August 15, 2001

by Caryl Rivers, Women's Enews

Why is the story that older women have trouble conceiving getting so much media play--including a Newsweek cover story and major hype on the cable shows?

The American Society for Reproductive Medicine has launched a campaign to tell women that advancing age, smoking, sexually transmitted diseases and body weight can interfere with fertility. Age, of course, is the issue getting all the ink.

One might ask, why all the press? The biological clock is, after all, a very old story. Most women don't need any help to hear its ticking. And the fact that a group of doctors is getting together to issue guidelines on some medical issue usually winds up buried in the science section of the newspaper, or relegated to a 15-second snippet on a "news you can use" segment on local TV.

What's different this time? It's that the subtext of the story is both familiar and incendiary: Watch out, women. If you are too ambitious, if you put too much time into your career, you will suffer.

This is certainly not the intended message of the doctors, who are rightfully concerned about growing infertility problems among women. But the media response is a knee jerk one--flashing a neon sign that tells women, Fear! Fear! Fear!

The Fear Message to Women: Don't Let Ambition Put Off Childbearing

Fear messages are not a new phenomenon. The fertility warning is only one of a whole series of stories with the same message to women. Remember the story about how women over 35 have as much chance of getting married as they do of getting killed by a terrorist? That story turned out to be bogus. The fact was that, for baby boom women who would only marry a man their exact age or older, there was a man shortage. But if these women would marry a man their own age or younger, there was no dearth of men. But the story became legend anyway.

So, should women be panicked about loss of fertility if they wait to have children?

No. Caution, but not fear, is in order. In fact, many more women are waiting to have children than ever before. First births to women in their 30s and 40s have quadrupled since l970, and last year Massachusetts became the first state in which more women over 30 than under 30 gave birth. Still, only some 2 percent of babies are born to women over 40. Women in their twenties and early thirties are most likely to conceive, and after 35, the ability to conceive drops for most women, and the risk of birth defects or other abnormalities rises.

But sound bites too often don't present a balanced picture. Many women do conceive healthy children after 35. In-vitro fertilization has helped many conceive, although media attention to older celebrity moms like Cheryl Tiegs and Jane Seymour may give the impression that this is an easy route. It is not. In-vitro fertilization has low success rates--and the procedure costs between $8,000 and $25,000.

Despite such over-optimism about technology, and the need to be clear about its limitations, some observers are suspicious of the motives of the fertility doctors.

Amy Allina of the National Women's Health Network, a nonprofit advocacy group in Washington, D.C., told Newsweek that the skeptic in her wonders if the members of the American Society for Reproductive Medicine may have a financial stake in raising anxiety about conceiving.

"If women are more anxious about pregnancy, they may be more likely to seek medical help earlier, which would be in the interest of fertility doctors," she says. "I hope that's not what the campaign is about." The society denies any such concerns and says business is already booming.

Real Issue: Lack of Family Leave, Child Care Cause Childbearing Delay

The doctors probably aren't just trying to drum up business. In fact, there's a bigger problem with their campaign--beyond the scare stories in the media, which the physicians can't control.

The major gap in the doctors' campaign is that it does not address the major societal issues faced by women of reproductive age. Why are so many women waiting until their late 30s or early 40s to conceive? Often, because the United States has pitiful supports for families: no paid maternity or paternity leave and little financial support for child care.

While European nations fund child care centers and offer free pediatric care, the United States has a dismal record of family-friendly supports for working parents. Women are told they have to go it alone if they want to advance in their jobs. And most women are in the workforce now and will be in the future. Nearly 70 percent of women work and more than half of all mothers of toddlers are employed. Women now outnumber men in college classrooms, and are equally represented with men in many medical, law and business schools.

If the United States had better child care and leave policies, if the American workplace were more family-friendly, women would not be forced to wait until they were older to have children.

This is the real crux of the infertility issue. If the physicians really want to deal with the anguish of women who find they can't conceive, if they are alarmed by more and more infertility problems, they have to look beyond their medical offices. How on earth could they launch a national campaign that does not address the major social and economic reasons why women are postponing childbearing?

Scaring women is not enough. How about giving them some real help?

Caryl Rivers is a professor of journalism at Boston University.