Melanie Goose finds out why so many women are waiting until their forties to have children, and wonders whether we should have routine fertility checks in our early thirties…
When my mum had me at 27 her hospital notes described her as a ‘geriatric mother’. Crazy, isn’t it? By those standards I must have been positively decrepit when I had my son in my late thirties. But there’s a lot to be said for older mums. We’ve got life experience and perhaps more patience. We’ve probably satisfied some of our career, travel and life goals and we may be financially secure. But should the next generation of mums be scheduling parenthood in the same way we’ve arranged our careers, mortgages and pensions?
Focusing on a career, not meeting the right person or not feeling ready are just some of the reasons why women delay having a child. But when it comes to family planning, we should be educating young women about fertility, not just STDs and contraception.
There’s been a baby boom over the past decade, and a big increase in the number of older mums. The number of women over 45 giving birth has trebled, and the number of 40-plus mums has jumped by more than 80 per cent. The Royal College of Midwives claims 688,120 babies were born in England in 2011 – the highest figure for 40 years – and early figures from the Office for National Statistics show the first half of 2012 is likely to be a record breaker.
This is a major concern for maternity support services. There is a national shortage of midwives, and older mothers can be a greater burden on the NHS with a higher risk of multiple births and babies having abnormalities or Down’s Syndrome. ‘Older women are more prone to diabetes or obesity,’ says Gail Johnson, RCM professional advisor for education. ‘And there’s the added risk of caesarian section plus a slight risk of developing hypertension or heart disease, which can be more treatable if you have an earlier pregnancy,’
IVF has helped a lot of older women to become mothers, but biologically our early twenties are still the best age for us to reproduce. After 35 women’s fertility declines dramatically; the chances success at 37 are roughly 25 per cent. By 38–40 it’s about 20 per cent and it nosedives to 6–10 per cent for women over 40. Which is why many IVF clinics use donor eggs for women in their forties. New technology is helping, too. ‘We implant the blastocyst [embryo] at day five and can test it for genetic or chromosome problems,’ says Dr Geetha Venkat, director of the Harley Street Fertility Clinic. ‘Women over 38 are more prone to miscarriage so pre-natal genetic screening allows us to choose the best embryo to implant and hopefully save the couple the misery of miscarriage.
‘It’s sensible for women in their early thirties to have their fertility tested. It reassures them that everything is working well, even if they are not at a point where they want to have a baby. If their egg count is low or there is another problem, we can discuss not delaying motherhood too long or freezing their eggs for later use.’
Nuria was 42 when she had IVF after suffering a miscarriage the year before. ‘We went to a clinic and they were asking for £150 for this test and that test,’ she says. ‘I felt like a lab rat. I didn’t understand what I would be going through and I felt out of control. When we changed to Dr Venkat’s clinic she explained everything and took the fear out of it. My IVF worked first time and we have a gorgeous baby girl who is seven months old.’
IVF isn’t only a difficult experience for women – many men feel the pressure, too. ‘I found providing a sperm sample embarrassing and it was dealt with in a clinical, impersonal way,’ says Gareth, 43. ‘We were lucky and it worked, but I would recommend our son has his fertility tested when he reaches 18.’
The expense is prohibitive for many, with costs starting at £3,000 per cycle plus drug and test fees on top. Some Primary Care Trusts will pay for one round of IVF, but it depends on where you live. Tom, 41, has three children, all of whom were conceived through IVF. ‘It should be cheaper,’ he says. ‘We were told by our GP that NHS treatment was not available for us. With only a one in four chance of success, you may have to try several times before it works.’
Being a parent isn’t just about conception and birth. Having a genetically related child is great, but there are other ways to be a mum or dad. Adoption and fostering can end the pain of infertility and the sadness it creates. They shouldn’t be seen as a last resort – they can be the light at the end of a very dark tunnel.