Issue 39 / 17 October 2011

IT’S no secret that Australians today are having children later in life than previous generations.

Australian Institute of Health and Welfare figures show the average age of Australian women giving birth in 2008 was 29.9 years, up by about a year on the 1999 figure.

We know that women bearing children after their mid-30s are at greater risk of complications — and their babies are too. This is important information and doctors and other health experts are certainly doing their best to get the message across.

Unfortunately, though, it seems far too easy for the facts to become lost in a sea of highly emotional rhetoric when talking about issues of procreation.

Perth-based obstetric medicine physician Dr Barry Walters created a mini-firestorm recently when he was quoted in a news article in The West Australian saying it was “selfish and self-centred of older women to have babies …”.

In a later article he wrote in the Sydney Morning Herald, Dr Walters complained that he had been the target of “bigoted, uninformed, unsubstantiated and in some cases violent” vitriol as a result of his remarks.

What, he lamented, had happened to the Australian quality of giving a person a “fair go”?

Well, many women commenting on the article appeared to feel the doctor had failed to give them a fair go (although others supported his position too).

Obviously, there is no justification for violent vitriol in a discussion such as this, but frankly Dr Walters derailed his own argument by his use of the word “selfish”.

Although his views were expressed more moderately in the Herald than in The West Australian, he was still arguing the adjective applied to some couples who chose to become pregnant “at ages above about 38”.

Whatever you might think about the decisions an individual couple makes about having children, labelling them in that way is hardly likely to encourage a sensible and calm debate.

I also wonder why this kind of criticism so often focuses on women as if they are the only ones making the decision about when and if to have a child.

Dr Walters seemed to reveal a surprising lack of insight into the reality of many women’s lives when he wrote in the Herald article: “Tens of thousands of women in this nation would avoid suffering if they chose to become pregnant earlier in life.”

How should women go about making this choice on their own? Should 20-something women be encouraged to entrap a reluctant partner by secretly abandoning their use of contraceptives? Or to access sperm donation so they could go it alone?

Researchers from the school of public health and preventive medicine at Monash University recently surveyed nearly 600 Victorian women in their early 30s and found the main reasons cited for childlessness were either being single or having a partner who did not wish to commit to fatherhood.

“At this point in time I cannot even consider having children”, a 30-year-old woman told the researchers. “I don’t have a partner, but if I had I would wish for a stable [relationship] that had lasted a couple of years before I considered children.”

The reasons for the rise in parental age are complex, relating to social pressures as well as individual choice, and our discussion of them should be equally nuanced.

Women — and men — need to be given the unadorned facts and they need to be given them early. It could even be part of sex education in schools.

But there will always be people who end up having children later in life and they, like all parents, need our support not our condemnation.

Jane McCredie is a Sydney-based science and medicine writer.

Posted 17 October 2011

13 thoughts on “Jane McCredie: Mum’s the word on age

  1. Dianna Kenny says:

    The assumption underlying the debate about women’s age and childbirth is that women can make a decision one day to have a child and immediately thereafter she becomes pregnant. Jane McCredie has highlighted some of the social reasons why women cannot have children when they want to. Another reason is inferility. One in every six Australian couples are either infertile or have problems with fertility. Infertility is not diagnosed until the couple has been unsuccessful in their attempts to conceive for one year. Some women can conceive but cannot carry a pregnancy to term. These women/couples, myself included, spend many years on assisted reproduction programs trying to have their much longed-for children, while simultaneously enduring the inconsiderate comments of family and friends of the order, “Isn’t it time you thought about starting a family/having another child?” There are myriad reasons why women are conceiving later, many of these are beyond their control. It is disappointing that an obsetric medicine physician could not present a more nuanced opinion regarding women and age of conception.

  2. Dr Barry Walters says:

    Had Ms McCredie read my article in The Age and the Sydney Morning Herald with care, she would have appreciated that I was condemning noone. Of course people sometimes cannot choose when they conceive or have no opportunity until later in life (I am not referring to those situations), but mostly they can and the delay is self imposed, or compelled by a partner.
    The scientific and clinical facts relating to age and pregnancy speak for themselves. My article stated that a public health message was necessary to educate couples about the increased risks of pregnancy as age advances, risks to both baby and mother. I cannot resile from the truth, even if it is to my own hurt, condemned by unreasonable critics. If I succeed in convincing 1000 women to embark on pregnancy at the age of 25 – 35 instead of 40, I will have saved the lives of 150-250 babies (references available re miscarriage and other rates) who would otherwise have been miscarried or lost in other ways and I will have prevented many women from experiencing medical and/or obstetric disasters. This is a chance that few Doctors get in a lifetime, and Doctors should give the correct advice, as difficult as the interpersonal situation it provokes may be.
    My conscience is clear. I argue for Mothers and Babies after a third of a century of caring for them, that continues now, every day and every night, whilst my critics enjoy barbecues and relax at home with their families, until things go wrong at 3am one dark night during the pregnancy when I am called to yet another calamitous tragedy.
    Dr Barry Walters
    Physician in Obstetric Medicine

  3. Kate says:

    This issue is always going to be devisive depending on which side of the fence you are sitting on. Womes are delaying families out of choice and medicine is helping them conceive when is this is not possible naturally. I’ve sat on both sides of the fence as an infertile woman who with IVF was lucky enough to have a baby at 25, then the surprise baby at 40. Had I waited I may have not been so lucky and now at 55 with a very trying 15 year old daughter I really do think Im too old for this (so does she) My advice, have your children while you are young, if it doesnt work out that way accept that there is a time when it should be getting too late and I kind of agree with 38, you are a parent for a long time and its harder as you get older, especially when your parents need care, you are everything to everyone and the older you start the harder it is, just my thoughts and I know many will disagree….now about breastfeeding……

  4. Doctor K says:

    There are so many drivers in the decision making around conception and child birth. These are so complex and individual. Yet the fact remains that Dr Walters is right about the risks of later pregnancy and he has the weight of evidence on his side. I admire his willingness to speak up for what he believes in the face of considerable societal opposition. Can we ignore an important aspect of preventative health care just because we don’t like the social implications?

  5. Fiona says:

    I understand this article is about the health risks of pregnancy and childbirth in older women and accept that I took this chance when I had a child at 45 but I wish these types of debates would stop condemming women as the only decision maker in the ‘process’. While it is acknowledged that the average age of having children has increased, albeit marginally, I would be interested to see if any research has been undertaken in the average age of fathers particularly given societal trends of women having partners equal to or greater than in age. What is to be said of these men who leave it until later in life to have children, especially the ‘2nd family’ men who reproduce with the ‘younger model’ or vice versa. I am not making judgements but rather pointing out that men are making choices about parenthood as well but without the burden of the ‘ticking biological clock’. Is this seen as selfish and self centred as well?

  6. Sue Ieraci says:

    “Can we ignore an important aspect of preventative health care just because we don’t like the social implications?” I find Dr K’s comments interesting in that medicine has stretched so many other societal expectations and yet we don’t seem to load them with the same emotive significance. Older people can no keep running or playing sport, or carry extra weight, and when their joints are too damaged thay can have joint replacements. Do we consider those people as selfish when they could just have limited their activity earlier and thereby practised prevention?

  7. Tom Gavranic says:

    Having lived through the antibiotic, contraceptive, cardiovascular and psychotropic revolutions, I see late pregnancies as but one more manifestation of the horrendous unintended consequences that modern medicine is driving us into. This was well described in Ivan Illich’s “Medical Nemesis” and Ratray-Taylor’s “Biological Time Bomb” in the 1970s and even earlier by Aldous Huxley in “Brave New World”. How long before we have the artificial placenta? We are being driven headlong into an engineered death-denying hell, all with the best of intentions.

  8. Sue Ieraci says:

    I am confused by the last post – Tom, did you mean to say that antibiotics, contraceptives, cardiovascular interventions and psychotropic meds as included in your class of “horrendous unintended consequences that modern medicine is driving us into”. If so, what are the horrendous consequences, and what are the horrendous consequences of late pregnancy? If one were not into death-defying at all, why practise medicine? (If I have misunderstood, I would appreciate your clarification).

  9. Anonymous says:

    I think it is incorrect to say that “Australians today are having children later in life than previous generations”.
    Perhaps “generation” singular, but before that (before contraception) women were having babies until they no longer could. I had my last at 43. My mother had me, her last, at 27. Her mother had her last at 36. And her mother had her last at 43. It’s nothing new.

  10. Anonymous says:

    Is the argument about the maternal age at first pregnancy or at last pregnancy? I imagine in the generations before easy access to safe effective contraceptives that women were regularly having unplanned babies in their late 30s and 40s.

  11. Jenny Bradford says:

    I agree that many women would like to have a baby earlier in their lives, but do not have the opportunity. However, I regularly see women who have the man, the house and the money, but who have deliberately put “making a baby” further down their list of priorities. These are often women with risk factors for sub-fertility and pregnancy complications, who seem to believe that assisted conception is a “quick fix”for any sub-fertility. To these women I suggest that they should re-prioritise conception a little higher up their list of things to do.

  12. Barry Walters says:

    In response to some of the comments – I have seen 12 women in the last 2 months who are dealing with demented mothers or fathers, dying mothers or fathers with cancer etc, all of whom said it was very difficult dealing with ageing parents. My patients were aged 30-35 and their ailing parent was 40 – 46 years older. AIHW data shows that 60% of Australians have at least one serious health problem by the age of 70, when a child born at maternal age 42 will be 28 years old. The fathers, of course, are usually older, but also have to be cared for when they develop dementia or any of the other problems of age.
    I’m sorry for presenting an uncomfortable truth, and I understand the situation that some cannot choose the time of conception, but the scientific truth is that there are great costs to the offspring in the long term, as well as to the woman and baby in the short term, of pregnancy at age 40 and above. I did not make up this information and I give it to help people. To deny it is to play the ostrich, and good doctors don’t do that – they give the correct information, in full knowledge that they cannot force good health on people and that they make their own decisions, even if they may be seen at times to be selfish in so doing. Patients have said to me “Sure smoking is bad, but I could be run over by a car as I cross the road outside your office this afternoon – I’ll keep smoking”. What do you think?
    Doctors rate health and wellbeing of their patients and their children above everything else – but some women and men are more taken with a feminist ideology that says “I will do what I wish, when I wish, as what I want overrides everything else”. How does one describe this philosophy?

  13. Sue Ieraci says:

    “Some women and men are more taken with a feminist ideology that says ‘I will do what I wish, when I wish, as what I want overrides everything else’.”
    This is a very unusual view of what feminism is. Feminism is about women having equal value as human beings, and equal rights to make life choices with their co-humans – men. Does anyone imagine that, while women are deferring having children, their partners are clamouring for fatherhood? If anything, it is men who are deferring “commitment”. Is this “selfish”? Only if you choose to judge it so. Otherwise, it’s just the reality of a changing society. Late parenthood is no more “selfish” than late coronary stents or late knee surgery – indeed LESS so. Parenthood is undertaken to produce life – the next generation. Surgery is undertaken for one’s own well-being. Which is the more “selfish”?

Leave a Reply

Your email address will not be published.