Hisar, India – Pregnancy and childbirth take a toll at any age, but Rajo Devi Lohan has struggled to regain her health more than most other women since becoming a mother.
After she had given birth eight years ago, the Indian woman was diagnosed with cancer. She has had three operations to repair a ruptured uterus and to remove tumours, many rounds of chemotherapy, and still suffers from stomach pain.
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Lohan was 70 years old when she gave birth in 2008, becoming the oldest mother in the world at that time.
“The doctor didn’t tell me anything about the dangers and I never felt that there was any danger,” Lohan says.
A doctor who is now treating Lohan believes that her health problems could have been caused by fertility treatment and pregnancy.
Stories of elderly women having babies in India have made international headlines in recent years, including a 72-year-old who set a new world record when she gave birth in April.
The doctor responsible for helping these women get pregnant says it is every woman’s right to have a child regardless of their age.
But the ethics surrounding such births are increasingly coming under attack.
Critics insist that doctors, eager for fame and fortune, are putting lives at risk – from the elderly mothers and the young women who provide donor eggs, to the children themselves.
At least two young Indian women have died after donating eggs.
India’s booming IVF industry
The first IVF baby was born in India almost 40 years ago. Since then, the industry has exploded, with IVF clinics opening up across the country.
Couples of all ages have flocked to fertility specialists in the hope of having a baby and shaking off the stigma associated with being childless in India, the world’s most populous country.
But no laws – or age restrictions – apply to this booming industry.
Al Jazeera travelled to the northern Indian town of Hisar and visited the National Fertility and Test Tube Baby Centre, the clinic that has helped create babies for some of the world’s oldest mothers.
The son of Daljinder Kaur, who gave birth in April at the age of 72, was created here, as was Lohan’s daughter eight years ago.
Kaur had been married for 46 years before she and her 79-year-old husband became parents to baby Armaan, which means “hope”.
Seventy-two is not the right age to have a baby ... Getting a 72-year-old pregnant is putting her life in jeopardy.
“A lot of people used to tell me, ‘adopt a child’, but I never felt the urge to adopt or have someone else’s baby,” she says.
“The Almighty only has made this possible for us; it’s his gift … we haven’t done anything. It’s his wish and he granted him to us.”
Doctors ‘playing God’
While Kaur considers her son a miracle from God, the man responsible for his birth is Dr Anurag Bishnoi. The embryologist claims to have helped more than 100 women over the age of 50 become pregnant.
“If men can have children into their 60s and 70s, why shouldn’t women be able to?” he asks.
Bishnoi insists his older patients must pass rigorous health checks before starting IVF treatment.
“We don’t see much of a risk as far as middle-aged and older ones are concerned,” he says.
Others disagree, arguing that age limits on who can access fertility treatment are urgently needed to protect women’s health.
“Seventy-two is not the right age to have a baby,” says Dr Narendra Malhotra, president of the Indian Society of Assisted Reproduction. “Getting a 72-year-old pregnant is putting her life in jeopardy.”
Malhotra accuses Bishnoi of “playing God”. He says even though science can help women give birth at any age, “it is for society to decide whether we are going to let scientists do things … which are unethical or which put the patient and the child to great harm.”
The risks of being an egg donor
While the elderly mothers attract the headlines, the other crucial players in this industry are largely invisible – the young women who donate their eggs. Without them, India’s record-breaking births would not be possible.
An agent tells Al Jazeera that he and his colleagues can easily recruit many egg donors.
“There are no complications in this procedure at all, so my agents tell other ladies that we pay a handsome amount for egg donations,” says Subhas Chandra. “If someone works in a factory they earn less than $75 a month but we can pay $525 for the 10-day process.”
But, for some women, the true cost of being an egg donor can be much greater – the procedure can claim their life.
In 2010, 17-year-old Sushma Pandey died in Mumbai. Despite guidelines that egg donors should be at least 18, no action has been taken against the clinic.
Four years later, 24-year-old Yuma Sherpa died in Delhi after donating eggs.
The 24-year-old mother from West Bengal was working in a garment shop when she decided to become an egg donor to make extra money to help support her husband and young daughter. She was told that she would be paid $448. But she died after having her eggs extracted.
“When I tried to wake her up I realised something was wrong,” her husband, Sanjay Rama, says. “I started screaming and asked for the doctor. They called the doctor and the doctor came half an hour later.”
Another three and a half hours would pass before Sherpa was taken to a hospital and pronounced dead, a delay her husband’s lawyer says amounts to negligence.
An autopsy showed that the young woman suffered ovarian hyperstimulation syndrome, a potentially fatal condition that can occur when high doses of hormones are used to produce higher numbers of eggs.
Vikram Pradeep, the lawyer acting pro bono for Sherpa’s husband, said clinics were harvesting many more eggs than was recommended, sometimes up to 50.
“That ends up putting the woman’s life in danger,” he says.
The clinic which treated Sherpa did not respond to Al Jazeera’s request for comment.
‘God is his guardian’
For the women who become mothers at an age when most of their friends are already grandmothers, their desire to have a baby is so great that health risks are of little concern to them.
Lohan, whose daughter Naveen is now aged eight, still suffers stomach pain. Her doctor suspects her health problems may be related to having fertility treatment and going through her pregnancy when she was 70.
“I feel the treatment she underwent at this age may have caused all these problems, because having a baby at this age means there is some fiddling with the hormones,” Dr Praveen Sharma says.
Bishnoi denies that fertility treatment and pregnancy could be responsible for Lohan’s health problems.
And what of the children at the centre of this ethical firestorm? For the world’s oldest woman to give birth, looking after a newborn is exhausting and at times, overwhelming.
“I have been feeling very weak. I had a really tough time,” says Daljinder Kaur. “At times, he keeps on crying and doesn’t get pacified. Then I get very nervous.”
Asked who will care for her son after she and her husband die, Kaur says, “Don’t talk to me about this. I don’t want to talk about it … God is his guardian.”
From the 101 East documentary India’s Miracle Babies. Watch the full film here.