The unfairness of certain facts

Sometimes I think NPR finds the most nettlesome people possible to interview, just to annoy me on my drive to work.  I imagine them talking to dozens of people and finding the most entitled-sounding clips to air.  To wit, this from a piece this morning about how women’s fertility rates drop with age:

Kate Donnellon Nail never imagined she’d have trouble conceiving. For one thing, people always tell the San Francisco musician she looks much younger than her 43 years.

“I work out regularly, I have a personal trainer,” she says. “I’ve been doing yoga for 15 years.”

Nail’s grandmother gave birth at 42, so she figured she was predisposed to “fabulous fertility.” Doctors says there’s no such evidence. But Nail is healthy and makes a point to eat well.

“Unfortunately,” she says, “that doesn’t always translate to those little eggs in your ovaries. They’re not getting the message!”

When she was nearly 41, Nail and her husband went to a fertility doctor, who laid out the stark stats for someone her age.

“They put them out on a piece of paper on the desk right in front of me and I was like, whoa. It just seemed so fashionable to have kids in your 40s, these days,” she says.

What’s wrong with your fishin’ ovaries, Kate?  Don’t they know you do yoga?

The online version of the story goes on to say that Nail has had six unsuccessful IVF treatments, which I don’t think made the radio cut.  I really don’t intend to come off as callous or glib when discussing her quote, and I am genuinely sorry to think of how hard it must be for a woman to want children and struggle.  But man, does that line about how “fashionable” it is to have babies at a certain age stick in my craw, as though a newborn is this season’s purse-sized chihuahua.  Then there’s this:

“I just feel like it’s something else they lump onto women that we have no control over,” says filmmaker Monica Mingo, who’s blogged about her decade-long effort to conceive. She says the real issue is society at large, which is pushing back the age people are expected to settle down and have kids. Mingo didn’t even meet her husband until she was 32.

“You tell us your fertile years rapidly decline in your mid-20’s,” she says. “Well, if I’m not dating anyone, and I want to have a family, what’s that information going to do for me?”

Um… nothing much, I guess.  Information doesn’t actually have a duty to do anything for anyone.  Facts just sort of sit there, independent of our desire for them to be other than they are.  I don’t know who comprises this “they,” but declining fertility with age isn’t part of a campaign to keep women from being self-actualized.

Biology isn’t fair.  It isn’t fair that Saul Bellow and Larry King were able to father children decades after a woman would have been able to conceive.  That sucks.  As I counsel adolescent girls when discussing sexual and reproductive health, biology isn’t fair at their age either.  An untreated STI for them is much more likely to cause long term problems (including with fertility) than it is for the guy who gave it to them.  But to quote a great movie, if you can’t fix it, you gotta stand it.

Reportedly part of the problem is that women underestimate the degree to which fertility wanes with age.  However, a campaign to increase awareness certainly didn’t seem to win many fans:

A decade ago, a fertility ad campaign on public buses in several big cities sparked a vicious backlash. It featured a baby bottle shaped like an hourglass, to warn women their time was running out. But women’s rights groups called it a scare tactic that left women feeling pressured and guilty.

So what would those women’s rights groups propose?  The truth is somewhat scary, which doubtless creates a sense of pressure.  I didn’t see the posters in question, which were apparently displayed in New York when I was still living there, but according to this article the message read “ADVANCING AGE DECREASES YOUR ABILITY TO HAVE CHILDREN.”  (The author of the article says she wondered if Rush Limbaugh was footing the bill for the ad.)  That’s true!  It may be unfortunate or unpalatable, but that doesn’t make it false, nor has human physiology conspired with a cabal of social conservatives to keep women from having it all.

The truth is that fertility wanes with age, and fertility treatments are onerous, expensive and frequently unsuccessful.  Women who truly want children simply have to take those facts into account when determining what they want in life.  It’s not fair, but neither is life.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. It is indeed one of the great curses in life that it’s not only the case that women are much better emotionally and financially in their 30s than in your 20s. The children of women in their thirties do much better in a variety of ways (the well-known increase in likelihood of genetic disorders is, I would argue, more than offset by the thriving of the healthy children). Yet of course, it’s much harder. It is unfair. I am reminded of a student of mine who complained that a smarter kid got higher gradesneven though she worked harder. To paraphrase Cathleen Schine, no one deserves to be born with strawberry blond hair and no one deserves not to be born with strawberry blond hair.

    As a 38 year old mom currently great with my third child (also have a 4 year old and a two year old) whose social life is largely made up of similarly aged parents with similarly aged sprouts:

    1) the belief that veganism, yoga, and generally looking a bit younger means that your eggs are also duped is widespread – as if all-you-can-eat pasta bowls at Olive Garden are what ultimately cause a decline in fertility.

    2) Approximately 40-50% of my friends used some kind of fertility treatment to get pregnant.

    3) People are highly aware of the risk of a genetic disorder at this age. The risk of a genetic disorder of any kind at my age is something like 1 in 100. They are far more likely to have fertility issues than a genetic disorder, yet they seem wholly unaware of that. I am truly shocked at the number of people who ask me why I choose to have kids so close together in age. When I agree that it would be nice to have the leisure of waiting, but I wanted to make sure I had them while I could, people are really shocked and insist there’s no reason why you can’t have a kid into your 40s.

  2. And to your larger point, people’s sense of entitlement never fails to amaze me (unfortunately, including my own)….

    • Elizabeth, do you think it’s possible that American women feel a greater need or pressure to be fruitful and multiply since the Europeans have taken the opposite fork in the road? And, by the way, what’s with that? It looks like having that nice BMW, a summer cottage on the lake and a lucrative career far outweighs having a screaming, colically baby to drive you nuts everyday. I seriously doubt a conscious or unconscious decision to eliminate the Caucasian race in order to even the genetic playing field is at play here. Good God, may that not be the case. Charles Murray wrote and absolutely fantastic book a few years ago–“Human Accomplishment: The Pursuit of Excellence in the Arts and Sciences, 800 B.C. to 1950”. It’s a great, great book and should be read by everyone. Essentially, and with gads and gads of evidence and illustration, he states that human accomplishments in the arts and sciences–from at least the 1300s to late 1900s–has been centrally focused and located in Europe–okay, better sit down now!—and these accomplishments, by at least a 95% margin, have been achieved by, white men. Uh-oh, I can see the spears and arrows getting sharpened for an all-out assault on Mr. Heidegger Kringle. Better seek shelter, FAST!!

  3. On the one hand, you could have children in your early twenties.

    On the other hand, you could finish college, get a job, and go party and have fun at that perfect time when you’re old enough to have money and young enough to enjoy spending it.

    Where’s the incentive for the first option?

    Maybe what needs to happen is that we need to develop some method of egg extraction and preservation, so that the younger and more-viable genetic material is available for later use.

    But then we’d be admitting that it’s okay for young women to go out and party and have fun, and America has 400 years of Puritan heritage screaming that this should not be so.

    • if we wanted to do what was best for our daughters, we’d insist that they got pregnant by about age 14 or so.
      But that’s not a pleasant truth, either, is it?

      Girls go through a phase, where everyone conspires against them — tells them that they’re commodities to be bought and sold, rather than worth their wits. The least we can do is have their bodies get over that shtick Fast.

      • “if we wanted to do what was best for our daughters, we’d insist that they got pregnant by about age 14 or so.”

        No, we wouldn’t.

        • Well duh — it’s because if they start when they’re 14 and have a kid every year, then they can beat out the Duggars by the time they’re 35, get their own TV show, and still be young enough to maximize their enjoyment of the profits.

  4. The consumer society has produced the sense of entitlement that Russell points out; we feel entitled to ripe oranges in New England in winter, we feel entitled to instant gratification of nearly any desire the instant we want it. Why should a child or spouse be any different?

    As an architect, I see this a lot- McMansions designed invariably in a “traditional” style with the massive kitchens sized to feed the King’s court that, in their aesthetic style refer to and promise the sort of “traditional family” intimacy and joy right out of The Waltons, yet the actual family that inhabits it usually is the bizarrely truncated nuclear family, consisting of 2 or 3 people where no one ever eats in the same room at the same time.

    Consumer choice envisions “traditional family” as an unmitigated joyous consumption- ignoring the messy, painful economic reality that forced a “traditional family” of 8, 10, or 12 members to live under one roof. We ignore also the suffocating emotional conflicts that such intimacy brought.

    So like the woman on NPR, we consume choice after consumer choice, deftly cherry picking rights from responsibilities. I think often of the family member eating takeout food on their granite island, alone late at night with only the tv for company. And wondering why the French Provincial cabinetry 6 burner Viking range and tumbled limestone tile seems so unsatisfying.

    • I don’t suppose the reaction I was supposed to have to your post was, “oooooo, 6 burner Viking range! I wish I had that!”

      • No more than my reaction of “oooh, 3 lovely children! I wish I had that!”

  5. While, for a medical reason, I *completely* agree with everything said here, I also understand why there is the pushback on getting the accurate (and depressing) information out there. Namely, these statistics are used by misogynists in order to try to hit women where it hurts. Suggesting that women’s standards are too high and if they don’t lower them they will be shriveled up and barren by the time they hit 30. And so on.

    Of course, having more accurate information out there would also defang some of the falsehoods flung around. I have had to provide data to demonstrate that no, in fact, “almost all women” are not barren by the time they hit 35. Anyway, I wrote about this a while back.

    Obviously, as a man in a married couple in their thirties and trying, this is a subject of particular interest to me. The statistics out there are pretty daunting. We remain hopeful, and regretful that we kept waiting for “the right time.”

    • Namely, these statistics are used by misogynists in order to try to hit women where it hurts.
      —In other words, it’s used by people (aka “misohynists”) who live in reality, not the fictional universe feminists and their beta-boy lackeys live in.

      And deleting my comment won’t remove the truth, blog owner.

      • Not misgynists that live in reality. Misogynists that try to say things like “most women are functionally infertile by the time they’re thirty-five[1]. Hahahahahaha[2]!!!!!”

        The first part of that statement is being wrong.

        The second part of that statement is being a misogynist.

      • I’ll let this comment stay, since Will has gone to the trouble of replying. However, assuming all of your comments will be as witless and devoid of meaningful content as your first two, future contributions will be deleted.

        • Great essay, Dr. Saunders. Very, very well stated–at some point older women, 40+, have to realize they can’t all be Octo-moms and that healthy fertility, beginning at 12-13 years of age, does not follow a straight to rising trajectory as one ages. Even if conception is not a problem or the problem, the chance of birth defects rises exponentially for women giving birth after 40. Postpone your careers when you’re in your 20s or early 30s, for five years or so, to raise your healthy children, then continue on with whatever job interests or occupations you wanted to pursue. If that’s not possible, then don’t have kids. And please, don’t forget the adoption option.

  6. > The truth is somewhat scary, which doubtless
    > creates a sense of pressure.

    I keep hoping that people will advance to the point where they will be able to process data without immediately engaging the hindbrain.

    Research in disaster preparedness is chock full of this; telling people they need to have some semblance of preparation is often a very disagreeable task, because you’re pretty much by definition hauling people out of a comfort zone and trying to get them to be objective.

  7. Interesting article. I guess at some point liberals will recognize that life isn’t fair and will stop trying to make it so. Until then the rest of us will have to suffer.

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