Advanced Age for Childbirth

Correspondence Advanced Age for Childbirth To the Editor.-The birth of the twenty-seventh child to a 65·year-old Negro woman was publicized both in the lay press, September, 1946, and in the Journal of the American Medical Association. This publicity has resulted in many inquiries to this clinic for verific-ation. The present letter summarizes the case as well as the efforts made to establish the patient's true age. The patient, Mrs. M. J., entered the Prenatal Clinic of the Ohio State University Hos· pita! in July, 1946. She purported to be gravida xxi, para xxvi, and stated that she was 65 years of age. Her last menstrual period was March 22, 1946, but she gave a history of menses the first few months of each previous pregnancy. Menses had started at the age of 13 years, the patient had a 28-day cycle and flowed three to five days with no unusual blood loss with her periods. Fetal movement was first noticed April 5, 1946. Physical examination revealed an obes~ Negro woman; weight 284 pounds; height 5 feet 2%, inches. Patient did not appear to be her stated age of 65 years, but looked to be approximately 45 years of age. No fetal heart was heard; Chadwick's and Hegar's sign were positive; ballotment was present. Pelvimetry indicated a gynoid pelvis. X-ray report: single fetus, cephalic presentation, adequate pelvis. The remainder of the prenatal course was uneventful, and a living female was delivered spontaneously, Sept. 26, 1946. A review of the patient's obstetric history reveals that she had six sets of twins and 15 single children. She had been married twice. Her first husband was killed in a mine accident in Greensboro, N. C., in 1913. The second husband is a resident of this city and is 60 years of age. Verification of an individual's age is not always easy. This patient's claim rests chiefly upon her birth date as recorded in her family Bible. The date of birth is given as April 5, 1881, and her maiden name is recorded as Mary Matilda Walker, A photostatic copy of this Bible record was obtained in the course of efforts to establish her actual age. The patient referred the writer to a white family of this city with whom she had had long contact. The oldest living member of this family, an insurance agent, aged 35 years, was willing to sign a certified statement to the effect that the patient had worked as a cook for his grandfather in Hickory, N. C. This man further stated that to the best of his memory the patient's present professed age coincides with that she gave when she was in his grandfather's employ. An attempt to verify the marriage and subsequent death of the first husband was unsuccessful. The Recorder of Deeds in Greensboro, N. C., reported that no vital statistics were kept in North Carolina before 1913. A systematic review of the birth certificates of the patient's children, however, revealed a marked discrepancy. In March, 1927, the patient delivered twins whose births are recorded at the Bureau of Vital Statistics. On these birth certificates the mother's age is given as 27, which would make her age, at present, 48. It is then noted that the ages for the mother in subsequent births are not chronologie. In 1928, her age was given as 43 ; in 1930, 44; in 1936, 55; and in 1942, 61. Scrutiny of the initial birth certificate on file in Cblumbus, Ohio, shows that this patient then (in 1927) reported six previous children. It would seem, therefore, that this patient had six children by her nrst marriage rather than the purported 14. 719

CORRESPONDENCE

720

Am.]. Obst. & Gynec. October, 1947

It is the opinion of the writer that the wide variety of ages which the patient gave in recording ·the births of previous children, anti particularly her rapid "aging" in the last few of these birth certificates mitigates against the at•ceptance of her stated age. The fact that the earliest birth eertitlcate we are able to ohtain reeords six previous ehildren born to this mother instead of 14, the number she states werr born prior to coming to this eommunity, also casts doubt on her story. It is not felt, on the hasis of the investigation to date, that this can be accepted as a delivery at an admnced age. .JonN II. Hor.ZAEPFEL, :M.D. COLUMBUS, OHIO

July 22, 1947.

Item American Board of Obstetrics and Gynecology, Inc. Examinations The next written examination (Part I) for all candidates will be held in various citie:l of the United States and Canada on Friday, Feb. 6, 1948, at 2:00 P.M. Candidates who successfully complete the Part I examination proceed automatically to the Part II examination held later in the year. A number of changes in Board regulations and requirements were put into effect at the last annual meeting of the Board held in Pittsburgh, Pa., from June 1 to June 7, 1947. Among these is the new ruling that the Board does not subscribe to any hospital or medical school rule that certification is to be required for medical appointments in ranks lower than Chief or Senior Staff of hospitals, or Associate Professorship in Schools of Medicine, for the obvious reason that such appointments constitute desirable specialist training. At this meeting the Board also ruled that credit for graduate courses in the basic sciences which involve laboratory and didactic teaching rather than clinical experienee or opportunities will be given credit for the time spent up to a maximum period of not more than six months regardless of the duration of the course. Applications are now being received for the 1948 examinations. Closing date for these applications will be Nov. 1, 1947. For further information and application blanks address Paul Titus, M.D., Secretary, 1015 Highland Building, Pittsburgh 6, Pennsylvania. PAUL TITUS, M.D.