Tuesday 28 March 2017

Fertility: Born in the nick of time

As her biological clock wound down, Kasey Edwards had to rush her parenting plans, writes Celine Naughton

Baby joy: Christopher Scanlon and Kasey Edwards couldn't wait to have their daughter Violet, now 22 months
Baby joy: Christopher Scanlon and Kasey Edwards couldn't wait to have their daughter Violet, now 22 months
Mother of all gifts: Kasey Edwards was shocked to learn she would be infertile by the age of 32, so jumped feet first into having a baby
Wise words: Dr David Walsh of the SIMS clinic, Dublin

Celine Naughton

A routine health check dealt Kasey Edwards a shocking blow when she was told she would be infertile within a year.

"But I'm only 32!" she gasped. "That's not old."

"It is in fertility years," replied her gynaecologist.

This bombshell thrust Kasey, a successful management consultant and author in Australia, into making a life-changing decision -- and with her body clock ticking louder and faster with each passing day, time was not on her side.

The rollercoaster that followed is documented in her new book, 30 Something and the Clock is Ticking, a first-hand account of a woman weighing up all the pros and cons of motherhood in a frantic effort to make a choice she would not regret. But would she have put the same thought and consideration into the decision had she not had such a short window of opportunity?

"I suspect that if I hadn't been given the now-or-never speech by my doctor I would have sailed through the next few years believing that I would be able to pop out a baby if and when I chose," says Kasey. "I wouldn't have thought about the motherhood decision because I wouldn't have made it a priority."

But a priority it certainly was, and while Kasey and her boyfriend Chris had been together for a year, they had agreed that the baby talk would be kept for the far distant future. Now it was all she could think about. And as she spoke to friends, consulted experts and conducted extensive research, the prospect of motherhood was not looking a pretty picture.

"It's 70% monotonous, thankless, hard work, 20% okay and 10% pure delight which makes it all worth it." Her friend Sophie's equation didn't exactly sell Kasey on motherhood, so she looked to Susan Manshart, author of The Mask of Motherhood who noted, "After the birth of a child, a woman's domestic workload increases by 9% to an average of 55 hours and 48 minutes a week, and is only noticed if it doesn't get done. Her partner's workload increases 0%."

The stark reality highlighted by such studies infuriated Kasey. "We are all complicit in perpetuating the belief that real work, the sort that you can put on your CV, happens outside the home," she writes. "It is truly scandalous that the vital work of motherhood is totally taken for granted. Yet nobody seems scandalised."

With a history of depression, the possibility of post-natal depression terrified her, and that was only one of the fears that Kasey addressed. "This is a job for life; you can't undo it. What if I have a baby and discover it's a terrible -- and irreversible -- mistake?"

But what of the alternative, of wanting a baby and not being able to have one?

Kasey's friend Danielle had been just like her, sailing through her twenties and thirties with all the confidence that she could have children later but, when the time was right, she and her partner had lost the egg and sperm race. Having spoken to her, Kasey made her decision.

"For the sake of the book I wish the decision had been more dramatic," she says, "but the turning point for me was talking to Danielle. Her grief was so raw and so consuming I realised that I just couldn't face that myself. I decided that all the sacrifices and inequalities of motherhood could not possibly be as bad as experiencing a grief like Danielle's."

As six months of trying to conceive naturally took their toll, there followed a gruelling course of IVF treatment which resulted in the birth of her daughter, Violet, now 22 months old.

So is motherhood all she had hoped and feared it might be?

'I love Violet more than I have words to express and I feel so lucky and so grateful that I was able to have her, yet I often struggle with the lifestyle that motherhood imposes," she says.

"I often miss my old life and I suspect I will for many years to come. It's such an intense equation -- the good of being a mother is really, really good, but the bad bits of motherhood (exhaustion, loneliness, thanklessness, inequality, etc) can be really, really bad. For me, the good outweighs the bad, but I can see that this wouldn't be the case for all people.

"You don't really know what motherhood is like until you are there. However, I was truly shocked by how many people I have spoken to who say they regret having children. I really don't believe it is the right choice for every woman, and perhaps some of these women would have chosen differently if they were better informed.

"I also think that taking time to understand what it's really like and what you will sacrifice before you make your decision helps you get through the hard times as a mother and cherish the good ones more."

But when time is not on your side, as Kasey herself discovered, the body clock may have stopped ticking and the decision is taken out of a woman's hands. So should we be having babies earlier?

"Obviously it is easier to conceive and less risky to have babies when we are younger, but society is now so far out of sync with our biology that for many women having babies earlier is not feasible," says Kasey.

"I really don't want to advocate one way or the other. The point I do want to make is that we should be better informed so we can make better decisions when we are still young enough to have options."

Her call is of concern worldwide, especially in Ireland where women delay childbirth for many reasons -- establishing a career, waiting for the right partner or financial issues among the more common ones. According to the Central Statistics Office, the average age of women giving birth for the first time increased from 20-something in the 1970s to 31 in 2009.

Fertility expert Dr David Walsh of the SIMS clinic in Dublin warns that not just Ireland but the whole of Europe is facing a fertility timebomb in the coming years if couples continue to put parenthood on the back burner.

"Ours is the only continent with a shrinking population and over the next decade this will become a serious public policy issue," he says. "Who's going to pay for all the pensioners?

"European governments across the board, including our own, will have to address this issue by incentivising people to have children and supporting them when they do."

He also urges women to realise how important age is in relation to fertility.

"A simple blood test can predict how long a woman's fertility may last," he says. "This is a one-off test and the closest thing a woman has to a sperm count. It costs about €100 and while fertility clinics use it as the norm, within a few years it should be widely available in GP surgeries and become as routine as cholesterol or other common tests.

"This blood test is worth doing in the late 20s, as it gives a woman a bit more time. Otherwise she may trundle along, not knowing that her fertility window is becoming shorter.

"It would also allow time to set up a proper screening to look for other problems and identify the 10% of the female population who have fertility problems."

Women seeking treatment at the SIMS clinic are mostly in their late thirties and typically go through two-to-three cycles of IVF. At €4,000-€5,000 per cycle, it's a costly business, and not everybody can afford it.

"The recession is having a significant impact," says Dr Walsh. "Fewer couples come to the clinic, but those who do attend are likely to go ahead with IVF, so we are doing as many cycles as ever.

"Meanwhile, there is an increase in the number of patients applying for treatment at the Rotunda Hospital's Human Assisted Reproduction Ireland (HARI) clinic which offers a free scheme to medical-card holders. The result is that the waiting time for that is going up."

And, as Kasey Edwards understands all too well, time is exactly what these couples don't have.

30 Something and the Clock is Ticking by Kasey Edwards is published by Mainstream, £7.99 sterling.

Irish Independent

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