Tuesday 12 December 2017

Comment: Starting a family in our twenties? You must be kidding

A fertility expert this week warned Irish women to start having their babies younger. But how realistic is it to expect millennials, whose lives are defined by a sense of impermanence, to take this massive step?

Knock-on-effect: Grainne Clear (28) says no one should be surprised by young Irish women delaying parenting. Photo: Damien Eagers
Knock-on-effect: Grainne Clear (28) says no one should be surprised by young Irish women delaying parenting. Photo: Damien Eagers

Róisín Kiberd

Forget what they told you in school about safe sex: today, society wants us to start having children younger. Rather than waiting till later, Irish women are being urged to conceive in their mid-twenties, that famously stable period during which we all find well-paid jobs for ourselves, get a home and a mortgage, and settle into long-term relationships with our equally stable, financially secure partners...

If you think this sounds a bit unrealistic, you're not the only one. For many Irish twenty-somethings, the prospect of children is about as likely as, well, finding a stable career, a home and a mortgage.

Still, in an article in an Irish newspaper this week, Dr Simon Fishel, who was part of the team responsible for the birth of the world's first IVF baby, warned Irish women that their fertility declines dramatically after age 30, whereupon the risk of chromosomal abnormalities during pregnancy also increases.

A Eurostat survey cited by Fishel found that over 50pc of Irish women wait until their thirties to have children. Indeed, Ireland is third in Europe for babies born to mothers aged over 35 and is above the EU average for first-time mothers in their forties.

The implication is that Ireland's already greying population is on the brink of a new crisis, placing further pressure on our beleaguered health service and risking the health of older mothers and their babies.

The study also showed that in Italy, Spain and Switzerland, couples are waiting longer than in Ireland, while those in the Netherlands, Germany, Portugal, Sweden and Denmark are on average slightly younger. But this is by months, rather than by years - so should doctors really be issuing public warnings?

When all your homes are rentals, all your jobs are on temporary contract, where do you put down the foundations of adulthood? [Pic: scene from Broad City]
When all your homes are rentals, all your jobs are on temporary contract, where do you put down the foundations of adulthood? [Pic: scene from Broad City]

On the one hand, this is a fair concern: ­infertility affects roughly one in five Irish couples, and the number of those pursuing expensive, emotionally taxing IVF treatments is increasing. Former health minister Leo Varadkar promised state-sponsored IVF last year, but the option has yet to materialise, and Irish people are now ­travelling to places like the Czech Republic for more affordable treatment (between €4,000-5,000 in Ireland, and around €2,500 abroad).

On the other hand, we have the second-highest fertility rate in Europe, just behind that of France. As a nation, we are living longer, healthier lives, one by-product of which is having children later.

"When you speak to people working in the field of fertility, we are inherently biased by our jobs," says Dr John Kennedy of the Sims Clinic, Dublin.

"All we see all day is couples struggling to conceive, but that isn't the experience of the majority of the population.

"It's true that the older you are, the more likely you are to struggle. Not necessarily to the degree of needing fertility treatment, but you might take longer to conceive."

Rather than telling young women to abandon their careers in favour of starting families, Kennedy stresses the need to improve education around the subject of fertility.

Girls' star Jemima Kirke gave birth to her two children while she was in her 20s (Photo by Robin Marchant/Getty Images)
Girls' star Jemima Kirke gave birth to her two children while she was in her 20s (Photo by Robin Marchant/Getty Images)

"Historically, the way our education system has worked in Ireland is that you're taught to be terrified of getting pregnant in your teens and twenties.

"You're told that you're rampantly fertile and will remain that way indefinitely, which isn't the case for most."

It's also worth remembering that public ­dialogue around fertility, much like that around pregnancy in general, tends toward the extreme.

The AMH (anti-Mullerian hormone) test, for instance, is often portrayed in TV dramas as a diagnostic test which can seal your fate and declare you infertile forever. But it is only a form of screening.

"Loads of things can affect AMH. It can go up and go down again, and is affected by other medications," says Kennedy.

It's worth checking for any underlying issues as early as possible, not to resign yourself to infertility, but so that you know your options and can make informed choices later on.

Millennials, and particularly Irish millennials, seem to me to be marked by a sense of impermanence. We are 'contract workers', nomadic and flighty by necessity, not choice. We are romanticised one minute as 'Generation Emigration', pilloried the next as 'Generation Snowflake'. We are caricatured as self-involved and immature, but what's less frequently addressed is the economic and social climate which keeps us this way.

When all your homes are rentals, all your jobs are on temporary contract, where do you put down the foundations of adulthood? How can you be 'adult' enough to raise a child, without a stable home in which to raise them? How can you call yourself an adult at all?

I wrote a Facebook post asking friends what their thoughts are on having children. I'm in the second half of my twenties, but a few exceptions aside, I have yet to notice any baby pictures appearing in my timeline.

One friend in her late twenties, Teresa Coyne, who has prolactinoma (a condition affecting the pituitary gland which can lead to infertility), is well used to being advised by medics to start her family sooner rather than later.

"My doctor gives me grief, saying I need to make a plan now as I'm nearing 30. But I'm in college, renting a tiny room in Dublin and living month to month. There's not a hope I could deal with a baby," she says. For others, the issue relates more to how they see the world and where it is headed.

Alan Maguire, host of the Juvenalia Podcast and an editor at Headstuff.org, is known for his cheerful Twitter presence, but he gives me an unexpectedly nihilistic vision of the future.

"I'm very, very lucky and stable, but the Arctic is melting," says the 32-year-old. "Things are going to get really bad for everyone really quickly, so even I can't justify having a child to myself, except to fulfil some kind of The Road-style fantasy."

Meanwhile 31-year-old Shawna Scott, a young entrepreneur known for her online business Sex Siopa, thinks finances play a big part.

"I have a lot of personal reasons for not wanting to have children, but the financial barrier is probably the biggest. I think the way we frame the issue can often place the onus on women to make lots of babies, when actually it's a far more complex, systemic issue."

Grainne Clear (28), who works in publishing in Dublin, says no one should be surprised by young Irish women delaying parenting.

"Life and culture has changed so dramatically and quickly, even compared to the generation before us. If society invests in the education and careers of its women, as it should do, it's inevitably going to have a knock-on effect."

Progress in one area might lead to a few steps back in another, but this won't necessarily take away from what's gained, she says.

"If Irish people can't afford to get married and own their own homes in their twenties, then they're not going to have babies until they can."

Another friend of mine, Adam Hurley, links fertility trends to broader economic ones.

"For a lot of people, there's a sense that Ireland has abandoned us, that the needs of our generation have been consistently ignored. We're not having children because we're busy trying to get our lives together," says the 29-year-old.

It's worth acknowledging that fertility, as a force of nature, is inherently sexist - while fertility issues can - and do - affect men, the window of time for women to conceive is far shorter. Nature can't be helped, but does it justify the tiresome 'clock's ticking' rhetoric we grew up with, the hackneyed questions about 'having it all'?

For a generation deeply aware of the need to advance gender equality - in the workplace, the home and even in the Constitution - fertility poses an awkward prospect.

Recently married at 34 and living in Waterford, Sarah, who preferred not to give her second name, feels targeted by all the public concern for her reproductive health. Family members are asking questions; friends often corner her on nights out.

"I keep thinking I should have that 'ovaries burning' moment," she tells me, "but I don't. Maybe I'll feel differently when I get a mortgage and live in my own house - secretly I'm hoping I do change my mind - but for now I don't want to have children."

For Sarah, the reward for years spent working towards stability and happiness is not to have children, but to enjoy life as it stands.

"I'm not sure I want to give up that lifestyle at all, though I get the feeling my friends would be disgusted at me for saying that."

Meanwhile her friends continue to get pregnant. "I'm not naïve, I know their whole lives change. So many people tell me it's worth it, but I don't believe them."

"Women are a lot more educated now," says Helen Browne, chairperson of the National Infertility Support and Information Group (NISIG) which supports and advocates for people experiencing reproductive challenges.

"My grandmother got married at 16, had her first child at 17 and, in the end, had 11 pregnancies and nine children. Most women wouldn't put themselves through all those pregnancies today."

Browne's own experiences undergoing IVF, though ultimately unsuccessful, have led her to empathise with the couples and individuals she speaks to every day on NISIG's 24-hour support line.

She often hears from women diagnosed with conditions linked to infertility such as endometriosis, polycystic ovary syndrome and irregular periods, conditions which doctors can fail to take seriously until it's too late.

"GPs will often tell women in their twenties not to worry, that they can address them later when they want to get pregnant. But if these conditions aren't treated early, they'll have a greater chance of doing damage to the reproductive system," says Browne.

As a woman in the second half of my twenties, researching this article raised worrying questions. Not so much about my biological clock - am I ever truly allowed to forget that - as to the layers upon layers of conjecture and well-intended 'advice', clouding a choice which remains intensely personal.

Women have been told so many contradictory truths around what is 'natural' or 'normal' or 'sensible' or 'safe', when really it's down the individual, their biology and their circumstances.

Browne also noted a frequent bias against women in this public dialogue: "I often speak to people in strong and loving relationships, but whose partners are not ready to be fathers yet. That's rarely mentioned in the media; often it's men who are not ready to be fathers yet. But there's always this blame placed on women."

Worth keeping in mind next time another 'warning to young women' is published.

Indo Review

Promoted Links

Life Newsletter

Our digest of the week's juiciest lifestyle titbits.

Promoted Links

Editors Choice

Also in Life