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The problem with 21st Century Motherhood

17 August 2009
By Dr Sammy Lee
Sammy Lee is based at UCL, where he teaches medical ethics, embryology and biomedical sciences. He also carries out research on regenerative medicine.
Appeared in BioNews 521
Did the death of Maria Bousada change public attitudes to the modern phenomenon headlined as 'Oldest Mums'? The world's media certainly made hay and the news reverberated for a few days; and it seems likely that the Channel 4 documentary 'the Worlds Oldest Mums' was rescheduled to screen early to catch the media wave which the death generated. The aftermath, though, of this tsunami seems to have largely been relative indifference.

Since May, I have been organising the conference '21st Century Motherhood' (TCM), which will take place at University College London (UCL) on 18 September. During this time, it has been interesting to see the responses of the prospective speakers to the phenomenon. Everyone approached has expressed views on how interesting and important it is to hold this conference. The consensus is that the conference is needed and Maria Bousada's case probably heightens the need and urgency to have a public debate on the conundrum. A number of persons approached expressed the opinion that though this was a very important topic, there was a paucity of data and expertise. Some were reluctant to participate because, even though they were experts in the ethics, sociology, anthropology or psychology of human reproduction and technology, they felt the lack of hard data made it difficult to make meaningful statements on the subject.

What are the problems then? If a review is done of the world's press, despite headlines indicating ethical and moral outrage, the content of the articles contains little or no discussion of the ethical issues. The key criticisms centre on the individual selfishness of the 'mother(s)' and their lack of responsibility. Comments have been made on the dangers of pregnancy and giving birth at an advanced age, but other than a few mutterings concerning the welfare of the children there have been few other issues mentioned.

All those years ago, when working with Ian Craft and Paul Serhal (now UCL's IVF medical director) at the Wellington Hospital, I recall my reticence about the ovum donation (OD) project, which the Wellington team pioneered in the UK. As head of the laboratory, my job was to provide 'engine room' support to the project. As such, I really saw OD as just a 'small beer' option for young ladies who had undergone premature menopause. My reticence was linked to the way that the egg donors were recruited (at the time controversial, but now commonplace and routine), but perhaps it was also linked to a subconscious foreboding. Who would have thought that OD would spawn a field which would produce about 2,000 cycles per annum in the UK alone! Moreover, who would have predicted that it would be used to treat 70 year old ladies?

Now, almost 25 years after the first UK OD babies were born, and a journey stretching from specialising on male infertility to a diploma in counselling (trying to help couples cope with childlessness and letting go of treatment), when reflecting in the cold light of day, in fact TCM is not really a surprise. Rather, it is the ultimate expression of a primal desire. Over the years, it has become clear to me that infertile couples very rarely let go. This seems to happen only when egg or sperm and money run out. In the old world, this produced a halt. In the new world, technology has yet again moved the goal posts. The danger is that TCM is on the threshold of moving into the realm of OD. It might be that 10 years from now there will be 2,000 per annum of this modern phenomenon.

The conference will help throw more light on the matter, hopefully serving to highlight what the real issues are, helping to generate new insight which will help the clinics and the regulators deal with likely increasing demand. For me, the ethical issue which looms largest is the likelihood that TCM is driven by desire and that object of desire is children. TCM costs a lot of money and the desire seems to place the child(ren) in the worrying position of commodity. Kant's ideas of being a 'means to an end'; i.e. making a child the 'means to an end', is a bad idea. When I heard about Bousada's death, my first thought was of the twins and my second thought was that this is what happens when you make children a 'means to an end' (commodity). Forget all the other arguments, the objectivisation of people is perhaps the biggest danger here.

Sammy Lee is organising the conference 21st Century Motherhood - cosponsored by the charity that publishes BioNews, the Progress Educational Trust (PET) - in London on 18 September 2009.

28 August 2012 - by Department of Cell and Developmental Biology, University College London 
Sammy Lee, visiting professor in the Research Department of Cell and Developmental Biology, University College London (UCL), since 2010, and visiting professor in biomedical science at the ABC Medical School in São Paulo, Brazil, an expert on fertility and in vitro fertilisation, passed away suddenly on 21 July 2012...
28 June 2010 - by Dr Gabrielle Samuel 
Women could soon find out how long they have left to start a family thanks to a blood test that determines when they will go through menopause....
19 October 2009 - by Antony Starza-Allen 
Maria Bousada, 69, once the world's oldest mother, died in July this year leaving behind two young children born following IVF only two years earlier. Her death reignited the debate surrounding 'older mothers' - or more specifically, post-menopausal women who require fertility treatment to conceive. In response to media attention surrounding Ms Bousada's death, Professor Sammy Lee, an expert in medical ethics, embryology and biomedical sciences based at University College London...
20 July 2009 - by Antony Starza-Allen 
The world’s oldest mother has died from cancer aged 69. María Carmen del Bousada de Lara, from Spain, gave birth to twins two years ago through IVF...
16 February 2009 - by Sarah Pritchard 
A 60 year-old woman has sparked controversy in Canada by travelling to India to receive fertility treatment after years of failed attempts to conceive naturally. Ranjit Hayer, originally from India, has become the oldest woman in Canada to give birth after receiving IVF at Dr Anoop Gupta's Delhi fertility clinic; her twin boys were delivered seven weeks prematurely by Caesarean section at the Foothills hospital in Calgary last week....
14 December 2008 - by Sarah Pritchard 
An Indian woman has given birth to a baby girl by Caesarean section at the age of 70, after receiving fertility treatment in her home state of Haryana in India. Rajo Devi and her husband Bala Ram remained childless during 55 years of marriage before they heard...
7 July 2008 - by MacKenna Roberts 
A 70-year-old woman in India is reportedly the world's oldest woman to give birth, when she had twins last week. The girl and boy babies were delivered one month early by emergency caesarean section but are reportedly alive and well after being transferred to specialist neonatal...
29 May 2007 - by Danielle Hamm 
A sixty year-old woman has become the oldest women in the US to give birth to twins. The two healthy boys were delivered in the US Hackensack University Medical Centre on 22 May. The twins were conceived via IVF in a South African clinic. The couple, Frieda...
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