Age and Fertility: A Different Perspective

An article in the Washington Post presents a little different perspective on age and fertility, “Stop freaking out about having babies in your 30s. Your great-grandma did it, too.” The bottom line is “don’t worry be happy.” We would probably say ” be happy but as time goes on, worry.”

The article says: The shift toward late motherhood – commonly defined as motherhood after 35 – is often presented as a story of progress and technological liberation from the biological clock.

The narrative goes something like this: Before the widespread availability of the pill, women had no choice but to have children in their teens and early 20s. But the introduction of effective contraception meant that women could trade babies for briefcases. And technologies such as IVF, egg donation and egg freezing allow women to beat the biological clock, freeing them from the tyranny of their own biology. A recent Newsweek headline, for example, announced that women can now “freeze” their biological clocks, while the cover of Businessweek urged women to “Freeze Your Eggs, Free Your Career.”

While this triumphal narrative contains a few grains of truth, it is as simplistic as it is satisfying. History shows us that the “best age” to have a child is very much a product of the cultural and economic moment, not a just dictate of biology that we need to escape.

The roots of our modern discussion on delayed parenthood lie in the 1970s, when the average age at first birth began to increase dramatically. The number of women having their first child between the ages of 30 and 34 almost doubled, from 7.3 births per 1,000 women in 1970 to 12.8 per 1,000 in 1980. But the 1980 figures mirror those recorded between 1920 and 1940, where the number of first births among women ages 30 to 34 averaged 12.1 births per 1,000 women. By 1986, the first-time pregnancy rate for women between 30 and 34 hit 17.5 per 1,000 births, an increase of 140 percent over 1970 levels. By the late 1980s, post-30 motherhood was becoming the middle-class norm. And the trend has only intensified: In 2013, the first-time pregnancy rate for women between 30 and 34 hit 29.5 per 1,000 births.

Reproductive technologies are often cast as the heroes of this story. Women who waited too long to have children were “saved” by the ingenuity of these technologies, tricking their own biology to have children later and later in life.

We love to be the heroes. But like anything in medicine the best option is prevention. If childbearing is not fitting into your life at a time and age when your reproductive potential is still good, look at the options open to you, egg freezing, embryo freezing if you are in a stable relationship or if it is appropriate for you, single motherhood.