How old is too old to give birth? The answer to this question would have been obvious 30 years ago, but recent advancements in fertility treatments mean that in 2015, a woman’s biological clock can be permanently put on hold. Thanks to science, a 55- or even 65-year-old woman can do what was once unthinkable: become pregnant and give birth to a healthy child. However, just because a woman of this age can physically become pregnant, is the decision to do so ethical?

A Breif History Of Pregnancy Over 50

The oldest mother in history is Rajo Devi Lohan, an Indian woman who gave birth at age 70 thanks to the help of fertility treatments. Lohan’s case is not isolated. In 2006, a 62-year-old great-grandmother in California gave birth to her 12th child with the help of in-vitro fertilization (IVF), and later that same year, a 66-year-old Spanish woman underwent IVF at a Los Angeles fertility clinic and gave birth some months later.

In 2010, a survey from The Pew Research Center found that although overall birthrates peaked among women in their late 20s, the birth rates for women aged 35 to 39 had increased by 47 percent and the birthrates for women aged 40 to 44 had increased by 80 percent. In England, around three children every week are born to mothers in their 50s, according to the Daily Mail.

Physical Limits In Older Women

At 20 weeks of pregnancy, a female fetus has a fully developed reproductive system, complete with her entire life's worth of eggs — six to seven million to be exact. But by the time that woman is 30, she will have lost nearly 90 percent of her eggs, and at age 40, only around three percent of them are left. Most women are no longer able to become naturally pregnant in their mid-40s. However, while a woman’s eggs have an expiration date, the uterus, or where a fertilized egg will attach and grow, does not.

“The bottom line is that the uterus can function just about until the death of the woman,” Dr. David Adamson, a fertility expert for Advanced Reproductive Care, in California, told Medical Daily.

While it seems there are no longer biological constraints to pregnancy past menopause, the risk of dangerous complications associated with carrying a child and giving birth significantly increase as a woman ages. Generally speaking, any woman who reaches age 35 and becomes pregnant is considered an older mother. This puts her at an increased risk for multiple pregnancies, gestational diabetes; high blood pressure during during pregnancy; premature birth; having a baby of low birth weight; needing a C-section; having a child with chromosome abnormalities; and experiencing a miscarriage. Pregnancy is also physically hard on the older body, and the weight of carrying a child can be more stressful for women over 50 than it would be for younger women.

'These Women Do Really Pretty Well'

With all that said, humans are healthier than they have ever been in history, and therefore living longer than ever before. A study published in The Lancet last year showed that in 2014, human life expectancy around the globe hit an all-time high of 71.5 years. This is largely thanks to modern medicine, which is constantly improving — and it's also making pregnancy less dangerous each year. How so? A 2012 study looking at 101 pregnancies in women over 50 found that, if screened and cared for, “these women do really pretty well,“ senior author of the study Dr. Mark Sauer told Live Science.

For this reason, Dr. Eric Flisser, a Long Island medical director from Reproductive Medical Associates of New York, told Medical Daily that age is no longer the biggest indicator of whether or not a woman should receive IVF treatment. Also, because the eggs implanted into older women are usually harvested from younger women, there is no longer a risk of chromosomal abnormalities generally associated with older pregnancies.

There is more to being a parent than just giving birth. Photo courtesy of Shutterstock

“You can argue that when people say, ‘This is too old, the risks are too high,'" it "is counterbalanced by younger patients who also have risks,” explained Flisser. “If a woman is capable [of becoming pregnant], on what grounds do you have to deny her services?”

While rising rates of maternal mortality in the U.S. is a great cause for concern, Adamson explained that only a small fraction of this increase is due to the risks of older pregnancies. “There’s no question that maternal mortality is going up, but telling older women not to have babies is not going to solve the maternal mortality in this country.”

Is IVF In Older Women Ethical?

Fertility doctors know that with the right amount of monitoring, a woman can safely carry out a pregnancy well into her 50s or 60s. But is it ethical for a woman to do this? There is no law in the U.S. limiting the age for a woman to receive IVF; individual clinics make that decision.

Some U.S. fertility clinics use a woman’s menopause as a guideline for when fertility treatment should no longer be conducted. Using this as a basis, Dr. Adamson said that if he were to give fertility treatment to a woman over the age of 50, there would need to be "compelling reasons to proceed" with the pregnancy, and that they would need to "outweigh the significant medical risks associated with pregnancy at this age." Once a woman reaches her mid-50s, "it's difficult to envisage a situation in which the social benefits of pregnancy and parenthood outweigh the major medical risks."

Flisser had a bit of a different perspective on the issue, saying that “menopause is no longer a limit on a woman’s fertility and it needs to be dissociated from it. In terms of determining the cut, it has to be passed on more than just age.”

Although pregnancy at an older age may not affect the health of the mother, there are definitely moral complications that may come from giving birth at an older age, with parental lifespan being the most obvious concern. If you have a child at 55, there is a high chance that you may not live to see them graduate from college.

The Ethics Committee of the American Society for Reproductive Medicine maintains the wellbeing of a child as a top priority in its stance on IVF in older women. It states that a doctor has the right to refuse a couple treatment “when there are reasonable grounds for thinking the patient will not provide adequate child-rearing to offspring.”

The Society fails, however, to mention how age might affect the ability to raise children. And unfortunately, because there are no universal laws on this, it means clinics can push the age of reproduction to the extreme. As Adamson puts it, “if you don’t do it, they will find someone who would.”

There’s More To Parenting Than Pregnancy

On the Today Show, Dr. Nancy Snyderman, medical correspondent for NBC News, gave an interesting perspective on the issue when she asked, “Do you want to parent, or do you want to pop a baby out through the birth canal?” Although Adamson explained that, for some couples, the need to become parents is so great that being told of their infertility is like hearing a cancer diagnosis, a couple doesn't need to get pregnant to have a baby. 

U.S. adoption agencies cap the age for adoptive parents at 50, but they are extremely flexible with this rule when it comes to adopting older children. For women who still feel the need to become mothers far past their natural fertility, this may prove to be not only the most healthy option but also the most ethical. 

Correction: It was originally printed that Dr. David Adamson worked at Fertility Physicians of Northern California, but he is now working at Advanced Reproductive Care. The story has been amended to reflect this.