Hilary Swank is pregnant at 52. Is it as rosy as it sounds?

When Hilary Swank announced that she is expecting her third child at 52, the news was met with excitement, and a bit of surprise. The two-time Oscar winner, who welcomed twins with husband Philip Schneider in April 2023 at 48, shared the announcement on Instagram on October 15. The baby is due sometime in December.Swank has previously spoken about freezing her eggs at 37, which helped her keep open the possibility of becoming a mother later in life. She has not disclosed how she conceived this pregnancy, however, and it would be wrong to assume that her current pregnancy involved IVF or donor eggs.Her announcement raises a question that goes beyond celebrity motherhood. With advances in fertility treatment making pregnancy possible later in life, how much do we know about the medical realities of having a baby in your 50s?“More often than not, a pregnancy at 52 is iatrogenic,” says Dr Anita Soni, Director of Obstetrics and Gynaecology at Dr L H Hiranandani Hospital, Mumbai. She explains that IVF using donor eggs is a common route to pregnancy at this age. But being able to conceive and being medically fit to carry a pregnancy are two different things.How is pregnancy at 52 even possible?Natural conception becomes increasingly unlikely as women age, largely because both the number and quality of the eggs decline. Menopause marks the end of natural ovulation, but it does not necessarily mean the uterus cannot carry a pregnancy. “Assisted reproductive technology can be used in some cases, to help women conceive, including previously frozen eggs, embryos, and donor eggs,” says Dr Sunita Tandulwadkar, President of the Indian Society for Assisted Reproduction (ISAR) and Head of IVF and Endoscopy at Ruby Hall Clinic, Pune.Women who froze their eggs or embryos earlier may be able to use them later. Donor eggs are another option. However, treatment does not guarantee pregnancy, and a woman's overall health must be assessed before proceeding.What are the risks of pregnancy after 50?Pregnancy at this age requires careful medical supervision. The risks include high blood pressure, pre-eclampsia, gestational diabetes, premature birth and restricted foetal growth. The likelihood of caesarean delivery and neonatal intensive care may also be higher. Dr Soni says the risk of complications is significant and stresses the need for tertiary care and a multidisciplinary team to monitor both mother and baby.Dr Tandulwadkar adds that eggs’ age also matters. As eggs age, the risk of chromosomal abnormalities increases. Using a younger donor egg can help address some age-related egg-quality concerns, but it does not eliminate the risks associated with carrying a pregnancy at an older age.Is pregnancy in your 50s harder on the body?It can be. Pregnancy places additional demands on the heart, blood vessels and other organs, and those demands may be more difficult to manage when a woman has existing conditions such as hypertension, diabetes or cardiovascular disease. “Different mothers often experience different experiences, but relatively it can be harder on the mother at that age,” says Dr Tandulwadkar.She adds that some women may experience greater physical discomfort and challenges during recovery, although age alone cannot predict an individual woman's outcome.Dr Soni emphasises that a detailed assessment of the mother's health is essential. In suitable cases, close monitoring by obstetricians and other specialists can help manage complications, but the risks should not be underestimated.Can women over 50 access IVF in India?There are legal and practical barriers. Under Section 21(g) of India's Assisted Reproductive Technology (Regulation) Act, 2021, ART services may be provided to women above 21 and below 50 years of age. This creates a legal age restriction for women seeking treatment at 50 or older.Treatment also involves significant financial costs, medical investigations and repeated consultations. Eligibility depends on the applicable law, clinical assessment and individual circumstances.Do celebrity pregnancies create unrealistic expectations?They can, particularly when the medical support, costs and uncertainties behind a pregnancy are not discussed.“Celebrity announcements can be inspiring, but not all women have experiences like that,” says Dr Tandulwadkar. She stresses the importance of realistic expectations, counselling and individualised medical advice.Swank's pregnancy is a personal milestone, but it should not become a yardstick for other women. Pregnancy after 50 is possible in some circumstances, yet it is neither straightforward nor risk-free.- Ends