Women having babies later:
One will commonly see reference to the fact that women are choosing to have their babies later for career reasons or because they cannot afford them earlier.  That may be true in the United States, but in socialist countries women are encouraged and supported both in having careers and babies.  There is little economic reason to put it off. 

But a look at UN statistics seems to support it.  Go back to the last posting, the one named World Fertility by region and find the “detailed data” button on the “World Population Prospects: the 2006 Revision Population Database” and click it.  In the “variable” pane click “age specific fertility rates” and in the “country/region” pane click “more developed regions,” “less developed regions excluding least developed regions” and “least developed regions.  This is what is there: 

Fertility of women broken down by age in more developed regions of the world, UN statistics.   

Fertility of women broken down by age in less developed regions excluding least developed countries of the world, UN statistics.   

Fertility of women broken down by age in least developed countries of the world, UN statistics.   

Unsurprisingly, fertility is falling in almost every age group in every region, and the fall is usually perceptible even over a five year increment.  The exception is women over 30 in more developed regions.  There you have your rationale for saying they are “postponing having their families.” 

But they aren’t.  That would mean that the younger woman could have more babies but choose not to.  But when we looked at the data from Iceland and Denmark, more advanced countries, we found that the number of children depended on who married whom and nothing else.  So they are having all the children they can at every age.  They aren’t postponing have babies.  They just can’t have them.  The women over thirty now are having more babies than the women over thirty were before.

Of course they may be trying harder.  They may still feel they want a bigger family.  I concede that this is possible; it just does not look like what the data are telling us elsewhere.  But there is another possibility. 

Having a baby is a very significant physical challenge for a woman.  Women have died in the attempt as long as there have been babies.  In clinical medicine, we are of two minds.  One is the concept of “the grand multipara” or the “grand multip,” the woman who has had many babies in the past.  Her labor is brief and fairly painless.  It seems no more dangerous than the labor of other women.  But these are not the usual case.  It is also true that women have more and more trouble with each successive pregnancy.  Each time takes something out of her that will never be replaced.  I have heard the same thing of men directing musical shows.  A director only has so many in him. 

So we have a test.  If women indeed are up against a physiologic limit, then if they have had fewer children when young, then they can have more when they are old.  That would account for rising fertility among women over 30 in societies where fertility is low across the board.

And this idea is subject to test.  If women are struggling against their physiological maximum and if that maximum is actually declining, then we should see complications becoming more common.  Crudely, we might be losing more mothers. 

At least in the United States, this appears to be the case. 

According to the report “Pregnancy-Related Mortality Surveillance – United States, 1991—1999” by the Pregnancy Mortality Surveillance System of the United States Centers for Disease control and Prevention in Atlanta, during 1991--1999, a total of 4,200 deaths were determined to be pregnancy-related. The overall pregnancy-related mortality ratio was 11.8 deaths per 100,000 live births and ranged from 10.3 in 1991 to 13.2 in 1999.  In other words we are losing more mothers.

These losses are not uniformly distributed by income or ethnicity, but that is beside the point.  Those things have always been around.  The fact is that with the same health care and better income, women are dying more often. 

I have already suggested that falling sperm counts are reported, and I have offered to attribute it to increased genetic diversity.  Yet the Iceland study showed no sex difference.  It may be that just as we are losing optimal male development, we are losing optimal female development.  There is other data to implicate males, but an element of loss of female reproductive performance seems quite plausible.  It would be for the same reason. 

But the suggestion that the whole issue is one of people “postponing” babies is quite dubious. 

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