Credit: Amy Ruiz

Amy RuizLast year, a 70-year-old Indian woman named Omkari Panwar made medical history as the oldest woman to give birth. She and her husband conceived via in vitro fertilization, and Omkari delivered boy-girl twins via C-section. The couple had two daughters and five grandchildren, but they had always wanted a son.

As radical as that story seems, the idea of having kids later in life is not. Medical advances—including in vitro fertilization, using donor eggs and/or sperm to conceive, and enlisting carriers—have all but erased the notion of a biological clock. In fact, between 1997 and 2007, the birth rate among American women ages 45 to 49 shot up 50%, according to the Centers for Disease Control and Prevention (CDC).

The CDC doesnt even have comparable data for moms over 50, because this trend is so new. Along with news reports of older moms from coast to coast (Frieda Birnbaum of New Jersey had twins at 60, and Janise Wulf of California had a baby at 62), theres a growing number of support groups such as,, and the Yahoo! group babiesafter50.

But there is a flip side to this phenomenon. In the June issue of Health, we reported on the health dangers of later-in-life pregnancy. Now, in part two of our series, we investigate the challenges these older moms face—from the stigma of being the oldest mom on the playground to unexpected, even life-threatening, health issues. Read on for three womens honest stories.

Next Page: Joanie Shook, 47 [ pagebreak ]

Joanie Shook, 47
Emmylou and Maggie, 23 months; Bernadette, 9
Scio, Oregon

For most of my adult life, I was a “single career woman.” No kids? No problem. I was busy dating, socializing, and seizing career opportunities. (I work in health administration.) So I wasnt troubled when, in my early 30s, I was diagnosed with premature ovarian failure, which left me infertile. I didnt mind—apart from the thought that it might make my boobs droop!

Eventually, I met my husband, Greg, and I got a lovely package deal: he had an adopted daughter, Bernadette, whos now 9, from his first marriage.

Problem was, he wanted more kids. “Well, youre barking up the wrong tree,” I told him early on. “I cant help you out there.” Ironically, he had had infertility issues, too. But one day, something made me look up fertility treatments on the Internet. I loved my husband so much that I wanted to do whatever I could to make him happy.

At a consultation with a fertility specialist in October 2006, when I was 44, we learned that we could try an in vitro fertilization (IVF) treatment using donor eggs and an intracytoplasmic injection of my husbands sperm (where a single sperm is directly injected into the egg). In March 2007, we chose our donor, who we dubbed Nel—as in Nice Egg Lady. I was placed on a strict protocol of hormone therapy. We did our embryo transfer in May 2007, and I got pregnant. Through the 13th week of pregnancy, I took regular progesterone injections—which my ovaries would have supplied had they been working.

Though I was 45 (and thus considered high risk), it was a near-perfect pregnancy. My ovaries may have been kaput, but the rest of my reproductive organs were strong. (My doctor joked to me, “Your cervix could hold Arnold Schwarzenegger.”) At 37 weeks, I gave birth to our healthy twins, Emmylou and Maggie.

Now, Im nearly 48, my girls are pushing 2, and … yes, Im often mistaken for their grandmother. In our rural town, youre not rolling in a lot of older moms, and I wasnt prepared for the sidelong glances or the comments like, “Oh, are they yours?”

I didnt mind the idea that people thought I looked old. But at first, “Are they yours?” made me wonder if people were referring to donor eggs. Were they asking if my babies were genetically mine? That hurt my feelings. Sure, I used donor eggs. But my girls are so mine, my eggs or not.

Ive since come to realize that “Are they yours?” usually means, “Are you the mother or the grandmother?” To me, that question is less offensive. I wear my age as a badge of honor. When I answer “Yes,” its as if Im saying, “Look how strong I am, that at my age I can have these beautiful babies.”

True, there are plenty of days when I feel alienated. Ive become a stay-at-home mom, and when I drop off our 9-year-old Bernie at school, its pretty obvious how much older I am than the other moms. I can only imagine how its going to be in five years, when I take the twins to school.

And there are little reminders that I hail from a different decade. At mommy-baby get-togethers, the other moms dress younger. And theres a technological gap. At the playground, theyre texting. And Im not always up on the latest Twitter topics.

But the only true downside to being an older mom is being older. Its grunting when you get up off the floor. I would love to have my younger body back. But the fact is, I couldnt have done this 10 years ago. I wasnt financially secure enough. And Im far more appreciative now than I would have been in my younger days.

My husband has been my rock. I cant tell you how many times we just look at each other over the chaos and laugh. Greg is the CEO, Chief Entertainment Officer, and Im more inclined to be the Chief Operations Officer. I give the baths, feed the kids, and get the little ones into pajamas. Were a very close family.

At the librarys story time last week, the twins sat down to color for the
first time, and I started to cry. I said, “Look what Emmylou did!” And I let
it flow, because at my age, I dont care what people think. I really do appreciate the little things, because I never expected to have them.

Next Page: Elizabeth Allen, 51 [ pagebreak ]

Elizabeth Allen, 51
Luke and Jake, 7 months; Elizabeth, 26; Ashley and Kristin, 22
Oyster Bay, New York

Seven months ago, I gave birth to my precious twins, Luke and Jake. They are an answered prayer. Would I recommend pregnancy and childbirth to others over 50? “Listen to my story,” Id say. “And decide for yourself.”
In 2006, I married my husband, Daniel, 51—a second marriage for both
of us. We both had grown children from our first marriages, but we wanted to have a family together.

Im a registered nurse, so I knew that pregnancy at age 48 was considered high risk. But I felt young. I was in good shape, and I still had my period. So I didnt think any of the complications would happen to me. Still, I heard out the fertility specialist, who presented us with the health risks that older women face. In the past, Id had a few episodes of tachycardia, which is a faster-than-normal heart rate. I knew that the physical stress of pregnancy might bring it on again. I saw a cardiologist, who did a cardiac stress test, an EKG, and an echocardiogram. I passed the tests easily. I also underwent a mammogram. The doctors said that I was healthy enough to have a baby.

Getting pregnant was easy, but staying pregnant proved difficult. I did in vitro, got pregnant, and had a miscarriage. I did in vitro again, got pregnant, and had another miscarriage. I switched fertility doctors, and had all kinds of blood work done. It turned up a gene mutation called MTHFR that can cause blood clots that keep nutrients from getting to the placenta. But it was treatable with anticoagulants.

I tried again, and eventually got pregnant with twins—at age 50. We were thrilled, despite my OB-GYNs warning that carrying more than one baby would be stressful for my body.

And how right she was. At 26 weeks, the problems began. First, the anticoagulants weakened a blood vessel in my uterus—so much so that it ruptured and caused heavy bleeding. I thought I was miscarrying again, but after a brief hospital stay, I moved past it. Around that time, my doctor suggested that I go on bed rest and use a wheelchair. As if I had a choice! Just walking from the La-Z-Boy to the bathroom, I would get short of breath. The babies felt heavy and stressful on my whole body. My legs swelled.

At 28 weeks, I felt the sensation of my heart beating at twice its normal speed. I knew instantly that this was tachycardia, and if there had been any doubt before, it was now clear that carrying two babies was too much for my heart to take. I spent four days receiving intravenous and oral medication at the cardiac-care unit of the hospital. But Dan was always at my side, and throughout the ordeal, the babies continued to do great.

With medication, the doctors kept my heart under control. But in the weeks that followed, I didnt feel right. Exhausted and swollen, I would go back and forth to my doctors office for test after test. Finally, when I was at 35 weeks, I lost the ability to urinate. This time, the doctor tested my blood for creatinine, a chemical waste molecule that gets filtered out of the blood and passed via urine. The level was unusually high, which tends to signal renal failure. My kidneys were shutting down. For the first time, I was frightened for my life.

On May 5, 2009, my OB-GYN did an emergency C-section. Dan held my hand the whole time, and my healthy babies sailed through the procedure. But I couldnt concentrate on them. I had lost 25 pounds of fluid, sending my body into hypovolemic shock caused by lowered blood flow throughout the body, which is a life-threatening condition. My temperature dropped to 96 degrees. I shook with cold and fear, fighting to stay alive. My very concerned doctor pumped me full of fluids, and I spent the next 10 hours in the recovery room. Dan stayed by my side, reassuring me that I would be all right. I wasnt 100% cognizant, but I knew that my very survival was touch and go.

At some point during that critical postpartum time, my kidneys began to function. Thank God! After five days in the hospital, I headed home—still swollen, weak, and anemic, but beginning to bounce back.

It would be another two months before I truly felt better, and Im still not myself. Even now, I struggle against constant fatigue. But were fortunate enough to be able to afford in-home child care. We had a health-care worker for the first six weeks, and weve had a babysitter every day since then. I also have a lot of family nearby. And, luckily, I havent hit menopause yet, so Im not dealing with those discomforts.

As for my kidneys, the renal failure was strictly due to the physical stress of two babies. Now that theyre out, my kidneys are fine. Nor have I had a problem with tachycardia, though I do plan to undergo ablation therapy—a treatment that prevents it from happening again.

In retrospect, I ought to have undergone ablation therapy before I got pregnant. I also could have used a gestational carrier. Id considered hiring one, but then thought, No, I can do this. I didnt realize that I would be risking my life. Nor did Dan, who had moments right before our twins birth when he was petrified he was going to lose me.

But we dont regret having our twins. If we try for another baby, though, Ill be using a gestational carrier.

Next Page: Randi Carol, 60 [ pagebreak ]


Amy Ruiz

Randi Carol, 60
Twin boy and girl, 20 months
Queens, New York

Like a lot of mothers with babies in my neighborhood, I take my twins to a weekly, mommy-and-me type program. Singing songs and playing games, we mothers cant get enough of our delicious toddlers. At times, Im even oblivious to the fact that Im the oldest person in the room. At 60, I may be the oldest person on the block.

Why did I wait so long to become a mother? Ive always liked children, and even worked with them daily for more than two decades, as a social worker. But I did not get in touch with my strong desire to have my own until after my clock had finished ticking. Then there was the inconvenient fact that I never met the right partner.

At 50, I did some soul searching. I realized that I really, truly, adamantly wanted to be a mother. My two sisters, who are both married with children, were wary of me having a baby—especially as a single person. This didnt deter me, though.

At my age, my odds of adopting a newborn were slim, and I feared that a pregnancy might compromise my health. So I searched for an egg donor, a sperm donor, and a gestational carrier to deliver my baby. It took five harrowing years—filled with dishonest or incompetent doctors, donors, carriers, and fertility agencies. I spent more than $100,000, much of it lost in fraudulent deals and outright scams. At times, I was beside myself with anger and disappointment. But finally, on April 12, 2008, a gestational carrier delivered my gorgeous, boy-girl twins from frozen embryos I received from a couple in Glen Cove, New York. (They actually have 8-year-old boy-girl twins that they conceived with embryos from the same batch as the one my embryos came from.)

I know that some people cant imagine chasing after two young children at my age. Its definitely not for everyone. Like any toddlers, my twins are natural-born explorers, always raring to go. Im not thrilled when I find my brand new cell phone soaking in my Diet Coke or when I discover that one of them has accidentally dialed the NYPD. (Yes, I had a policeman show up at my door once, and the twins toddled up behind me, big grins on their faces.) After the babies go to sleep, I have to clean up after all the days shenanigans, pushing my bedtime well past midnight.

And there have been bigger challenges—like the two-week period when we all had a stomach bug, and I cared for all three of us by myself. It was horrible! But you do what you have to do, and I rose to the occasion.

Like any single mother, I get overwhelmed. But a few days a week, I drop them off at a babysitters house to go shopping or to the hairdresser. My younger sister works nearby and often visits us during her lunch hour.

Naturally, Id love to meet somebody who completes the picture here. Id like to have a partner and father figure for my kids. When my single friends chat about dates, I dont have my own tales to contribute. Ive dated a little bit since Ive had the babies, but bringing them to the babysitter is a production, so I dont go out too often.

My life isnt much different from any single mother. I belong to the Mothers of Twins Club of Queens. The other mothers are younger, but I dont feel that my age is a major barrier.

While Im not hung up on the age issue, I am insulted when people sometimes express disbelief that Im the mom. It happened recently at the hair salon. The hairdresser said, “Are they your grandchildren?” I said, “No, theyre my children.” And he said something like, “Wow, thats a good one.” I let it go, but I think that people ought to be more aware of what they say. These days, there are more older mothers.

And we have some advantages over our younger counterparts. I was able to quit my job when I had the babies. Unlike mothers in their 20s, I dont have the stress of work or school or wondering, “What am I going to do with my life?” We live off of my pension. Sure, its a fixed income, but big expenses, like their college tuition, are still distant on the horizon. Eventually, Ill go back to work part-time.

Theres a notion that its irresponsible to have children so late in life, because you might not be around for them as they move into adulthood. Loving a child in the right way is the most important thing, as is being emotionally healthy as a parent. In that sphere, Im much better equipped than I was in my 20s and 30s. And since there are two of them, they will always have each other. Plus, they have the two siblings in Glen Cove. That couple and their twins have already come to visit. I hope that my twins will have a relationship with their older siblings. And while I havent made a will, I feel that if anything were to happen to me, that couple would be potential candidates to adopt my twins.

But who knows? I always say if I dance at their 40th birthday, my life will be complete. My parents are already north of 80 and in great shape. That bodes well for my longevity, too.