MADRID — She devoted years to caring for her mother, who died at 101. Then Maria del Carmen Bousada embarked on a quest to become a mom herself.
She lied to a California fertility clinic to skirt its age limit and at 66 she had twins, becoming the world's oldest new mom — and raising questions about maternity so late in life. Now she is dead at 69, leaving behind boys not yet 3.
Bousada's brother told the Diario de Cadiz newspaper his sister died Saturday, though he did not disclose the cause. Bousada said in November that she was being treated for stomach cancer.
Shortly after her sons, Pau and Christian, were born in December 2006, Bousada reflected on her decision to deceive doctors in order to have a family.
"I think everyone should become a mother at the right time for them," she told the British tabloid News of the World, which showed her beaming as she cradled her 1-month-old infants, both dressed in pale blue pajamas.
"Often circumstances put you between a rock and a hard place, and maybe things shouldn't have been done in the way they were done, but that was the only way to achieve the thing I had always dreamed of, and I did it," she said.
Beginning in 2005, Bousada underwent hormone treatments to reverse nearly 20 years of menopause and sold her house in Spain to pay $59,000 for in vitro fertilization at the Pacific Fertility Clinic in Los Angeles.
Slender with dark brown hair, she told the clinic she was 55 — the facility's maximum age for single women undergoing the procedure. When her sons were born in December 2006, Guinness World Records said she was the oldest woman on record to give birth.
Dr. Vicken Sahakian, director and owner of the clinic, said Bousada falsified her birth date on documents from Spain.
When he learned of the deception, "I figured something might happen and wind up being a disaster for these kids, and unfortunately I was right," he said.
It's easy for women to lie to their doctors, Sahakian said.
"We don't ask for passports, obviously. When is the last time you went to a doctor and he asked you for a birth certificate? We're not detectives here," he said.
Sahakian said he implanted the woman with a younger woman's eggs and donated sperm, using hormone therapy to "rejuvenate" her uterus after she had been in menopause for 18 years.
The hormone treatment lasted three weeks. Sahakian said he did not believe that increased the woman's cancer risk.
"Nothing she did (to get pregnant) caused her illness," he said.
The brother, Ricardo Bousada, told the Barcelona newspaper El Periodico de Catalunya that he had sold details of his sister's death to an unidentified television program and the proceeds would go to looking after his sister's twins.
Another brother, Jose Luis Bousada, said he was estranged from his siblings and read about his sister's death in the newspaper.
Asked who might raise the children, he said he imagined arrangements had been made and, "I suppose there will be no problem."
Bousada had once said she would look for a younger man to help her raise them.
Bousada lived with her mother most of her life in Cadiz and worked in a department store before retiring. She decided to have children after her mother died in 2005 and initially kept her plan secret from her family.
Spanish law on assisted reproduction sets no age limit, but state-funded and private clinics have an informal agreement establishing 50 as the cutoff, based on recommendations from the scientific community, according to the Health Ministry.
There is no U.S. law regulating the age of in vitro candidates, but Sahakian said his clinic won't take women older than 55 because "I would like the mother … to basically survive until the kids reach 18."
When Bousada told her relatives she was two months pregnant, they thought she was joking, she said.
Allan Pacey, secretary of the British Fertility Society, said the organization recommends that assisted conception generally not be provided to women beyond the natural age of menopause at about 50.
"The rationale … is that nature didn't design women to have assisted conception beyond the age of the natural menopause, he said. "Once you get into the mid 50s, I think nature is trying to tell us something."
Adriana Iliescu, a Romanian who also gave birth at 66, although she was 130 days younger than Bousada, said she was pained to hear of the Spanish woman's death and what it would mean for her sons.
"It is a great sadness when kids are orphans but civil society will help these children," she said. She described her daughter Eliza, born in 2005, as "very energetic and spoiled. We dance and sing together."