When Talking About Fertility, Try a Little Tenderness

I asked my doctor, "If I decide to have kids in the next few years, what do I need to think about now?" I was told, "Go home and start trying tonight."
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When the New York Times recently asked "Are You as Fertile as You Look?" the question was rhetorical. The reporter suggested womenfolk are ignorant about their declining fertility because they confuse youthful looks with having youthful ovaries.

It's easy to judge women like the ones trotted out for this piece; in their late 30s through mid 40s, they express surprise at having difficulty conceiving. After all, the fact that fertility declines with age -- particularly after 35 -- isn't exactly a revelation.

But the conception woes of women past their fertility prime can't be written off as a symptom of mass female stupidity. As Slate's Jessica Grose cautioned, focusing on women who think shiny hair, white teeth, and clear complexions are sign of fertility "takes away from the messy reality that most women who wait to have children aren't doing it because they believe they are endlessly fertile. They're waiting because they haven't found the right partner, or they don't have enough money, or they don't feel ready, or a million other reasons that have nothing to do with female ignorance."

Grose is right. The New York Times is ignoring a thornier predicament than naiveté: many women are increasingly out of synch with their biology. And no one knows quite what to do about it.

According to the census, far fewer folks are marrying than just a few decades ago. Those who do marry are marrying later, and the number of women in the workforce continues to grow at the same time that working-class men's prospects are floundering. Culturally, we're cheerleaders for narcissism and delayed "adulthood," encouraging a quarter-century-adolescence, especially for men. This all but assures that fewer women will find suitable partners and start families before their fertility declines precipitously. And for those who are willing to become mothers on their own, our government doesn't provide any of the social welfare or safety nets that protect and support women with kids, like nationalized healthcare, daycare, or even a living wage for many. How could the confluence of these factors not dramatically impact how women think about the circumstances under which they have kids? Wouldn't you expect to see more women "waiting" for children under these circumstances?

Newsflash: Most research points to a woman's prime fertility years being from 22 to 26. How many women that age do you know who are married or in a committed partnership, financially stable, and ready for kids? How many men? (I recognize that my upbringing puts me far outside the median, but I literally have one friend who had a child in her 20s-and she was 29).

It's time we start talking with some sensitivity and compassion about a growing type of women's issue: "circumstantial infertility." It's a term Melanie Notkin coined recently in a touching biographical piece she wrote about coming to terms with the fact that at 42 she may never be a biological mother. "Circumstantial infertility" is the name Notkin gave to the situation faced by many women who want(ed) children but never had them for reasons other than biological infertility. It is something that impacts women who hoped to be mothers but ended up missing the window (whether that's because they never found a partner, found a partner at too advanced an age, weren't financially secure, or encountered a host of other impediments). Two simultaneous trends are worth noting here: Many more women over 35 are having babies than just two decades ago, while, at the same time, the number of childless women overall is increasing. A 2010 Pew Report notes that one in five women has made it to 40 without ever having a child. This is an increase from the 1970s when only one in 10 women between the ages of 40-44 was childless. As might be expected, women with the most education are the least likely to have children. While we don't know what percentage of women are childless by choice -- versus biological or circumstantial infertility -- I think we can agree that childless women deserve our kindness, support, and understanding.

After all, it's not hard to imagine how women find themselves in this situation. One day you're busy living your life and the next you're suddenly in a race against the clock. Just look at me. I'm 33 and have always wanted children. I'm also lucky to share my life and home with a lovely gentleman who would make a wonderful father. In fact, that's what prompted me to inquire at a recent annual gynecologist appointment about my own fertility. My question was of a general nature, along the lines of, "If I decide to have kids in the next few years, what do I need to think about now?" Imagine my surprise when, instead of assurance that I still had plenty of time, I was told, "My best advice for you is to go home and start trying tonight."

Reality check, anyone?

Here's the double-whammy for many women who find themselves in this situation: The realization that you can't slow down your biological clock often comes hand-in-hand with the acknowledgement that you can't really speed up choosing the partner you'd like to raise children with -- at least not in a particularly healthy way. My doctor may have thought she was talking about fertility, but what she was really suggesting was that I'd better figure out the future of my relationship, and fast. But can anyone really do that on command, especially in a relatively new relationship?

Making a lifetime commitment to a partner (and eventual co-parent) isn't something that should be done hastily, and women in their 30s must often weigh difficult options: Put faith in your current sweetie and start procreating faster than you might otherwise? Head to the nearest sperm bank? Ditch your man and start auditioning a new potential life-mate? Of course, these kinds of tough choices are not new. But as the timing of landmark life events like marriage start taking place later and societal expectations around work and family change, the lives of many women are put on a collision course with biology. Of course single women can have babies alone, and many choose to do just that. But it seems uncontroversial to suggest that most women would probably prefer a co-parent and ideally a committed relationship before they have kids.

The emotion stirred by Lori Gottlieb when she told women to settle for Mr. Good Enough exemplifies the discomfort many feel when encountering the realities of pregnancy and aging. Gottlieb's advice to "settle," after all, was informed by her personal experience as a single mother who conceived with a sperm donor after not meeting "Mr. Right" by the time she was nearing 40 -- along with the subsequent challenge of raising a child alone. There was some realistic tough-love buried in her advice to unmarried women in their 30s: "If you want to have the infrastructure in place to have a family, settling is the way to go." But for anyone who has ever actually been in a nice-enough relationship with a nice-enough guy, it doesn't feel like sound advice.

At a time when more women than ever are childless, more are having babies later, and a record four-in-ten births are to unmarried women (that's up from 28 percent in 1990), we ought to think long and hard about the social, political, and emotional repercussions of our entrenched ideas about what makes -- and when to make -- a family. We need to understand that women who "wait" (often too long, biologically speaking) for kids are responding rationally to new paradigms that are still governed by old rules. We should talk more about options like nontraditional family units, adoption, and medical advances like IVF and do less judging and finger wagging. Our bodies aren't changing, but the world is. Maybe it's time our attitudes toward "circumstantially infertile" women do, too.

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