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The three ages of modern womanhood: don't get pregnant, won't get pregnant... can't get pregnant…

7 September 2009
By Professor Gedis Grudzinskas
Director of Fertility Focus Professional Services (FFPS is an expert, unaffiliated, independent, multi-disciplinary, international network of infertility specialists), 92 Harley Street, London W1G 7HU
Appeared in BioNews 524
Don't get pregnant:

Pregnancy within or without marriage is not perceived to be the norm in a young modern woman's life in the UK or the western world in general. Sensationalist headlines reporting the failure of government funding and strategies simply reinforce that pregnancy in early adulthood is unwelcome or a complication of faulty contraception. The easy access to effective contraception aimed at reducing unwanted pregnancies in young women appears to have had the opposite effect in terms of pregnancy rates. Responsible use of contraception and easy access to termination of pregnancy services are now a normal part of a European woman's life and no longer the subject of conversation or media interest. The promise of life- and society-changing effects of cheap and reliable woman-friendly family planning strategies are in evidence around us all. Women in early adulthood are in control of their reproductive health, personal and working lives. But the concerns of today are beginning to focus not only on failed contraception/family planning but recognition that family planning to many women, really means anti-family planning leading to worrying delays in starting to have children.

Won't get pregnant:

The avoidance of pregnancy is a personal matter, but for the modern career woman, is inevitably influenced by attitudes in the workplace. Whereas some corporations may be committed to retaining highly trained able female staff during their childbearing years, this approach is not universal .A senior HR manager in one of UK's most 'female friendly' corporations has acknowledged that the apparently women sensitive working arrangements such as flexitime, generous maternity leave and access to career advancement courses, in many instances have become grudgingly part of HR policy which are tolerated rather than accepted as a valuable employment norm designed to proactively retain women in the work force. It is then little wonder that the inner conflict of children versus career women simply adds the justification to delay until the 'right' moment to begin their family.

The impact of legislation for gender equality in the workplace should also be supplemented with access to affordable childcare facilities, argue other women who have achieved continuing career success during their early years of their family life. In the real world, the consequence has been for women to plan when to have a family. A leading journalist in London pointed out on Fathers' Day this year that the only effective and easy plan is when not to have a child by using effective contraception, so effectively used during the first age of woman, (don't get pregnant) (1). Regrettably what has not been emphasised enough is that it is not equally as easy to have a child. Other confounding issues such as suitable marital partner, who is in good reproductive health, may still need to be addressed. And since there is apparently no 'right' moment, delays continue...

Can't get pregnant:

For the lucky ones, the mean age of having the first child is now 31+ years in the UK. Presumably the women who have decided there is no right/wrong time/man when and with whom to start their family and face the joys and challenges the demographers have indicated lie ahead for parents. To some, the prospects of divorce, redundancy, compromised career progress and the drudgery of motherhood replacing a responsibility-free social life lead to further delays. Some women seek professional advice about their fertility with tests they are told will predict how much longer their fertility will be maintained; others believe that IVF or related strategies will be helpful, should they need help in their mid to late thirties. An awareness that a woman's ovarian reserve starts to diminish albeit slowly from the late twenties is either deemed to be irrelevant or denied as women drift childlessly into their late thirties. This is particularly the case in the UK where the mean age of women beginning IVF is over 36 years. Exciting new technology hailed to be the answer for some, the freezing of eggs as an insurance against the effect of age on the woman's fertility, has been said to be as liberating a milestone in a modern woman's life as the contraceptive pill so many years ago (2).The end result is procrastination, disappointment, greater demand for donor eggs and surrogacy.

Surely the time is nearing when we should be committing resources to addressing why women are delaying having their first child at such a late age, rather than focusing on those who have left it too late? Has the modern industrialised society concluded that parents are 'disposable'? Where do we then start to determine why the three ages of woman have changed so much from that depicted by Gustav Klimt in 1905?

We need to consult women in different situations and we could perhaps start with the chapter of the Women's Institute at Goldsmith's College, successful business women with and without children, and girls at single sex schools and co-educational schools.

The sources that may not be particularly helpful are politicians, sociologists and doctors.

1) Minette Marin, 'Baby or career: young women cannot have it both ways',
Sunday Times |  21 June 2009
2) Homburg, R., van der Veen, F., Silber, S., 'Oocyte vitrification - Women's emancipation set in stone', Fertility &Sterility 2008
|  26 May 2022
21 September 2009 - by Nienke Korsten 
Mothers who started menstruating at an earlier age are at a higher risk for complications at birth, researchers from Cambridge, UK report. This means that the higher risk for complications for older mothers identified in other studies may be dependent on the time that has elapsed since their first period, rather than the mother's age per se. These results are to be published in BJOG: An International Journal of Obstetrics and Gynaecology....
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