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A new inequality

· ​The biological clock ·

Young women today find themselves facing a new problem, almost unknown to the previous generations, to succeed in conceiving a child before advancing age makes it ever more difficult. For many reasons the number of women in Western societies who choose – or are forced to choose because of work or the lack of a partner – to postpone motherhood is growing at an alarming pace and women are often not adequately informed of the limitations that advancing age entails with regard to reproduction. Indeed, many young women believe that assisted procreation can allow a woman to conceive a baby at any age, an idea in which the news conveyed by glossy magazines featuring stars who procreate at an advanced age is complicit. In reality the effect of putting off this decision is a fall in the birth rate: today in many Western countries fertility rates are lower than the replacement level, which is 2.1 children per woman, and a high percentage of women remain childless although they want to be mothers.

Salvador Dalì “The Persistence of Memory” (1931, detail)

According to a survey cited in the 2017 Italian National Statistics Institute (ISTAT) report, La salute riproduttiva della donna [The reproductive health of women], the majority of Italian women say they want a family with two children but when all is said and done it turns out that the average number of children per woman in Italy is currently 1.34 (one of the lowest figures on the planet) and that the number of childless women is constantly on the increase (more than 20 per cent) with a variable rate from country to country of voluntary and involuntary nulliparity.

In addition, 75 per cent of women with one child plan to have at least one more, but a check made six years later found that only just over 50 per cent of these women had realized this plan while 50 per cent of those remaining, older than 36, desisted because of their age.

These figures are at the root of two worries: the demographical sustainability of the population in the long term and the widening gap between desired and realized fertility.

The gap between expected fertility and achieved fertility contradicts the hopes of the World Health Organization, which defines reproductive health as the possibility to decide freely when and if to reproduce, and for every woman this can become a source of frustration and stress because, even if the analysis of the causes of infertility is complex and demands the contribution of many disciplines, all evidence indicates that the postponement of births is the main factor which determines it.

Progressively postponing motherhood has led Italian women to have the highest age at giving birth in Europe, 31.8 years in 2015 with 8.6 per cent of mothers older than 40.

Installation by Agatha Haines for the exhibition “Humans+: The Future of Our Species”

The main cause of the decline in female fertility with age is represented by the continual depletion and aging of the female gametes, oocytes, which are already all present when a girl is born and proceed to mature, in the woman’s fertile phase, time after time in every menstrual cycle. The age of the uterus is far less important but the risk of diseases connected to infertility and barrenness, the percentage of miscarriages, gestational complications and the risk of abnormalities in the embryo increase with age. The decline of women’s fertility with age, described as the probability of being barren, increases by 4.5 per cent at the age of 25, by 12 per cent at 35 and by 20 per cent at 38, and then suddenly reaches 50 per cent at 41, and 90 per cent at 45, while at the age of 50 virtually the entire female population is barren.

Until the 1960s most women had their first child at between 20 and 30 years of age, a period which today is devoted to study, training, the search for work and the beginning of a career, all activities which have permitted women to play a significant role in the working world but come into competition with maternity, especially in the absence of social assistance policies and gender equality. Besides the quest for self-fulfilment, young women also find it difficult to create a bond with a man of the same age who is prepared to assume responsibility for a family: in fact males do not feel the burden of time passing, for them the biological clock does not tick so fast.

Reproductive technologies should be viewed positively, since they help couples who do not manage to conceive naturally to have children, but they must not create the illusion that they can turn back the biological clock.

Despite the many hopes placed in them, in fact, only a quarter of the couples who do not succeed in conceiving have recourse to medically assisted procreation (map) and, of these, only one couple out of five succeeds in obtaining a pregnancy and only 76 per cent of these pregnancies are carried to term successfully. In Europe map births range from 1 to 4 percent and the data show that the youngest women (under 29 years of age) have a greater probability of carrying a pregnancy to term with map. Unfortunately, instead, Italian women are having recourse to map techniques later and later: the most recent data, referring to 2007, demonstrate that the average age has even increased over the years, it was in fact 35.4 in 2005 as compared to 36 in 2007.

Thus the real situation cannot be denied: by putting off motherhood until an age somewhere between 30 to 40 and beyond, women are forced to reckon with their “biological clock”. Originally referring to the biological process of circadian rhythms (such as the alternation of sleeping and waking), the expression “biological clock” was first applied to female fertility only after the publication of an article in the Washington Post of 16 March 1978, entitled “The clock is ticking for the career woman”. The article’s author, Richard Cohen, warned women professionals involved: by putting off the “biological” desire for motherhood, they would come up against the limitations of their reproductive system when it was “too late”. The expression immediately spread, since it certainly represented the new kind of anxiety which assailed young women, a difference from men that was unfavourable to them, just when they were attaining equality in all other fields.

Of course, those who say that the metaphor of the biological clock has been used to stigmatize the role of women under the cover of biological determinism and to confine it to the traditional environment have some justification, because time also acts on men and many studies have shown that male fertility not only diminishes with age but also that an increase in the paternal age increases the risks of complications in pregnancy (miscarriages, and premature births), genetic and chromosomal abnormalities and risks that the progeny will develop pathological conditions, such as neurocognitive defects and autism. However for men, of course, the end of fertility is less obvious and follows a gradual evolution over time.

The reason for the almost exclusive attention given to female fertility is that the effects of maternal age are far better known than those of paternal age, and that predictions of fertility on the basis of the woman’s age are considered sufficiently reliable and prognostic.

In the absence of changes in society, in welfare and in relations between men and women, it will be hard for today’s young women to overcome their anxiety about their biological clock, which on the contrary does not concern men of the same age. 

Mariella Balduzzi

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St. Peter’s Square

Sept. 20, 2018

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