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Event Review: Postponing childbirth, extending fertility? Biotechnologies and the transformations of reproductive life

6 June 2016
By Dr Nolwenn Bühler
Reproduction research group, De Montfort University, Leicester

At the same as news broke of an Indian couple in their 70s becoming parents for the first time (see BioNews 851) a group of researchers and others met at De Montfort University to reflect on the postponement of childbirth and the crucial role of biotechnology in the extension of fertility.

Delegates sought to address the following questions: why do women in Europe postpone childbirth? What is the impact of this postponement in demographic and medical terms? Is it really an individual choice? How do biotechnologies such as IVF or egg freezing contribute to transformations of how women consider their reproductive lives? How do the media represent older parenthood and reproductive delay? And last but not least, what about men and their perception of the right time to have a child?

In contrast to Daljinder Kaur, the 72-year-old first-time mother in India, the archetype of the older mother in Europe is a well-educated, well-off, white, heterosexual woman 'choosing' to deliberately delay childbearing and possibly to freeze her eggs or turn to reproductive medicine. While framed as an individual choice, late motherhood has consequences for society more generally, suggested Professor Susan Bewley, obstetrician at King's College London, who added that it is a pressing concern from a public health perspective in terms of costs and health problems for the mother and children.

Reproductive timing may be thought of and experienced personally as an individual choice, but it is also one which is nonetheless strongly socially and culturally determined. Social class, educational level, and social definitions of what it means to be an adult have a great impact on the meaning of the 'right time' to have a child, as several speakers - Professor Ann Berrington, Dr Maud Perrier, Dr Irenee Daly, and Dr Emily Koert - made clear.

Moreover, women are not the only ones involved in making the highly relational decision to have a child. Men's perceptions of the 'right time' to enter into fatherhood, whilst often silenced, are increasingly recognised as important. Discourses of mandatory coupledom and 'love', as well as the notion of the child as a project, also greatly impact on the intimate negotiations people make in the navigation of their reproductive lives, as highlighted in talks by Professor Charlotte Kroløkke, Dr Robin Hadley and Caroline Law.

Another way of adding complexity to the study of childbirth postponement is to turn to the sciences of reproduction and ageing. Through an exploration of the history of Down's syndrome, Dr Ilana Löwy explored how the commonly cited risk threshold of 35 years of age for Down's has come into being and how this reproductive boundary has subsequently been generalized to a whole population of pregnant women.

My own talk on this theme documented the role assisted reproductive technologies (ARTs), and especially egg donation, have played in the production of knowledge about ovarian ageing, whilst Professor Joanna Latimer examined what 'reproduction' means for scientists working on life extension strategies.

Finally, the impact of ARTs on influencing fertility came under scrutiny. In particular two recent technologies were examined: egg freezing and AUGMENT, a procedure aiming at 'rejuvenating' eggs. Kylie Baldwin highlighted how through egg freezing women are encouraged to engage in self-monitoring and surveillance to manage the risks posed by age-related fertility decline. Dr Cathy Herbrand and I showed how the AUGMENT technique contributes to a redefinition of reproductive ageing as less fixed and open to external intervention.

In a domain where the debates can become easily polarised and the roles of society, the media, women (and men), and fertility clinicians tend to be seen dichotomously, the symposium represented a much-needed opportunity to account for the inherent complexity of these matters. Putting the 'social' at the centre of an interdisciplinary analysis of childbirth postponement and of reproductive ageing highlighted promising directions for further research aimed at gaining a richer understanding of current transformations of reproductive life.

However, what also emerged from the symposium was the difficulty of developing a critical perspective while simultaneously grasping the full complexity of the issues at stake. In this regard, I found it challenging to consider the needs of those groups who are underrepresented and marginalised in this context, in terms of class, ethnicity, gender, or sexuality, a direction for research which is urgently needed.

We also need to pay closer attention to the concerns and experiences of women who are actually themselves postponing childbearing and/or turning to technologies such as egg freezing and egg donation. While it is true that they usually are white, middle-class, heterosexual women, it is also necessary to go beyond the archetype of the careerist woman.

The most complex task for social sciences is therefore to address simultaneously both challenges, in order to grasp the full heterogeneity of these various experiences of reproductive timing, ageing, and biotechnologies and locating related inequalities within wider social structures.

A second tension I identified through participation in the symposium related to the need to acknowledge the limitations of biotechnologies, while simultaneously recognising their powerful and transformative affects in the domain of reproductive life. I think that by continuing to stress the complexity and relationality of ARTs as they relate to the timing of reproduction, and by maintaining an interdisciplinary lens on this set of contemporary social questions, social sciences can begin to address these challenges.

SOURCES & REFERENCES
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