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Why Women Wait to Have Babies

Quite often, the reason a woman chooses to delay childbearing is blamed on a high-powered career, but a new Canadian study finds that is not the case. In fact, less than a third of women of the 1,000 women surveyed in the study, published in the Journal of Obstetrics and Gynaecology Canada., cited career goals as the reason for deferring motherhood.

In Canada, 11 per cent of first births now occur in women aged 35 and older. In the United States, around 20 percent of women have their first child after age 35. "I have definitely seen numbers as high as 20 to 25 percent of women are waiting," says Alan Copperman, M.D., a fertility doctor and co-director of RMA of New York. "Both men and women of today would like to experience all that life has to offer, and whether that's being able to travel, whether that's having a fulfilling a career, or whether that's a couple that wants to spend some time with each other first and then have a child, I think that there really is the desire for men and women in their 20s, 30s and 40s to try to do everything."

Why Women Delay

The Canadian researchers set out to describe the reasons women may choose to delay childbirth and determine if the reasons differed according to the age at which a woman became a mother. They randomly selected women from a regional notice of birth databases who had their first baby between July 2002 and September 2003. The women were contacted by telephone, and the ones who participated completed a 20-minute survey over the phone.

They found that the factors that influenced childbearing were similar regardless of the women's ages. Three factors had the most influence:

  • Being in a secure relationship (97 percent)
  • Feeling in control of one's life (82 percent)
  • Feeling prepared to parent (77 percent)

Less than 30 percent of women reported career goals as being “very important” in their decision.

The Risks of Waiting

Fertility in women declines because of several reasons, particularly with regards to egg quantity and quality. Even though there is some debate about whether women are born with all of the eggs they will ever have, conventional wisdom is that there are fewer eggs in the ovaries as you age. In addition, there is a decline of egg quality, with the eggs remaining in the ovaries being more likely to develop chromosomal abnormalities known as aneuploidy. These abnormalities lessen the chances of getting pregnant and increase the risk for miscarriage. As a woman's age increases, there is also a greater risk of other disorders that may have an adverse impact on fertility, such as fibroids, damage to the Fallopian tubes and endometriosis.

Fertility experts tend to agree that women should be made aware of the risks of waiting. Dr. Copperman says it's not uncommon for "women [to] come in in their 40s, and they are surprised to find out that there is such a thing as reproductive aging, that [for] the average woman in her 40s, almost 90 percent of the eggs are now chromosomally abnormal, that it's now going to be hard to get pregnant either on their own or even with assistance. We still haven't reached that stage where we're educating women, men and women, in health class and high school or in college or in their 20s. Egg freezing has probably helped a lot of women preserve their fertility, but even more importantly , the awareness of the technology has improved the awareness out there because people are now talking about reproductive challenges for a woman is in her late 30s."

In late 2011, the Society of Obstetricians and Gynaecologists of Canada published a new set of guidelines recommending that women in their 20s and 30s should be counseled about the age-related risk of infertility and other risks such as increased risk of miscarriage, ectopic pregnancies, diabetes, high blood pressure, placental abnormalities and multiple births.

Accurate information about reproductive aging is empowering for women, according to Dr. Copperman. "I think that we need to find ways to increase the awareness of the difficulties of conceiving, but also, by the same token, the happy stories, the successful stories," he says. "Not all hope is lost when a 40 year old isn't getting pregnant. There are things we can do to help. We're getting better and better at [ovarian] stimulation and finding normal embryos and achieving a healthy baby. You don't want scare tactics, but you do want to create an awareness and do it in a way that has some of these success stories, so we can be educating and inspiring rather than scaring and discouraging."

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