50 are not healthy enough to have babies, saying he prefers to assess every patient on a case by case basis. "I consider the woman's health, not her age," he said. "These women are healthier than me. Our generation drinks and smokes. These women are labourers. They work hard in the field. They are in good physical shape." Many Indian doctors and social activists disagree, however, and have lobbied hard for legislation regulating private fertility clinics

They say the technology is reinforcing the same social prejudices that once led to childless women being socially ostracised. Main among the critics is Dr Pushpa Bhargava, the architect of a new law to regulate assisted reproduction in India that has been finalised by the health ministry and is going to be presented to parliament soon. "It is very irresponsible," he said in an interview. "As of today you can do exactly what you want to do. We have laws to run shops but there is nothing to stop you opening an IVF clinic."

Doctors say elderly women's bodies are not designed to withstand the strain of pregnancy, the caesarian births that are necessary for them or the stress of looking after a young child. A report by French scientists this week said children born through IVF ran a greater risk of suffering from some sort or malformation although it was not clear whether the process or the parents' age was the cause. Dr Bhargava said the main problem for the children born to elderly parents was the risk of being orphaned at a young age.

"It's a question of what is good for the child. If life expectancy in India is somewhere around 70, what are you doing helping women of this age to get pregnant?" He and other activists pushed hard to include an age limit for would-be-mothers in the new law, but IVF clinics successfully thwarted their efforts. "There is an age limit for surrogacy, a limit for sperm and egg donors, but there is no age limit to receive IVF treatment," said Dr Bhargava.

"It was discussed at great length but it was decided that it is the right of everyone to have a child. "Traditionally we have valued the right of a person to have a child over the rights of a child." @Email:hgardner@thenational.ae