Erramatti Mangayamma at age 74 gave birth to twins in India last week after becoming pregnant through IVF, making her the oldest person ever to give birth, according to her doctors, and reigniting debate over so-called geriatric pregnancies.

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Becoming a mother at 74

After struggling to conceive for more than 55 years, Mangayamma and her husband, who is reported to be between 78 and 82, last year reached out to Sanakayyala Umashankar, director of IVF at the Ahalya Hospital.  The couple said they had been stigmatized in their village because they did not have children.

After preliminary tests, Umashankar determined that Mangayamma was healthy enough for the procedure and in January 2019 gave Mangayamma one round of IVF treatment using donor eggs. The eggs were fertilized with Mangayamma's husband's sperm.

Through the treatment, Mangayamma became pregnant with twins. Due to Mangayamma's age and the fact that she was pregnant with twins, doctors determined natural delivery would be too risky. As a result, Umashankar last week opted to deliver the twin girls via caesarian section. Mangayamma's doctors said she produced a birth certificate that indicated she was 74, making her the oldest person to give birth, but that was not immediately verifiable, according to the Washington Post.

A successful delivery

Umashankar said, "The surgery went well ... the mother and the babies are all healthy with no complications," with each baby girl weighing approximately 4.4 pounds. However, because of Mangayamma's age, doctors plan to keep her under observation for 21 days after delivery.

The doctors are "not allowing the mother to breastfeed and the babies will be fed through the milk bank," Umashankar said. However, he added that he doesn't expect Mangayamma "will have any major health issues in the post-delivery period."

Shannon Clark, a professor of maternal and fetal medicine at the University of Texas Medical Branch at Galveston, said that while the delivery is atypical, it's not surprising in light of current technology around assisted reproduction. Clark explained that while a woman's eggs deteriorate over time, the uterus "is not subject to the same age constraints."

Ethical questions

Before Mangayamma's delivery, the "world's oldest mom" was Daljinder Kaur, who gave birth at age 72, though her age has never been verified, according to Gizmodo.

Ethicists voiced concerns about Kaur's pregnancy in 2016, according to the Post. Some called Kaur's decision to give birth at that age irresponsible. However, Kaur's doctor, among others, said that giving birth is a "fundamental right" and should not be determined based on a person's age.

In 2016, the Ethics Committee of the American Society for Reproductive Medicine discouraged physicians from "providing donor oocytes or embryos to women over 55 years of age, even when they have no underlying medical problems." The committee noted concerns about maternal and fetal safety, longevity and "the need for adequate psychosocial supports for raising a child to adulthood."

But for Mangayamma the birth was a joyous occasion. "We tried many times [to have children] and saw numerous doctors," Mangayamma said. "So this is the happiest time of my life" (Gupta/Pokharel, CNN, 9/6; Coleman, The Hill, 9/6; Hein, Fox News, 9/6; Cara, Gizmodo, 9/6; Tan/Dutta, Washington Post, 9/6; BBC News, 9/6).