Medical experts and politicians have rounded on a 65-year-old German woman who is pregnant with quadruplets, calling her decision irresponsible and inadvisable, and warned other women against following her example.



“I consider this to be a very questionable case,” Karl Lauterbach, a leading Social Democrat, said of Annegret Raunigk’s multiple pregnancy, which is in its fifth month. “Such a pregnancy cannot be allowed to become an example for anyone to follow,” he told Spiegel.

Raunigk, the oldest woman in the world to be expecting quadruplets, has overnight become a household name in Germany, and the pros and cons of her pregnancy are being hotly debated across the country on everything from internet forums to television chatshows.

I’m observing this development with great concern. We can’t just do everything because we’re medically able to do it Karl Lauterbach

Lauterbach said his main concern was the case had crossed medical and ethical boundaries.

“From both the medical and ethical point of view this oversteps the mark,” he said. “We know from experience that artificial insemination at an older age brings with it a considerably higher risk of premature births and underweight babies, and with that a higher chance of lasting damage.”

The health expert for the Christian Democrats, Jens Spahn, called Raunigk’s decision “negligent”.



So far Annegret Raunigk’s case has attracted overwhelmingly negative criticism, with only a few voices of support. Photograph: RTL/Pfeiffer

“A pregnancy at an advanced age means a big risk for a mother and child. Even if it’s medically possible, you need to ask yourself whether it makes sense. I am very doubtful about that,” he said.

Raunigk, who has 13 other children, the oldest of whom is 43, was too old to be considered for IVF treatment in Germany. Laws on reproductive medicine are much stricter there than in other countries, and include a ban on egg donation and a restriction on the number of eggs that can be implanted. There is a certain nervousness governing anything to do with the manipulation of embryos, partly due to the use of eugenics during the Nazi era.

The criteria for who is considered eligible for IVF are also strictly controlled and exclude, for instance, lesbian couples, meaning that thousands of Germans travel abroad each year for treatment. There are no restrictions on them doing so.

Raunigk went to a clinic in Ukraine, where she was implanted with eggs and sperm from donors. Seemingly contrary to the doctor’s expectations, all four of the eggs developed into embryos. The chance of a natural quadruplet pregnancy is otherwise one in 13m.

Raunigk said she had taken the decision after her youngest daughter, Lelia, nine, asked her for a sibling.

The German television channel RTL and the tabloid newspaper Bild have bought the exclusive rights to the story of the English and Russian primary school teacher, and will follow her pregnancy and birth.

Her case has thrown up many questions about when it might no longer be responsible for a woman to get pregnant, even if science allows it, and about the risks attached to reproductive medicine.

So far Raunigk’s case has attracted overwhelmingly negative criticism, with only a few voices of support.

In an exclusive interview with RTL this week, she defended her decision, telling the interviewer: “I’m of the opinion that everyone should live their life as they want to. Because this possibility exists and is used by thousands of people, I’m allowed to use it too.”

She said she was fit and expected to remain so, but would make provisions for her children in case she was unable to look after them.

“How should you be at the age of 65?” she asked. “It seems clear that you’re supposed to live up to certain cliches.”

Lauterbach said he hoped the pregnancy would spark a broader societal debate at a time when parents were getting increasingly older. “We need to discuss this case. It shows that age limits to becoming a parent are increasingly going up, and that increasing risks are being taken. I’m observing this development with great concern. We can’t just do everything because we’re medically able to do it.”

Annegret Raunigk with daughter Leila in 2005 – she said she was fit, but would make provisions for her children in case she was unable to look after them. Photograph: Patrick Lux/EPA

Doctors say that alongside the ethical issues are concerns about the considerable health risks to both the mother and her babies.

In Raunigk’s case there are three significant risks, said Frank Louwen, secretary of the German Society for Gynaecology and Obstetrics: her age, the fact she received egg and sperm donations, and that she is pregnant with quadruplets. “All three aspects are high-risk factors for a pregnancy,” he said. “They bring with them the danger of high blood pressure, pregnancy diabetes and pre-eclampsia, all of which impact on each other.” Risks for the babies include cerebral bleeding, paralysis, and sight and hearing problems.

Louwen was also highly critical of the Ukraine-based doctors who oversaw the procedure. “Simply from the point of view of allowing a quadruplet pregnancy is a mistake, based on what we know nowadays, because of the huge risks involved for the mother and the foetuses. But for a 65-year-old to get pregnant through egg donation with quadruplets, then it’s little more than someone trying to prove it can be done, and I find that disturbing,” he told Spiegel.

Christian Albring, president of BVF, the German professional body for gynaeocologists, strongly advised women against copying Raunigk’s example. “It is not advisable to have a pregnancy at this age that didn’t happen spontaneously but with sperm and egg donations, accompanied with hormone treatment,” he told Stern magazine.

Raunigk’s quadruplets are due in August, just as she is due to retire. But it is much more likely they will be born earlier, probably by caesarian section. On average, triplets and quadruplets are born around 11 weeks early.

She told Bild am Sonntag she had initially considered giving up some of the babies for adoption, before deciding to keep them all, citing the huge effort it had taken to get pregnant in the first place.

If all goes well, Raunigk would become one of the oldest women in the world to have children. The oldest mother was the Spaniard María del Carmen Bousada de Lara, who was almost 67 when she gave birth to IVF twin sons in 2006.

She died of cancer when they were aged two and a half.