The papers were full of it recently. 'Have your children by 30 or you can forget motherhood'.
Is this really the medical advice we should be giving young women nowadays? Is this the entire truth or is it plain simple scaremongering?
Does the young woman of today who wishes to have children not know her own 'ticking biological clock' or is it the case of the medical profession and media being patronising to women, denigrating their choices?
This debate is not new but surely this is a debate that women should have with themselves, and our role as doctors is to ensure that these women have access to accurate information on which they may wish to base their decisions on.
I am a female Consultant Obstetrician and Gynaecologist with over 30 years of medical experience, both in the UK and India. Every day I see women of all ages and at all stages of their life, some with children, some without, some trying desperately for a pregnancy, others not so bothered. I am also the mother of two daughters who are now young career women.
Here's my advice to young women of today, including my daughters and my nieces.
'You shouldn't become a mother, just because you are able to get pregnant. It should be a much bigger decision than that. Having a baby should not be just about your age, It's about it being the right time for you, perhaps meeting the right person, being financially stable, being at the right stage of your career.
It shouldn't be about being 30 so you have to get pregnant right away no matter what.'
I would have been very annoyed if I had been given this sort of advice at school or at home, which in turn may have compromised my life and career choices.
Having a child is a major decision to be carefully considered and mature mothers sometimes are in a better place as they can take on the responsibility that comes with having kids. The fact that women are living longer now with better quality lives, with life expectancy at 81 for women in the UK does mean there is less rush. The average age that the British woman has her child is now nearly 30.
I do think it is important to raise awareness of fertility issues but this kind of message creates fear and is counterproductive. Young women need evidence based medical advice and responsible journalism.
No doubt, there is scientific evidence that as you get older your fertility declines, but it is a gradual decline, not a sudden ending. It is important that women are made aware of this. Certainly as you get to your 30s it's harder to conceive than it was in your 20s, and your 40s is harder than your 30s.
Conditions such as Endometriosis, Endometrial Polyps, Fibroids and Ectopic Pregnancies do increase with age making it harder to conceive. The risk of genetic abnormalities and complicated pregnancies also increase with age. Family history of early menopause is also important. That said, my clinics have plenty of women in their late thirties and sometimes in their early forties with naturally conceived pregnancies that have a happy ending.
Women in their 40s today are often much healthier than women in their 40s were say 70 years ago. Science is advancing and while some women have to resort to assisted conception, they are still the minority.
There are also many women who simply opt not to have children as it is not a life path that interests them - they should not have to have this pressure put on them at a young age as they might make a decision they'd later regret. It shouldn't have to be a life goal.
Perhaps, my advice comes from not just my experience as a doctor but is also influenced by the fact that I come from a family of strong independent women who have put a lot of thought into their future and when they want to have a family. There are some who have chosen to fulfil the role set out by society, some who have chosen to have children when they feel more ready (very aware that they may need fertility assistance) and some who have chosen simply not to have children.
Finally, this sort of message is demeaning to all those amazing women out there who can't have children at all for a number of reasons and have adopted or used surrogacy. Being a good mother is a state of mind and is not exclusive to women who have conceived in the traditional way. Motherhood is not about age.
Dr Nitu Bajekal, FRCOG
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