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Careers and babies: Fertility decline underscores dilemma

Careers and babies: Fertility decline underscores dilemma

By Thurston Hatcher

ATLANTA, Georgia (CNN) -- When she was a kid, Beth Espy dreamed of having a big family. Four children, maybe, just like her mom, just like her grandmother before her.

Now 32 and single, Espy knows it's not going to happen.

"I like the fact that I went to school, had a career, had some fun," said Espy, an Atlanta television producer who still hopes to have two children. "But I think I started thinking about the future a little too late."

Others say they would do things differently, too.

"I just felt like I could put things off to when it appeared to be convenient to finally try to get pregnant," says a 41-year-old physician in Atlanta, now 35 weeks pregnant after spending more than $40,000 on in vitro fertilization, "and was mortified at the fact, as the event unfolded, that it was not possible through normal intercourse."

Are women waiting too late to have children?

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 •  CNN's Elizabeth Cohen reports on the controversy surrounding a new fertility book
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 • Stats: How common is infertility? 
 • Quotes: What are women saying? 

The career-vs.-family quandary is hardly a new one, but it has received renewed scrutiny thanks to a new book -- and a related Time magazine cover story -- suggesting many women may have missed out altogether on the chance to have kids.

Findings from the U.S.-Italian Study -- published Tuesday in Human Reproduction, Europe's leading journal of reproductive medicine -- underscore the dilemma, saying that a woman's fertility starts declining as early as her late 20s, not in her 30s as was previously thought. (Full story)

In her book, "Creating a Life," author Sylvia Ann Hewlett suggests some career-oriented women who thought they could hold off on having children find out too late that they simply can't.

She says a third to half of professional women are childless at age 40, and only a small percentage planned it that way. Most, she said, now feel "intense regret."

"Part of the problem is that they focused like a laser beam on their career for 10 years," she told CNN.

Education overlooked?

Although it's not a revelation that women's ability to conceive a child gradually declines as they approach middle age, some seemed surprised -- even shocked -- to learn that fertility begins to fall in their late 20s.

And they're wondering why nobody bothered to tell them.

The American Society for Reproductive Medicine argues that while the age-related decline in female fertility has been well demonstrated, it has been under-recognized by both the general population and many health care providers.

Indeed, a survey last year by the American Infertility Association found that nearly 90 percent of more than 12,000 women surveyed overestimated by five to 10 years the age at which fertility begins declining.

The society, which launched a campaign last year to better educate women about the narrowing window, suggests that's because many women in previous generations had finished bearing children by their late 30s, so perhaps the point was moot.

Espy says she can't recall ever receiving advice or guidance from obstetricians and gynecologists regarding the window for having children.

"They give you standard advice about birth control. But at least in my experience, they never talked about family planning other than preventing pregnancy," Espy said.

She thinks they should have.

"I think it's their obligation to tell me my options. I don't think they should say, 'You're getting old, you should have children,' but they should at least bring the subject up," Espy said.

So does Catherine Bonk, an OB/GYN in Decatur, Georgia, who says she began counseling patients about their biological clocks about five years ago, when it became increasingly apparent that some women didn't fully comprehend that their child-bearing opportunities were diminishing.

"I think that women just didn't think about it, and no one told them to," Bonk said.

Bonk suggests her generation bore the brunt of the problem.

"I'm 43, and people my age were just lied to. We thought our fertility would last forever," Bonk said.

'Women should have known'

While Hewlett's book has generated reams of publicity, some wonder why anyone would be surprised by her message.

Diane Passno, executive vice president of Focus on the Family in Colorado Springs, Colorado, suggests women who waited too late have nobody to blame but themselves.

"I'm so sick of women being this 'Poor pitiful me, why didn't you tell me, why didn't you tell me?'" she said. "People add two and two and they get five. Women should have known. Smart women should know better."

But Rosanna Hertz, a professor of sociology and chair of women's studies at Wellesley College in Massachusetts, argues women do know, and that Hewlett's premise is simply off the mark.

"This article presumes that she somehow made a discovery here that women didn't know, that they're not aware that their fertility declines with age, that they think they can get pregnant later," Hertz said.

"But most of the women I encounter are very aware of their biological clock ticking along with everyone else in their lives, and so I think that that is totally without any kind of real basis to it."

Hertz says Hewlett fails to make the case that if the working climate were altered, more women could have children younger and integrate that with work.

"She doesn't make that argument in this book that there is a way to do both," Hertz said. "I still believe that what she is advancing is an old model which says you either have children or you have a career and you should have your children younger."

But the 41-year-old internist and soon-to-be mom from Atlanta, who asked not to be identified, suggests it may not be such a bad idea for women to rethink their priorities.

"You don't have to wait until everything in your life is perfect," she says. "We wanted all this still for ourselves and wanted financial security before we decided we were ready to raise a family. And I wouldn't do it that way again."


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