The lined face of 'pensioner mother' Adriana Iliescu strikes at the heart of our most cherished ideals of blooming motherhood, writes Fionola Meredith.
'Elderly primigravida" - the old-fashioned medical phrase for any first-time mother over the age of 35 - has been given an emphatically literal meaning with the news that 66-year-old Romanian woman, Adriana Iliescu, has given birth to her first child after undergoing fertility treatment. Describing the birth of Eliza Maria, as a "dream come true", the former university lecturer said, "I always worked so hard in my career I had no chance to build a relationship and start a family, and after I retired I regretted it bitterly. But I never gave up hope. I believed all my life that a woman has a right to give birth and that is why I had to follow my dream, no matter how old I was. A woman who has not had a child has not led a complete life. One of the reasons for being on the Earth is to give birth."
But the fulfilment of Iliescu's maternal dreams have been met with thin-lipped disapproval by many campaigners and commentators. Josephine Quintavalle, of the campaign group Comment on Reproductive Ethics, described the situation as "horrifying". She says: "When you have reached an age which is well past the menopause you are not meant to have children - it is not what nature intended. Here we have a child which will have a mother the age of a grandmother. It is the ultimate act of selfishness. It is an example of a woman at her most selfish but also most vulnerable. I do not see how any specialist with integrity could have provided this treatment."
Other commentators were quick to join the chorus of condemnation: Deborah Orr, writing in the Independent, claimed that Iliescu had "undergone a medical intervention that is just an elaborate, expensive and grotesque form of adoption", while Times columnist Cristina Odone argued that "a woman who is 67 [sic] when she conceives is more likely to be a burden than a guardian to her child".
Is this outpouring of moral indignation justified? Or should concern focus more closely on the physical limitations of the older mother? Anne Marie Smyth, of Cuidiú, the Irish Childbirth Trust, says, "We work with many mothers of small children in their 40s, and they say that the tiredness they experience is unbelievable. What would it be like for someone in their late 60s?". But Smyth has less sympathy for Iliescu's motives in attempting the pregnancy in the first place. "I do think what she's done is selfish. She put her career first; she didn't think of the effects of that on her future children. It's as if she thought - now, did I forget to do something? Oh yes, that was it - have a child."
Cork-based independent midwife Bridget Sheeran says that what shocks her most about Eliza Maria's birth is not that the event has taken place, but the fact that mother and baby are pictured separately in all media coverage. "Skin to skin contact is vital between babies and their mothers. It's essential in the nurturing, bonding process. A baby needs to look at, touch and smell her mother. And, although it may be difficult, there's no reason why Adriana Iliescu should not breastfeed the child as well."
The dreadful toll which the fertility treatment itself takes on the post-menopausal mother's health concerns Marie O'Connor, of the Irish National Birth Alliance.
"The level of hormone augmentation needed to enable a pregnancy in a woman of this age would be enormous; I can't imagine the effects on the mother's body."
Although Iliescu's doctor, Bogdan Marinescu, agreed there were ethical questions to answer in the case, he insisted that "medically speaking, she is a success". But O'Connor is inclined to agree with Odone's assessment that "children are neither a right nor a commodity, and the IVF industry treats them as both".
O'Connor believes that public disgust should be directed not at the mother herself, but at the doctors who allow such procedures to go ahead: "This is a huge ethical question for the medical profession. You have to ask - who profits? I'm far from convinced that women benefit. It's said that it's a matter of individual choice, but here choice is a synonym for profit on the part of the IVF industry. We are looking at the commodification of life itself. And with the assisted fertility industry starting to take off in Ireland, we really need to sit up and take notice."
While most medical experts warn against giving birth over the age of 50, there is no such legal restriction in Romania. Here in Ireland, only a set of general guidelines issued by the Irish Medical Council is available in the absence of legislative provision. But is legislation the answer in such difficult, emotive situations?
Dr Karina Halley, who lectures in medical ethics at Trinity College Dublin, isn't convinced. "Hard cases make bad law. When this kind of thing happens, everybody starts calling for legislation. But I believe that it's a private matter. Legislation can take the process of judgment away from both the patient and the medical practitioners. The most vital thing is to balance the rights of the woman against the welfare of the child. We hear a lot about reproductive rights - particularly the right to found a family - but sometimes the needs of the child can be eclipsed by that. And there's been very little research done on the effects of having a post-menopausal mother on the child."
Does having a mum who could easily be mistaken for a granny do any real harm to a child? Children's charity Barnardos this week launched an ambitious 12-year strategy, "Valuing Childhood - Cherishing Children", which seeks to make Ireland the best place in the world to be a child. Does that organisation believe that having an elderly mother can negatively affect a child's quality of life?
Grainne Burke says: "In our experience, older people can parent very well indeed. Many children whose parents are unable to care for them are raised by grandparents, and most do a brilliant job. Although a parent-child relationship which extends throughout the whole of childhood and on into adulthood is ideal, there are other equally important factors - especially a responsive, caring approach to looking after a child's needs."
Although many commentators have objected to a 66-year-old woman giving birth on moral or social grounds, it seems evident that the widespread disgust also operates on a much more visceral level. While elderly fathers are admired for their continuing virility, elderly mothers are often seen as an offence against nature.
The lined face of "pensioner mother" Adriana Iliescu strikes at the heart of our most cherished ideals of blooming, burgeoning motherhood. And in the midst of the condemnation, there's more than a hint of distaste for the ageing female body itself, a shiver of revulsion for the "old shrunken paps" of the post-menopausal woman.