A wrinkled, saggy woman carrying a foetus? Yuk

Reasoned arguments against infertility treatment for fifty-year- olds mask deep prejudice, says Polly Toynbee
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The Independent Online
When a woman of 59 last year gave birth in London to twins conceived in an Italian clinic, the outburst of revulsion ricocheted round the world. Virginia Bottomley, fond of bandwagons, promised rules to stop it. The Italians are now moving to strike off doctors who give IVF to such old women.

Imagine an old woman with wrinkled dugs, prune-shrivelled womb, dewlaps and liver spots, challenging nature with such effrontery. Yuk. Could anything be more disgusting than pumping her full of eostrogen and implanting a poor innocent little fertilised egg inside her withered organs? Mothers in paintings or on the backs of nappy packs should look like icons of the Virgin Mary, not her grandmother.

Horror of older women is deeply embedded in the psyche, from myths of hags and harridans to savage mother-in-law and knicker-elastic jokes. When Les Dawson, loather of older women, became a father at 59 the press whooped with congratulations and no one thought his face would frighten the baby. As it happens, childbirth is starting later and later in most women's lives and the number of mothers over 40 has risen by 53 per cent in the last 10 years.

Now a bold series of articles written by senior consultants and philosophers in the British Medical Journal has challenged the conventional wisdom that older women should not be helped to conceive. The articles are a good example of the value of philosophy brought to bear on real problems, forcing the pace of thought, demanding rational justification for gut reaction.

All hospitals have their own ethics committees, and most ban IVF treatment for women of 50. There are very good reasons for this, which they can parade quite respectably, as success rates for older women are still low. Clinics have often taken large sums to put them through horribly humiliating and distressing cycles of treatment with a low to zero chance of conception. Doctors may tell women the facts, but desperate patients are even worse at making serious odds assessments than people buying lottery tickets. However, the BMJ authors say that soon success rates will be good enough not to justify refusal on those grounds.

The second respectable reason for refusal has been rationing: it is rare to get IVF treatment on the NHS, so younger couples take preference. But most IVF is now private, and if older women want to buy it the rationing argument doesn't apply. The third and most common reason for denying older women IVF is not respectable at all, and it is demolished with a clinical incisiveness by the BMJ philosphers. It is not in the interests of the child, goes the argument, to be born to a mother so old. She will be tired, too far apart in generation and she may die while the child is still young.

But what child? At the point of debate there is no child to have any interest in the matter. The question is whether this child should ever exist or whether it would be better off if it didn't. But you would have to postulate a life of torment to decide a wanted child is better off not born.

The arguments in favour of abortion are not that the child would have an unhappy life but that the mother has a stronger right to refuse to bear it. Now it is a dangerous slippery slope to start saying a wanted child would be better off never born. This is the frightening primrose path to eugenics.

We all of us go to hell in our own particular ways as parents, and age of parents is one of the weaker predictors of success. Few people seriously postulate the state banning unsuitable people from having children.

Ah, but assisting a post-menopausal woman to have a child is another matter. It is contrary to nature (whatever that may be). It is intervening in order to create a child with what may be less than perfect parents. But that does not help the argument either. Other parents paying for IVF treatment quite rightly do not undergo more than a cursory interview to check their suitability as parents.

As for nature, we fight it all our lives and celebrate every victory. We do battle with aphids in the garden, cancer in ourselves, we roll back the frontiers of ageing and praise our new longevity: women live to 78, but it was only 47 a hundred years ago. Was it "natural" for women to endure perpetual pregnancy and death in childbirth? Nature red in tooth and claw is our enemy as often as our friend and "natural" is no synonym for good.

Many people might think women of 50 or 60 who want to have babies may be a few nappies short of a layette. But is it any of our business? Childlessness at any age can cause anguish as deep and long-lasting as bereavement.

No, the Yuk gut reaction to older women bearing children overwhelms all these apparently rational arguments. Older men can carry on as sexy ageing matinee idols well into their sixties, with serial new young wives and flotillas of bouncing babies. But middle-aged women are supposed to abandon sex with dignity and slip silently into their K shoes and British Home Stores cardies. According to prison etiquette, the most disgusting offence a young man can commit is to rape an old woman.

But no more. Shirley Conran - nude on the beach at 62, liposucked, nipped, tucked and proud of it - is leading another revolution: older women refuse to be seen as revolting, or at least no more revolting than older men. A man's fold of flab is no better than a woman's. It is the conditioning of our eye to see a lined male face as characterful, while a wrinkled woman is past it.

The second wave of rebellious old bags will have to go one step further and dare to pose nude on the beach without the aid of the scalpel (if that's their peculiar bent).

Our concept of taste and propriety in matters of sex and fertility moves all the time. Louise Brown, the first test tube baby, was greeted as a freak. There were hysterical predictions that busy professional women would from now on hand baby production over to the labs. Frontiers of decency move on as we accustom ourselves to the conquest of nature: babies for post- menopausal women is just one more step along the path of choice and freedom.

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