The fertility panic

In 2005, doctors Susan Bewley and Melanie Davies published an article in the British Medical Journal about the optimum age for having children, entitled: Which Career First? I interviewed them; they were nice, they knew what they were talking about. Bewley said, "I don't want to speculate about things I don't understand - sociology, psychology. All we're saying is, if you saw a herd of people travelling north, you'd say, 'It's getting colder, take some warm clothes!' There's a herd of women drifting into a hazardous state. We are picking up the pieces."

This has been the line, from everyone, throughout the noughties - first, that women alone are making the decision about when to have children, while men, I don't know, watch; second, that being a herd of idiot sheep, we are drifting mindlessly into infertility and then bleating about it once it's way too late. This message was very noticeably driven by the media, rather than the doctors. An absolutely classic headline was one from 2003, in which an estimate was given of one in three couples needing treatment for infertility by 2020. Read more closely, it turned out to be a patchwork of other projections: if sexually transmitted diseases continued to spread at the current rate, coupled with advancing obesity, these factors between them would affect fertility. Well, sure, but you could just as well run a headline saying "One third of couples to contain at least one obese person by 2020". It would be just as true, but not as arresting.

The preoccupations of the decade are these: that women are delaying childbirth because they are consumed with ambition; that more and more women, knowing this, are freezing their eggs; that these women, and others besides, are starting to have their first child in their 40s. The prevalence of these stories would lead anyone to believe that we're in some kind of birthrate crisis; the actual numbers are tiny.

While it's true that 2001 represented an all-time birthrate low, 2006 represented a 26-year high. Why such crazy veering? Because the major drop in birthrate was all related to the pill, and all registered between the 60s and the late 70s - since then, it's been a relatively straight line, so the difference between an all-time low and a quarter-century high is nothing like as large as it sounds. Career bitches just aren't statistically significant. Nor, for that matter, are egg-freezers: the pioneering Assisted Reproduction and Gynaecology Centre in London has 100 women's eggs. This is not what we would call a runaway trend.

Now, it's true that some of us are "heading north" - there is a 50% increase from 10 years ago in the number of women aged 40-44 who are having a baby. But the numbers at this end of the curve were small to begin with (500 or so a year), and an increase this size has scarcely any impact on the average age of women giving birth, which in 2004 was 29.4, as opposed to 28.4 in 1994. The amount of IVF we're paying for, collectively, is laughably small - about 1,500 NHS-funded IVF babies a year: for pete's sake, there are 2,000 stillbirths a year, an alarming proportion of which are at the centre of negligence cases brought against the NHS.

Every time I research anything to do with pregnancy, from IVF to egg donors to listeria to foetal alcohol syndrome, there's this glaring fact - anybody who had a serious interest in healthy women having healthy babies would be concentrating their energies on maternity services, and all its mundane sums. Is there enough money? The rest of it is bilge.

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