Egg freezing as a “workplace perk”, the Grandmother Hypothesis, slowing menopause and ovarian tissue transplants…and why young women need to care about it all
As a mother reaching the end of the "active" stage of parenting (just one of five left at home) I think about this...a lot (and I wrote about the "grandmother hypothesis" in my upcoming book, too.)
I see both of the things you write about here in the mom communities I've been part of: "somewhat venomous attitudes on the parts of both some grandmothers and some of their daughters (“I raised my kids, it’s my time now” mentalities on the part of older women, and a toxic idealism in younger women who expect their mothers to align with their every preference lest they be shut out—the whole “going no contact” thing)"
And yet, I also think we got here...well, *honestly* isn't quite the right word, but how about understandably? We're all fighting against societal expectations of what a young family "should" be (private, nuclear, with clear "boundaries" around them) and what older people "should" be (living it up, as active as they were at 35, financially secure, and maybe even still "hot")
I want to be meaningfully involved in my future grandkids' lives, but it will require my kids - and of course, their eventual partners - to be open to that. And it will almost certainly require me to adjust my expectations beyond the version of menopause/retirement age living that has been marketed to me. And it will require all of us to push back against the current quite a bit, the one that wants young families sequestered away in their own households, consuming, and myself and my husband as old people consuming somewhere else (Europe, maybe, or the golf course.) I hope we'll all be able to give each other a lot of grace and understanding because my goodness, the world really isn't currently set up to encourage multigenerational bonds.
Also, a few years back I got really interested in midlife content - until it was completely hijacked by conversations about HRT, protein intake, supplements, weight loss and "age-reducing" skincare. I had to turn it all off; it was getting into my head so much and completely derailing what my gut told me this time of life is actually for.
I very much see what you mean here. I think a lot of this is something we have to work through from the ground up as we raise our children and prioritize (to the best of our abilities of course) ways of life which are foundational for multigenerational contact and living. Which yes, as you observe here, is a difficult thing in our culture.
I think this goes back in a way to one of my thoughts from the post, that education and information at a young age about fertility is the way young women and men can best plan for their futures. If given real, honest information, and also are given the opportunity to perceive their future parenthood as a positive thing they don’t have to put off for years in order to focus on other things, I think more young people would choose to stay closer to their parents.
As for the parents, i think being resistant toward marketing and the whole “keeping up with the whoevers” could maybe be helpful as well as a spirit of service and frugality. Not to say people shouldn’t enjoy their retirements though! It would need to be a conscious effort and balance.
I had a postpartum patient not too long ago who I discussed this with. She was lamenting the way her mother wasn’t interested in her children and at the same time, really nostalgic and appreciative of how involved and kind and warm her own grandmother had been for herself and all of her many cousins and siblings. I think there has been some really toxic shifts in culture in a very short period of time, which is illustrated here. And I think it is all worth thinking about more and discussing so that we may all collectively start thinking about how we want to ideally handle these things as we grow older.
Glad you were able to shut out and escape the messaging! Also, congratulations on your book!
Thanks for the thoughtful response to my comment, Emily, and for the congrats as well.
This line jumped out at me - "...the opportunity to perceive their future parenthood as a positive thing they don’t have to put off for years in order to focus on other things." - I have long thought it's such a shame that young people put so much pressure on themselves to have "adulting" completely figured out before they have children. In a society where multigenerational support was accepted and not seen as somehow shameful, it would feel so much simpler and more possible to have kids young, when your body is primed for it but you perhaps don't have all the "rest of it" figured out yet. Because the whole point would be that you wouldn't HAVE to have all the rest of it figured out; you'd have real, tangible support from the next-older generation, who also would still be relatively young. You'd have a chance to develop all those adult skills with hands-on support and a safety net. But women my age (late 40s and into the 50s) are often horrified by the idea of being grandparents because we are harboring some weird fantasy that we're really thirty...
Agreed that the collective conversation is so helpful. I very much enjoy reading your take on how we got here!
This is a great thought and I especially appreciate the fact that you pointed out that the next-older generation themselves wouldn’t be too old, that is so key! By putting off parenthood into our forties, after a few generations we will effectively phase out the grandparent, as people will just be too old to be truly involved. With generations having less of an age gap, the energy and resources will still be there in terms of what can be passed down. Imagine not having grandkids until your 70s or even 80s—and further, great-grandparents wouldn’t exist at all. My 13 year old has a great relationship with my maternal grandmother and I think about what a shame it would be if that wasn’t possible. She had my mother at 17, my mother had me at 29 and I had my daughter at 21. Imagine if we all had waiting until 40! What a thing to ponder….
This also means that most people (as is already the case for many) would have the burden of caring for aging parents at the same time as raising very young children. It is also worth pondering the way medical “technologies” replace care work for the elderly and dying too. The women’s work in the care for aging communities is also being hyper-medicalized and removed from the home.
Gorgeous! I am a 51 year old grandmother to six (soon seven!) little boys. I married at 21, had babies every other year, eschewing mechanical and hormonal birth control. At 35, i bore my seventh child, and there was quiet. Then one last baby at 39. I lost a baby to miscarriage at 44, and have not conceived since. I realize this is n=1, but my window of fertility was shorter than i expected. At the same time, i am very contented to have my clever little 12 year old daughter, helping me care for the four little boys who are weaned, while their little cousin and brother Siegfried adjusts to life outside the womb. Grandmotherhood is delicious, but i am weaker than i was, and i see the wisdom in completing the mother aspect before embarking on the matriarch years.
Everytime you write something, it's always a ray of light. You are so, so right, but people who have never tried surrendering to their body do not know and do not want to know. Reality is that women are usually fooled that they will be forever young, and that medicine and technology are always a net benefit. They do not think about how we, as doctors, play with something we don't even understand completely, and often mess it up. The human body is much more than a set of equations, and even if it was just a set of equations, we are so far from even understanding them all.
Use immunosuppressants to keep your ovaries young, you get cancer or autoimmune diseases. Use AMH, induce a PCOS-like state, no more monthly ovulations, erratic cycles, and you get ova that age anyway, many but old, ruined, unviable. Give birth control to every girl, mask their PCOS or their hypothalamic amenorrhea, mask their baby fever, mask their normal fluctuations, and you get numb depressed women, riddled with migraine and blood clots, and breast cancer. Freeze healthy 25 year old eggs, forget about fertility for 20 years, then find out at 45 that you are not healthy anymore and no one of those eggs survived past first trimester and your only chance is to steal an egg and gestate a baby who's not truly yours. But hey at least we are empowered...?!
These are uncomfortable truths no one dares to say. Even I don't dare to, openly, with my fellow doctors, who keep taking all the meds, staring at me because I had my first baby at "just" 26, being on birth control and giving birth by CS due to "fear of childbirth"
And at last, about the grandmother hypothesis and how being a granny keeps your brain healthy, I know in retirement homes where sad and forgotten people go to die, elderly people with dementia are given realistic, baby-sized dolls to cuddle. Apparently, some peer reviewed study or something showed that even cuddling a FAKE baby can improve outcomes in such patients. But then again, let's not talk about real grandchildren, lest we make some childless cat lady in her late 30s uncomfortable ;)
Ahh this whole comment is it!!! Thank you Erika! You summed it all up perfectly and much more concisely than I and with your own unique expertise and experience. It’s all a big game and many women are losing, and the long-term, collective societal effects are going to be something to witness. As if we need the state of things to be any worse.
I used to work on a palliative care/oncology floor and we had those babies for the dementia patients. They made a world of difference and it honestly makes me tear up now thinking about it, and how lonely so many of them really were and how much they would have benefited from the presence of real life children.
I was pregnant at 45 and 46 (one pregnancy) and the major extra risks were hypertension and gestational diabetes for me, and unexplained stillbirth for the baby. Extending childbirth for a mother at advanced age is dangerous. Check out the ACOG guidelines for women above forty. Significant differences from under forty. Uterus preservation, egg freezing cannot address hypertension or gestational diabetes.
They sent me for extra consultation appointments purely for being old. Normal pregnancy. I gave birth at 43 also.
They said that numbers that wouldn’t give me a gestational diabetes diagnosis younger would now.
There is no way that maternal mortality and injury isn’t worse as women age. And there is no way that advanced age motherhood hasn’t increased the rates of maternal mortality.
I appreciate this insight from the perspective of experience. I’m also very sorry for the loss of your baby. I think there are definite increased risks and that that is just a fact. I also think a woman who has given birth before and isn’t trying to start in her 40s with the use of all sort of technologies are two different things to consider as well, just a general thing to consider.
I’m fairly sure it was pretty common to have the last baby in their early forties, I’m still hopeful that someone will want to marry me and start a family. But when I turned 42 (the age my grandmother was with her last child) I took a deep dive into older women having babies without IVF. One paper I read was about the introduction of the pill into the Netherlands in the 1940’s, the researchers expected a drop in teen pregnancies (which did not happen) but the pill did seem to eliminate almost all the 40+ pregnancies. So the control group was having quite a few babies over 40.
I will say that having worked in OB for years, I have taken care of a good amount of postpartum women in their 40s who conceived naturally (often on accident). Even a few in their early 50s! The numbers are obviously much lower than 20s/30s but I just thought I would share this to give you some extra hope, best of luck to you ♥️
Growing up, my dear Grandma was my favorite person. She retired when I was four or five, and was such an important figure in my life. She just passed last year after living with my family and I for ten years, so I also had the joy of seeing her with my little children. Although her mind and body declined much in the last five years or so, just her presence was valuable. My youngest son was very close with her and when he was upset, he would just go cuddle with MeeMaw to regulate. I just got off the phone with her sister, who is 93 and because she is blind and can’t do much, she spends much of her day praying, and specially praying every day for me and each of my children.
What a beautiful story. And what a beautiful gift to both your Grandmother and your children (and you I’m sure!) that she was able to live with your family for so long. Also what a gift to have those prayers being prayed so diligently for your family from her sister. I just love hearing things like this, thank you.
I listened to a podcast recently on the ethics of IVF, and one of the hosts talked about how the focus on these technologies has been at the expense of research on the actual causes of infertility. I had my children late because I married late, but I also had non-age-related infertility, and there was literally nothing the doctors I saw had to offer to help my particular condition. So much medical effort that could be focused on restoring health and normal female bodily function is instead focused on enabling delayed childbearing for the professional-managerial class. It’s sad.
This is exactly why I rail so hard against all of this! The priorities are extremely, extremely skewed and the fact that so many resources are poured into something that has not so great outcomes and not so great social implications over the true issue shows who is actually being catered to here. It certainly begs the question of who it is exactly that society wants to be birthing babies.
I started trying to conceive after age 30, only to discover I had major fertility issues as did my husband. We did consult a fertility clinic but none of their treatments worked. Our two children were natural conceptions, thanks to the fact I did learn to understand a lot about my (very wonky) cycles and also I was really stubborn. I also see the presence of my children as the miraculous breaking into the mundane and I believe their lives have something to teach me about the true nature of the world. I don’t pretend to have figured it out yet.
I also started menopause at age 39 and completed it (meaning total cessation of periods) at about age 44. Honestly I love it. It is a relief especially after the years of obsessive focus on my body. The grandmothering hypothesis makes a lot of sense to me, though I’m a long way from being a grandmother.
I’m also increasingly suspicious of fertility tech. We were initially open to almost any kind of intervention, because we were told we would never have a baby without it. Actual experience with a fertility clinic, observations of others who went through treatments, successful or not, as well as information from our brutally honest doctor slowly changed my mind about assisted reproduction. For my family, I’m very glad we did not go the egg or sperm donor route.
I think it makes a lot more sense for girls and young women to think about having children younger, versus trying to extend fertility. But so many questions are then raised about finding a decent man, when and how to pursue education and work alongside motherhood. I hope I can give my daughters the message that they can think creatively about these matters, not just copying what their peer group might be doing (most of my peer group from my 20s never had children).
Thank you Síochána. Thank you for always reading and commenting as well, I really do appreciate your presence here.
I’m so glad you were able to have your miraculous babies and that your dedication paid off with those rewards to you. I imagine I will feel the same way about menopause when it comes, I really resonated with what you said about the obsessive focus on your body. What a relief that can be!
You raise very important points about the questions that go along with earlier family creation for the young women and girls who are growing up now, I know dating seems to be very challenging now. I also very much value education as well. I almost wish we could have babies in our 20s and then go to college in our 30s as the standard 😂 I personally think I would get so much more out of higher education as a mother and woman with more life experience than I did when I was so young. The key is what you say here—we have to think creatively!
I remember how I felt when I learned that I had my maximum number of eggs when I was a five-month-old fetus, still inside my mother. By the time that girl babies are born, we have already started to lose viable eggs, and we never generate any new ones; unlike sperm production, we have a fixed and ever declining number of chances at motherhood.
I grieve for all those young women captivated by the lure of today's workplaces who feel ever so lucky that our "modern" life will allow them to have their great careers first and motherhood a distant second. Except that for most of them, delayed motherhood will be translating into no (biological) motherhood at all. I cannot imagine the sadness of the cohort of women who have dreamed for decades of holding their babies in their arms, only to wake up to the nightmare of painful medical procedures that end with emptiness.
Artificial ovaries and all that sort of nonsensical thinking fits right in with gender ideology and the whole "not all pregnant people are women" mantra that has taken over the brains of so many previously intelligent people: https://lucyleader.substack.com/p/um-yes-this-is-interesting-but-how
And every wrinkle I have I have EARNED through using my body as it was intended. Why would I want to pretend otherwise?
You touch on such an important point here—that despite all the fancy tech, the success rates are bleak. It’s an all-for-nothing situation for many and then it is just too late. And telling women these lies and making these promises is such a disservice to them and their future families:
Amazing piece! I can’t wait to teach my daughters (3 and 1.5 now) about the amazing design of their bodies, and how to honor it and cherish it instead of suppress it out of fear or ignorance! I think this knowledge empowers women to really Know what they want vocationally and make clearer life choices in their teens and twenties.
Great stuff! I’m so glad you are putting this information out. I want to share it so badly with my niece but I am pretty sure it’s the kind of thing that would anger her unfortunately. There’s so much I wish I had known when I was younger.
Thank you Christie ♥️ I know exactly what you mean, and this is one of the reasons I choose to write about the topics I do, in case some women younger than I can stumble across them and get a little perspective shift. I also totally understand not wanting to push it either, it’s one of those lines we have to walk.
But I and many women I know, are not waiting to have children because of a choice, but because of a lack of a spouse. If God gives me a child in my 40’s then I will be the most joyful mother in the world.
I am adamantly pro-life, and will not use IVF to have a baby.
One note on the freezing eggs thing. From my research on fertility medicine, gynecologists almost never use the frozen eggs, they harvest fresh. Many times the frozen eggs are not viable, and the doctors don’t want to bother with them.
I understand and I recognize that these sorts of situations are becoming more and more prevalent as well. None of what I share here is meant to be a judgement on women in your situation, it is a criticism of the predatory practices of industries that are built on the profiting off of women’s desperation, and of the high-tech research being done when more resources should be utilized to deal with root cause, restorative reproductive care in my opinion.
They use them if they have no other options (eg if you had cancer and have no eggs left, OR if you are too old and can't harvest), but it's true that fresh eggs are better. If you freeze 10 eggs you are expected to lose 2-3 just thawing them, then another 3-4 won't fertilize, and among the 4-5 left who do fertilize 1-2 will not develop into blastocysts, and among the 2-3 left, only about 30% will stick around and become a real baby (IF eggs were good quality, if you froze them after 30 it's less). If you do the maths, with 10 eggs frozen you may get one baby. It's not that different with fresh eggs but at least if you harvest 10 you can try to fertilize 10
As a grandfather on this journey with a grandmother and a pastor of many mothers, grandmothers and not yet or maybe not to be but wish to be grandmothers, I wish these conversations happened more.
This is such an insightful article. I loved reading your thoughts on the grandmother hypothesis. These topics need to be talked about more! The ethical dilemmas we're facing (and how women all too often become victim to a society that seems to want to medicalise her reproductivity at every level) deserves this kind of thought provoking, awareness raising conversation that encourages critical thinking, informed choice, and a reclamation of autonomy over women's bodies and cycles.
We see girls put on the pill before their menstrual cycles even have a chance to mature, which of course is the slippery slope into menstrual pathologies, hormonal birth control side effects, and unfortunately all too often leads to the "fertility support" and a medicalised birth that I can't help but question– could it have been avoided if she had holistic, personalised support to begin with? If she was taught about the menstrual cycle, and not told that her debilitating period pain and other symptoms were "normal"? Because they're not.
Common has become synonymous for normal, unfortunately. And now we are seeing the way that women have been conditioned to somehow feel "lesser" as they age. As though their usefulness has passed once they are no longer able to bear children. Sold the girl-boss ideology only to find that they did in fact desire to be mothers. Feminism tells women one thing, while the subliminal messaging society has still conditions women to not truly step into or embody their power, autonomy, and innate wisdom—keeping them caught between the illusion of empowerment and the deeply ingrained expectations of compliance, self-sacrifice, and seeking external validation.
Yes to all of this!! I really appreciate your insight about the cascade of lifetime female medical intervention from menarche to birth…we hear about the cascade of intervention in the labor and birth process but it is so helpful to zoom out and look at the whole female lifespan and the long term interventional cascade.
As a mother reaching the end of the "active" stage of parenting (just one of five left at home) I think about this...a lot (and I wrote about the "grandmother hypothesis" in my upcoming book, too.)
I see both of the things you write about here in the mom communities I've been part of: "somewhat venomous attitudes on the parts of both some grandmothers and some of their daughters (“I raised my kids, it’s my time now” mentalities on the part of older women, and a toxic idealism in younger women who expect their mothers to align with their every preference lest they be shut out—the whole “going no contact” thing)"
And yet, I also think we got here...well, *honestly* isn't quite the right word, but how about understandably? We're all fighting against societal expectations of what a young family "should" be (private, nuclear, with clear "boundaries" around them) and what older people "should" be (living it up, as active as they were at 35, financially secure, and maybe even still "hot")
I want to be meaningfully involved in my future grandkids' lives, but it will require my kids - and of course, their eventual partners - to be open to that. And it will almost certainly require me to adjust my expectations beyond the version of menopause/retirement age living that has been marketed to me. And it will require all of us to push back against the current quite a bit, the one that wants young families sequestered away in their own households, consuming, and myself and my husband as old people consuming somewhere else (Europe, maybe, or the golf course.) I hope we'll all be able to give each other a lot of grace and understanding because my goodness, the world really isn't currently set up to encourage multigenerational bonds.
Also, a few years back I got really interested in midlife content - until it was completely hijacked by conversations about HRT, protein intake, supplements, weight loss and "age-reducing" skincare. I had to turn it all off; it was getting into my head so much and completely derailing what my gut told me this time of life is actually for.
I very much see what you mean here. I think a lot of this is something we have to work through from the ground up as we raise our children and prioritize (to the best of our abilities of course) ways of life which are foundational for multigenerational contact and living. Which yes, as you observe here, is a difficult thing in our culture.
I think this goes back in a way to one of my thoughts from the post, that education and information at a young age about fertility is the way young women and men can best plan for their futures. If given real, honest information, and also are given the opportunity to perceive their future parenthood as a positive thing they don’t have to put off for years in order to focus on other things, I think more young people would choose to stay closer to their parents.
As for the parents, i think being resistant toward marketing and the whole “keeping up with the whoevers” could maybe be helpful as well as a spirit of service and frugality. Not to say people shouldn’t enjoy their retirements though! It would need to be a conscious effort and balance.
I had a postpartum patient not too long ago who I discussed this with. She was lamenting the way her mother wasn’t interested in her children and at the same time, really nostalgic and appreciative of how involved and kind and warm her own grandmother had been for herself and all of her many cousins and siblings. I think there has been some really toxic shifts in culture in a very short period of time, which is illustrated here. And I think it is all worth thinking about more and discussing so that we may all collectively start thinking about how we want to ideally handle these things as we grow older.
Glad you were able to shut out and escape the messaging! Also, congratulations on your book!
Thanks for the thoughtful response to my comment, Emily, and for the congrats as well.
This line jumped out at me - "...the opportunity to perceive their future parenthood as a positive thing they don’t have to put off for years in order to focus on other things." - I have long thought it's such a shame that young people put so much pressure on themselves to have "adulting" completely figured out before they have children. In a society where multigenerational support was accepted and not seen as somehow shameful, it would feel so much simpler and more possible to have kids young, when your body is primed for it but you perhaps don't have all the "rest of it" figured out yet. Because the whole point would be that you wouldn't HAVE to have all the rest of it figured out; you'd have real, tangible support from the next-older generation, who also would still be relatively young. You'd have a chance to develop all those adult skills with hands-on support and a safety net. But women my age (late 40s and into the 50s) are often horrified by the idea of being grandparents because we are harboring some weird fantasy that we're really thirty...
Agreed that the collective conversation is so helpful. I very much enjoy reading your take on how we got here!
Thank you!
This is a great thought and I especially appreciate the fact that you pointed out that the next-older generation themselves wouldn’t be too old, that is so key! By putting off parenthood into our forties, after a few generations we will effectively phase out the grandparent, as people will just be too old to be truly involved. With generations having less of an age gap, the energy and resources will still be there in terms of what can be passed down. Imagine not having grandkids until your 70s or even 80s—and further, great-grandparents wouldn’t exist at all. My 13 year old has a great relationship with my maternal grandmother and I think about what a shame it would be if that wasn’t possible. She had my mother at 17, my mother had me at 29 and I had my daughter at 21. Imagine if we all had waiting until 40! What a thing to ponder….
This also means that most people (as is already the case for many) would have the burden of caring for aging parents at the same time as raising very young children. It is also worth pondering the way medical “technologies” replace care work for the elderly and dying too. The women’s work in the care for aging communities is also being hyper-medicalized and removed from the home.
Gorgeous! I am a 51 year old grandmother to six (soon seven!) little boys. I married at 21, had babies every other year, eschewing mechanical and hormonal birth control. At 35, i bore my seventh child, and there was quiet. Then one last baby at 39. I lost a baby to miscarriage at 44, and have not conceived since. I realize this is n=1, but my window of fertility was shorter than i expected. At the same time, i am very contented to have my clever little 12 year old daughter, helping me care for the four little boys who are weaned, while their little cousin and brother Siegfried adjusts to life outside the womb. Grandmotherhood is delicious, but i am weaker than i was, and i see the wisdom in completing the mother aspect before embarking on the matriarch years.
What a beautiful life of life-making and life-tending, and thank you for sharing it here! ♥️♥️♥️
Everytime you write something, it's always a ray of light. You are so, so right, but people who have never tried surrendering to their body do not know and do not want to know. Reality is that women are usually fooled that they will be forever young, and that medicine and technology are always a net benefit. They do not think about how we, as doctors, play with something we don't even understand completely, and often mess it up. The human body is much more than a set of equations, and even if it was just a set of equations, we are so far from even understanding them all.
Use immunosuppressants to keep your ovaries young, you get cancer or autoimmune diseases. Use AMH, induce a PCOS-like state, no more monthly ovulations, erratic cycles, and you get ova that age anyway, many but old, ruined, unviable. Give birth control to every girl, mask their PCOS or their hypothalamic amenorrhea, mask their baby fever, mask their normal fluctuations, and you get numb depressed women, riddled with migraine and blood clots, and breast cancer. Freeze healthy 25 year old eggs, forget about fertility for 20 years, then find out at 45 that you are not healthy anymore and no one of those eggs survived past first trimester and your only chance is to steal an egg and gestate a baby who's not truly yours. But hey at least we are empowered...?!
These are uncomfortable truths no one dares to say. Even I don't dare to, openly, with my fellow doctors, who keep taking all the meds, staring at me because I had my first baby at "just" 26, being on birth control and giving birth by CS due to "fear of childbirth"
And at last, about the grandmother hypothesis and how being a granny keeps your brain healthy, I know in retirement homes where sad and forgotten people go to die, elderly people with dementia are given realistic, baby-sized dolls to cuddle. Apparently, some peer reviewed study or something showed that even cuddling a FAKE baby can improve outcomes in such patients. But then again, let's not talk about real grandchildren, lest we make some childless cat lady in her late 30s uncomfortable ;)
Ahh this whole comment is it!!! Thank you Erika! You summed it all up perfectly and much more concisely than I and with your own unique expertise and experience. It’s all a big game and many women are losing, and the long-term, collective societal effects are going to be something to witness. As if we need the state of things to be any worse.
I used to work on a palliative care/oncology floor and we had those babies for the dementia patients. They made a world of difference and it honestly makes me tear up now thinking about it, and how lonely so many of them really were and how much they would have benefited from the presence of real life children.
Exactly! Uncomfortable truths that no one wants to face. This comment is everything.
I was pregnant at 45 and 46 (one pregnancy) and the major extra risks were hypertension and gestational diabetes for me, and unexplained stillbirth for the baby. Extending childbirth for a mother at advanced age is dangerous. Check out the ACOG guidelines for women above forty. Significant differences from under forty. Uterus preservation, egg freezing cannot address hypertension or gestational diabetes.
They sent me for extra consultation appointments purely for being old. Normal pregnancy. I gave birth at 43 also.
They said that numbers that wouldn’t give me a gestational diabetes diagnosis younger would now.
There is no way that maternal mortality and injury isn’t worse as women age. And there is no way that advanced age motherhood hasn’t increased the rates of maternal mortality.
I appreciate this insight from the perspective of experience. I’m also very sorry for the loss of your baby. I think there are definite increased risks and that that is just a fact. I also think a woman who has given birth before and isn’t trying to start in her 40s with the use of all sort of technologies are two different things to consider as well, just a general thing to consider.
Just wanted to say that your story about your Grandmother is really amazing!
Well that’s amazing! I’m sure she had so many stories!
I’m fairly sure it was pretty common to have the last baby in their early forties, I’m still hopeful that someone will want to marry me and start a family. But when I turned 42 (the age my grandmother was with her last child) I took a deep dive into older women having babies without IVF. One paper I read was about the introduction of the pill into the Netherlands in the 1940’s, the researchers expected a drop in teen pregnancies (which did not happen) but the pill did seem to eliminate almost all the 40+ pregnancies. So the control group was having quite a few babies over 40.
I will say that having worked in OB for years, I have taken care of a good amount of postpartum women in their 40s who conceived naturally (often on accident). Even a few in their early 50s! The numbers are obviously much lower than 20s/30s but I just thought I would share this to give you some extra hope, best of luck to you ♥️
Growing up, my dear Grandma was my favorite person. She retired when I was four or five, and was such an important figure in my life. She just passed last year after living with my family and I for ten years, so I also had the joy of seeing her with my little children. Although her mind and body declined much in the last five years or so, just her presence was valuable. My youngest son was very close with her and when he was upset, he would just go cuddle with MeeMaw to regulate. I just got off the phone with her sister, who is 93 and because she is blind and can’t do much, she spends much of her day praying, and specially praying every day for me and each of my children.
What a beautiful story. And what a beautiful gift to both your Grandmother and your children (and you I’m sure!) that she was able to live with your family for so long. Also what a gift to have those prayers being prayed so diligently for your family from her sister. I just love hearing things like this, thank you.
I listened to a podcast recently on the ethics of IVF, and one of the hosts talked about how the focus on these technologies has been at the expense of research on the actual causes of infertility. I had my children late because I married late, but I also had non-age-related infertility, and there was literally nothing the doctors I saw had to offer to help my particular condition. So much medical effort that could be focused on restoring health and normal female bodily function is instead focused on enabling delayed childbearing for the professional-managerial class. It’s sad.
This is exactly why I rail so hard against all of this! The priorities are extremely, extremely skewed and the fact that so many resources are poured into something that has not so great outcomes and not so great social implications over the true issue shows who is actually being catered to here. It certainly begs the question of who it is exactly that society wants to be birthing babies.
Fantastic essay.
I started trying to conceive after age 30, only to discover I had major fertility issues as did my husband. We did consult a fertility clinic but none of their treatments worked. Our two children were natural conceptions, thanks to the fact I did learn to understand a lot about my (very wonky) cycles and also I was really stubborn. I also see the presence of my children as the miraculous breaking into the mundane and I believe their lives have something to teach me about the true nature of the world. I don’t pretend to have figured it out yet.
I also started menopause at age 39 and completed it (meaning total cessation of periods) at about age 44. Honestly I love it. It is a relief especially after the years of obsessive focus on my body. The grandmothering hypothesis makes a lot of sense to me, though I’m a long way from being a grandmother.
I’m also increasingly suspicious of fertility tech. We were initially open to almost any kind of intervention, because we were told we would never have a baby without it. Actual experience with a fertility clinic, observations of others who went through treatments, successful or not, as well as information from our brutally honest doctor slowly changed my mind about assisted reproduction. For my family, I’m very glad we did not go the egg or sperm donor route.
I think it makes a lot more sense for girls and young women to think about having children younger, versus trying to extend fertility. But so many questions are then raised about finding a decent man, when and how to pursue education and work alongside motherhood. I hope I can give my daughters the message that they can think creatively about these matters, not just copying what their peer group might be doing (most of my peer group from my 20s never had children).
Thank you Síochána. Thank you for always reading and commenting as well, I really do appreciate your presence here.
I’m so glad you were able to have your miraculous babies and that your dedication paid off with those rewards to you. I imagine I will feel the same way about menopause when it comes, I really resonated with what you said about the obsessive focus on your body. What a relief that can be!
You raise very important points about the questions that go along with earlier family creation for the young women and girls who are growing up now, I know dating seems to be very challenging now. I also very much value education as well. I almost wish we could have babies in our 20s and then go to college in our 30s as the standard 😂 I personally think I would get so much more out of higher education as a mother and woman with more life experience than I did when I was so young. The key is what you say here—we have to think creatively!
I love to hear about these prudent and healthy nest doctors!
This is an OUTSTANDING article‼️😊❤️
👏👏👏👏👏👏👏👏👏👏👏👏👏
Thank you! Truly appreciate this!
I'd love to see you put this essay in a book! It's a book I would love to read!
Well this is the ultimate encouragement, thank you! It is my hope to work up to a book sometime in the next year or two 💗
I remember how I felt when I learned that I had my maximum number of eggs when I was a five-month-old fetus, still inside my mother. By the time that girl babies are born, we have already started to lose viable eggs, and we never generate any new ones; unlike sperm production, we have a fixed and ever declining number of chances at motherhood.
I grieve for all those young women captivated by the lure of today's workplaces who feel ever so lucky that our "modern" life will allow them to have their great careers first and motherhood a distant second. Except that for most of them, delayed motherhood will be translating into no (biological) motherhood at all. I cannot imagine the sadness of the cohort of women who have dreamed for decades of holding their babies in their arms, only to wake up to the nightmare of painful medical procedures that end with emptiness.
Artificial ovaries and all that sort of nonsensical thinking fits right in with gender ideology and the whole "not all pregnant people are women" mantra that has taken over the brains of so many previously intelligent people: https://lucyleader.substack.com/p/um-yes-this-is-interesting-but-how
And every wrinkle I have I have EARNED through using my body as it was intended. Why would I want to pretend otherwise?
You touch on such an important point here—that despite all the fancy tech, the success rates are bleak. It’s an all-for-nothing situation for many and then it is just too late. And telling women these lies and making these promises is such a disservice to them and their future families:
Amazing piece! I can’t wait to teach my daughters (3 and 1.5 now) about the amazing design of their bodies, and how to honor it and cherish it instead of suppress it out of fear or ignorance! I think this knowledge empowers women to really Know what they want vocationally and make clearer life choices in their teens and twenties.
Thank you! I agree, and starting with good and honest information is the start girls deserve, so thank you for providing that for your daughters ♥️
Great stuff! I’m so glad you are putting this information out. I want to share it so badly with my niece but I am pretty sure it’s the kind of thing that would anger her unfortunately. There’s so much I wish I had known when I was younger.
Thank you Christie ♥️ I know exactly what you mean, and this is one of the reasons I choose to write about the topics I do, in case some women younger than I can stumble across them and get a little perspective shift. I also totally understand not wanting to push it either, it’s one of those lines we have to walk.
This is a really great read! Thank you!
Thank you so much Kelly!
I agree with the ideals of what you say here.
But I and many women I know, are not waiting to have children because of a choice, but because of a lack of a spouse. If God gives me a child in my 40’s then I will be the most joyful mother in the world.
I am adamantly pro-life, and will not use IVF to have a baby.
One note on the freezing eggs thing. From my research on fertility medicine, gynecologists almost never use the frozen eggs, they harvest fresh. Many times the frozen eggs are not viable, and the doctors don’t want to bother with them.
I understand and I recognize that these sorts of situations are becoming more and more prevalent as well. None of what I share here is meant to be a judgement on women in your situation, it is a criticism of the predatory practices of industries that are built on the profiting off of women’s desperation, and of the high-tech research being done when more resources should be utilized to deal with root cause, restorative reproductive care in my opinion.
They use them if they have no other options (eg if you had cancer and have no eggs left, OR if you are too old and can't harvest), but it's true that fresh eggs are better. If you freeze 10 eggs you are expected to lose 2-3 just thawing them, then another 3-4 won't fertilize, and among the 4-5 left who do fertilize 1-2 will not develop into blastocysts, and among the 2-3 left, only about 30% will stick around and become a real baby (IF eggs were good quality, if you froze them after 30 it's less). If you do the maths, with 10 eggs frozen you may get one baby. It's not that different with fresh eggs but at least if you harvest 10 you can try to fertilize 10
Gosh those odds are horrible…
As a grandfather on this journey with a grandmother and a pastor of many mothers, grandmothers and not yet or maybe not to be but wish to be grandmothers, I wish these conversations happened more.
Thank you Eric! I find this so encouraging, so I truly appreciate your taking the time to say so!
This is such an insightful article. I loved reading your thoughts on the grandmother hypothesis. These topics need to be talked about more! The ethical dilemmas we're facing (and how women all too often become victim to a society that seems to want to medicalise her reproductivity at every level) deserves this kind of thought provoking, awareness raising conversation that encourages critical thinking, informed choice, and a reclamation of autonomy over women's bodies and cycles.
We see girls put on the pill before their menstrual cycles even have a chance to mature, which of course is the slippery slope into menstrual pathologies, hormonal birth control side effects, and unfortunately all too often leads to the "fertility support" and a medicalised birth that I can't help but question– could it have been avoided if she had holistic, personalised support to begin with? If she was taught about the menstrual cycle, and not told that her debilitating period pain and other symptoms were "normal"? Because they're not.
Common has become synonymous for normal, unfortunately. And now we are seeing the way that women have been conditioned to somehow feel "lesser" as they age. As though their usefulness has passed once they are no longer able to bear children. Sold the girl-boss ideology only to find that they did in fact desire to be mothers. Feminism tells women one thing, while the subliminal messaging society has still conditions women to not truly step into or embody their power, autonomy, and innate wisdom—keeping them caught between the illusion of empowerment and the deeply ingrained expectations of compliance, self-sacrifice, and seeking external validation.
Yes to all of this!! I really appreciate your insight about the cascade of lifetime female medical intervention from menarche to birth…we hear about the cascade of intervention in the labor and birth process but it is so helpful to zoom out and look at the whole female lifespan and the long term interventional cascade.
Precisely!