Monday 21 January 2019

Rachel Mackey: Women must heed the age factor or risk childlessness

As more Irish women put off having a baby, Rachel Mackey asks if they are leaving it too late to plan a family

Rachel Mackey

IS THERE ever a perfect time to have a baby? It seems that, increasingly, many Irish women and their partners are putting their lives on hold, at least when it comes to this big decision: "Let's wait until the economy improves. Let's wait until we can afford a house or a bigger place. Let's wait until I am made permanent, or made manager, or until we know whether or not we are staying in Ireland." There is such an array of considerations facing couples, many of them influenced by our current economic context.

So, is there a right time to have a baby? Well, fertility research indicates that the ideal age for a woman to have a child is in her early 20s. In Ireland now, the average age at which a woman has her first child is 31. Twenty years ago it was 26. So, why are we having babies at an older age, and should we change how we plan our families?

There are several reasons for the trend of Irish women starting families at an older age. The economic climate in Ireland certainly means that women, and couples, have had to think long and hard about when to start a family. A woman who might have once thought of leaving the workforce to have a child might have to think twice about the financial consequences. Couples may need two full-time incomes to service their mortgage and other expenses.

Maternity benefit is at the discretion of Irish employers, and State benefit may not be sufficient for women in straitened financial circumstances.

There is also the enormous financial burden of full-time childcare to consider when the woman returns to work; many mothers end up taking part-time employment.

Undoubtedly the attitudes and atmospheres of some workplaces have a bearing on the decision to have children. Many women are aware of an unspoken negative bias within the workplace towards maternity leave, and the perceived disruption it causes in the work environment. So they strive to reach a position of seniority and relative safety before becoming pregnant.

There is no doubt that relationships have also changed. Men and women now take longer to find their life partner, with whom they want to have children. Gone are the days of a woman marrying the man with whom she has her first serious adult relationship.

Of course, reliable long-term contraception has also enabled women to control their fertility to a large extent.

The decision as to when to have a child is not just confined to the first baby. Irish couples can reach the stage where they ask themselves whether they can have a second or a third child. When they embarked on their life together they may have dreamed of having several children, but in these recessionary times they may have to make the difficult decision to defer a subsequent pregnancy until their financial situation improves. But sometimes this can end up being too late.

The idea of "putting your life on hold" for whatever reason is certainly a major factor in the trend of older women having children and, consequently, the increasing rate of infertility in Irish couples. Studies have consistently shown that the best "biological" age at which to have a baby is in our late teens to early 20s; in this age group women have the lowest rate of miscarriage and stillbirth. But to have a child at such a young age has implications for on-going education and long-term achievement of career goals. Women usually prefer to continue their education and join the workforce.

So far, so good. What is often unknown to women is

that while they are climbing the corporate ladder, the quality of their eggs produced by their ovaries is declining. This becomes more marked over the age of 35, and egg quality is significantly reduced by the age of 40. What this means is that as you get older, your fertility reduces and there is an increased risk of miscarriage.

One of the major factors contributing to the infertility rate of one in seven Irish couples is their leaving pregnancy until an older age. Women should be more aware of the risks attached.

The Anti Mullerian Hormone blood test was specifically formulated to allow women to defer pregnancy for up to two years at a time, by measuring their egg quality or ovarian reserve. Women are increasingly availing of this test in Ireland, which highlights the way our society is changing. Interestingly, the test is not even recommended for women aged 40 or older, as deferring pregnancy at this age is not advised.

The question is, do you put off having a baby until the recession is over, until you have fulfilled your ambitions at work or travelled the world? Or do you prioritise fertility ahead of lifestyle choices?

There is no doubting the physical evidence that we should be having have children at a much younger age, but we live in a changing world. Women are increasingly prominent in the workplace, with society organised around full-time employment and smaller families. Women today are making different choices to those from previous generations, but they need to understand the possible consequences of those choices on their hopes for a family.

Dr Rachel Mackey is a women's health specialist and author of 'The Women's Health Book: A Guide for the Irish Woman', published by Orpen Press; available nationwide and online from www.OrpenPress.com

Irish Independent

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