Late-life motherhood

Raising a child in one's 50s and 60s is not a choice many women would make. The small group of mothers who do, evoke fascination and empathy as well as criticism

In her hometown of Highland, California, at the foot of the San Bernardino Mountains, Arceli Keh feels she can hide the fact that, at age 63, she became the oldest woman on record to have a baby.
Keh says few townsfolk seem aware of the controversy surrounding six-year-old Cynthia's birth, and when people mistake her for Cynthia's grandmother, she rarely bothers to correct them. "I just wanted to have a healthy baby and live a quiet life,'' Keh says.

But the normality of Keh's life and her desire to blend in belies her extraordinary quest to have a child - and the resulting impact she and similar women have had on society and the field of reproductive medicine.

While it appears that raising a child in one's fifties and sixties is not a choice many women would make, this small group of mothers wields enormous influence. Their well-publicised successes, Keh's chief among them, have made pregnancy in one's forties appear almost young.

"I think that there are women who saw Mrs Keh and say, 'I'm only 51. She was 63,'" says Dr Richard Paulson, the University of Southern California infertility specialist who helped Keh become pregnant with the use of eggs donated by a younger woman. "She's the one who makes it so much easier for the women 15 years younger.''

In the U.S., the birth rate to women ages 40 to 44 rose 44 per cent from 1990 to 2000 while the number of births to women ages 45 to 49 reached its highest number in more than three decades. Among women aged 50 to 54, births jumped from 174 in 1999 to 255 in 2000, according to the recently released National Vital Statistics Report, which cites infertility therapies as one factor behind the increases.

Such births evoke both people's fascination with medical miracles and their empathy for women who want children so badly they are willing to undertake pregnancy at an advanced age. Reports that actress Geena Davis gave birth earlier this month at age 46, and Britain's first lady, Cherie Blair, had a son two years ago at age 45, generated intense interest.

But such late-life pregnancies are not without criticism. Some social critics and medical experts suggest that the births do not always take into account the welfare of the child. And the effect on women is great as well, says Sylvia Ann Hewlett, founder and president of the National Parenting Association, which promotes family-friendly policies in the workplace and communities. The medical risks and emotional and financial costs of having a baby late in life are enormous, she warns.

In her new book, Creating a Life: Professional Women and the Quest for Children, Hewlett writes that post-50 moms "send a dangerous message: that women can wait to have children because technology will be there to save them when they are ready. But for every 52-year-old woman who succeeds, thousands more waste an inordinate amount of energy, time, and money.''

But Keh couldn't care less about what kind of message she sends or her place in history. Like other older mothers, she was driven by her deep desire to have a baby.

She and husband Isagani were married in 1980 in their native Philippines when she was 47 and he 44. They immigrated to the United States to be near relatives. "I thought I would still have a chance to have a baby then because I was under 50,'' says Keh, granting a rare interview in the couple's home.

Like many women, Keh mistakenly thought she could still get pregnant simply because she had not yet completed menopause. Years passed with no pregnancy, and she came to think she would never have a child. But her hopes were renewed when she read about the use of donor eggs. In 1993, scientists reported that even post-menopausal women could have a baby through in vitro fertilisation if a younger woman's eggs were used.

In 1995, Keh made an appointment at USC's infertility clinic, which takes qualified patients until age 55. Most clinics turn down women older than 50. Keh arrived with medical records that she had altered to put her age at 51. She was 61. "I lied,'' says Keh, who defends her actions by saying, "I felt young.''

Keh retired from her job as a bank secretary and underwent five cycles of IVF, exhausting the couple's $40,000 retirement savings, before becoming pregnant. She had Cynthia - whom Keh named after model Cindy Crawford - by Caesarean section on November 7, 1996. Keh had gained a scant 22 pounds and had navigated the pregnancy with no more trouble than morning sickness and mild high blood pressure.

The Kehs' relatives and friends warmly accepted the couple's choice. But the public response was not as kind. The remarks ranged from fears about the unknown medical risks faced by an older woman giving birth to doubts that a retirement-age parent could adequately parent a teenager. Others wondered whether such desperation to have a child was "healthy''.

And ethicists questioned the decision to have a baby that the couple might not live to see graduate from high school. The Kehs would be 81 and 78 when Cynthia receives her diploma.

Public attitudes about late, late motherhood have softened in the five years since Cynthia's birth, Paulson says. "I think it's still controversial but not to the extent it was in the beginning,'' he says.

Little is known about the lives of these families after the child's birth. Do the parents have the energy to tend to a toddler? Do children care if their parents look like grandparents? How many will experience the death of one or both parents before graduating from high school? Keh and other older mothers say they have carefully weighed those questions.

The Kehs, who are both retired, will depend on their extended family to care for Cynthia should they die or become infirmed. In the meantime, they and Arceli Keh's mother, 90-year-old Liwayway Solis, dote on the cherubic and shy Cynthia.

The child's crayon drawings are taped to the living room walls. Cynthia has many friends in kindergarten. She is obedient, but silent and unsmiling, when visitors from the media arrive one recent day after school. Out of the earshot of strangers, however, she loves to sing, says Keh.

"Being a mother keeps you young,'' says Keh, who says she dyes her hair to maintain a more youthful appearance. She says she knows that Cynthia will someday quiz her parents about their age. "I will tell her that I wanted to have a baby - that 'I wanted you,'" says Keh.

© Los Angeles Times-Washington Post News Service