German mom expecting quadruplets at 65

Excerpted from “German Mom Expecting Quads at 65 Is 'Irresponsible': Bioethicist,” NBC News. April 14, 2015 — Berlin school teacher Annegret Raunigk is proudly prolific and, at age 65, not done making babies — pregnant with quadruplets that would enlarge her family from 13 to 17 children. Raunigk said she became pregnant again because her 9-year-old daughter asked for a younger sibling. (Her first 12 children — by five men — are ages 22 to 44). She told German tabloid Bild that donated eggs were fertilized and implanted at a clinic in Ukraine. Multiple attempts were required to get the eggs to fertilize. She did not say whose sperm was used or if the egg donor was paid.

What she is doing is unethical. She doesn't think so. But she left her country to receive an infertility treatment that's illegal in Germany due to her age. And she sought that help on the sole grounds that her youngest daughter wants a sibling. Of course, given that logic, future requests by any of her newest kids apparently guarantee no end to her pregnancies.

The number of reasons why this very-late-in-life pregnancy is morally wrong nearly equates to the number of children Raunigk has conceived. But let's stick to the main issues. First, she likely will not live long enough to raise her current children, much less any new kids. It is not fair to children, as adoption agencies know when they limit adoption to those under 55, to intentionally create a family where mom and dad will enter a nursing home as the kids enter junior high.

Making four kids in a 65-year-old body also is irresponsible. The quadruplets are likely to be premature and, if they survive, may pay a steep price for this decision in terms of their health. Her older body makes the pregnancy extremely high risk all the way around. There will be a C-section, which is dangerous for her. And there certainly will be no breast-feeding by mom.

And what clinic would agree to accept as a patient a woman with 13 children — simply because her daughter wants a sibling? What clinic would not insist on a surrogate mom? What clinic would not demand she stay nearby during the pregnancy? What clinic would even let her try to deliver four fetuses?

The answer: One looking to gain fame and clients by engaging in a publicity stunt with nascent lives. Then again, this theoretically could have happened as well in the U.S. where there are no restrictions about who can use technology to have a baby — grandparents, mentally ill, very old single parents, even child molesters. Despite the headlines babbling about "miracles" and "gifts," and despite Annegret Raunigk's insistence that she should be free to reproduce however and whenever she wants, what's needed is a far more thoughtful, moral stance to govern reproductive technology.

Commentary

CMDA Member John Pierce, MD: “The case of Annegret Raunigk is another clear example of doing what is ‘…wise in your own eyes’ (Proverbs 3:7a, NIV 2011). In the world, there are arguments for age limits on IVF including the multiple health risks for the older mother and her infant, as well as arguments against age limits purporting reproductive freedom, equality for women (as older men can father a child) and social factors ‘to help fulfill lifelong dreams.’ Moral arguments might ask questions such as, ‘Is it right to have a child when the average life expectancy (about 80 years old for women in the developed world) means the child would be without a mother before driving a car?’ or ‘On what grounds do you deny the patient her rights?’

“Clear thinking using the principles of autonomy, beneficence, non-maleficence and justice has been supplanted with situational ethics incorporating intense emotions and cultural relativism. Why would we not have these struggles when there is no standard and a crumbling foundation? The law is silent on age in reproductive rights and most medical organizations provide weak recommendations,ⁱ leaving the decision up to individual clinics,ⁱⁱ or refute the need for practitioners to use their conscience.ⁱⁱⁱ

“Solomon sincerely asked the Lord, ‘So give your servant a discerning heart to govern your people and to distinguish between right and wrong...’ (1 Kings 3:9, NIV 2011). While we may argue vehemently, the loudest voice will be undeniable examples of healthy relationships, thriving marriages, happy families and renewed minds.”

ⁱEthics Committee of the ASRM. Oocyte or Embryo Donation to Women of Advanced Age: A Committee Opinion. Fertil Steril, 2013;100:337-40.
ⁱⁱ Fisseha S and NA Clark. Assisted Reproduction for Postmenopausal Women, AMA Journal of Ethics, Jan 2014, Vol 16, No 1:5-9.
ⁱⁱⁱCommittee on Ethics. ACOG Committee Opinion: The Limits of Conscientious Refusal in Reproductive Medicine. Obstet Gynecol, 2007 (reaffirmed 2013);110:1203-8.

Resources

CMDA’s Assisted Reproductive Technology Ethics Statement
Standards4Life – Infertility and Reproductive Technology