Commentary: As Robert De Niro and Al Pacino become dads again, how old is too old to have babies?

SINGAPORE: In the realm of family planning and parenthood, the question of the “right” age to have babies has long been a topic of debate.

Teen parents often face scrutiny for perceived immaturity, lack of financial stability, and the potential challenges of balancing personal growth with the responsibilities of raising a child.

On the other end of the spectrum, critics of older parenthood highlight the higher likelihood of pregnancy complications, health issues, and concerns about being able to actively engage in the child's upbringing.

In recent months, several celebrities in their 70s and 80s welcomed new additions to their families, sparking discussions about bringing a child into the world at an advanced age. Some called them creepy and selfish.

Star of The Godfather, Al Pacino, confirmed in June he had become a father for the fourth time at 83. A month before that, fellow actor Robert De Niro, 79, revealed that he had just had his seventh child.

They may be a few of the oldest celebrity fathers, but they certainly aren’t the only late-in-life parents.

Janet Jackson was 50 when she gave birth to her first child in 2017. More recently in June, supermodel Naomi Campbell welcomed baby number two at 53.

"It’s never too late to become a mother," Campbell said on Instagram. 

Similarly, in Singapore, a 55-year-old woman gave birth in 2022, making her the city’s oldest mother to a newborn last year.

DELAYED PARENTHOOD

As societies progress, educational levels rise, career opportunities expand and life expectancies increase, late-stage parenthood has and will continue to be a reality for many couples.

More people in Singapore are postponing marriage, and more couples are also delaying having children or having fewer children.

The reality is that with increased educational attainment and growing career aspirations, men and women may be inclined to postpone parenthood, as work stress and busy schedules get in the way of starting a family.

Another factor that may further delay parenthood could come from the financial burden of caring and providing for one’s aged parents, which is a familiar story in many ageing societies like Singapore. This is why falling birth rates are mostly observed in developed nations, compared to those in developing countries.

With advancements in reproductive technologies and shifting societal norms, the notion of "too old" to have babies is evolving.

Nonetheless, it's crucial to recognise that there are valid medical concerns associated with older pregnancies.

ESCALATING MEDICAL RISKS

It is well-documented that a woman’s age affects her ability to conceive. A healthy woman in her 20s and early 30s has a 25 per cent chance of conceiving each month, but this falls to around 10 per cent when she turns 40, according to the American College of Obstetricians and Gynecologists.

Ageing also impacts the quantity and quality of sperm in men, making it more difficult for sperm to fertilise an egg.

Parenthood at an advanced age also carries its share of medical risks and genetic implications. Aside from increased risks of medical conditions for the pregnant mother such as hypertension, diabetes and obesity - and correspondingly, their metabolic imprinting on the foetus such that the child is at higher risk of these conditions in future - there are also accelerated risks of birth defects and miscarriages from genetic mutations.

Older mothers suffer increased risks of an abnormal number of chromosomes. For a woman who gets pregnant at 25, the likelihood of having a child with Down syndrome is about one in 1,250. This rises to about one in 100 for a woman who conceives at 40.

The risk of adverse birth outcomes, such as low birth weight, seizures, and the need for ventilation immediately after birth, is also higher for infants born to ageing fathers.

Beyond the biological aspects, however, when it comes to physical parenting responsibilities, ageing is not expected to be a major stumbling block for child raising given higher life expectancies and the increased retirement age.

Still, some significant differences in mindsets and perspectives may be present across generations, which could pose challenges and consequently, impact family unity or harmony.

DEEPLY PERSONAL CHOICES

Ultimately, the decision to become a parent at an older age is a deeply personal one that affects each individual and couple differently. As no one can predict exactly how long one will live, advanced age does not make a parent selfish or irresponsible. Every individual’s and every couple’s circumstances are unique.

For couples who choose to delay parenthood, various family planning methods - including innovative technologies - can help overcome fertility challenges.

One commonly discussed assisted reproductive technology is in-vitro fertilisation (IVF), which helps individuals or couples conceive when natural conception is difficult or not possible. During the IVF procedure, an egg is fertilised by a sperm in a laboratory, and the resulting embryo is transferred back into the female body for conception.

Aside from IVF, elective egg freezing has come to the fore in recent months as one option for women who wish to postpone conception without compromising their reproductive choices.

Egg freezing is a process that retrieves, freezes and stores a woman’s unfertilised eggs - usually during her peak fertility years - to increase her chances of conceiving later in life. The process circumvents the issue of declining egg quality, a common problem faced by ageing women.

In July, the age limit of elective egg freezing was raised from 35 to 37. Women aged 21 to 37 can now also choose to freeze their eggs for non-medical reasons, regardless of their marital status. Only legally married couples, however, can use their frozen eggs for procreation.

Clearly, elective egg freezing and IVF can add another dimension to the complex issue of family planning, potentially empowering individuals to make the right decisions that align with their unique life goals and circumstances.

However, IVF may not be feasible for everyone, due to the invasive nature of such a treatment, the costs involved or existing medical conditions that could impact success rates. IVF can also take a heavy physical, emotional and psychological toll on individuals.

Instead, what’s crucial is the ability to make informed decisions as well as the availability of counselling sessions for those considering such treatments.

More options available do not necessarily mean they are accessible to everyone - whether from a physiological or financial perspective. In fact, early fertility screening and understanding one’s biology even before the topic of family planning comes up on the radar can help individuals understand what options are practically available to them based on their own biology.

This will pave the way for open conversations about fertility, pregnancy and parenthood choices.

With societal shifts leading to a greater acceptance of people becoming parents at various - and later - life stages, it’s important to destigmatise late-stage or delayed parenthood.

As the adage goes, age is just a number. What’s more important is providing a loving and nurturing environment for their children.

Dr Janice Tung is a mother of two, a consultant obstetrician and gynaecologist, and an accredited IVF specialist. She practises at both The O&G Specialist Clinic in Thomson Medical Centre and Thomson Fertility Centre.