Career or a baby? Which one first? Is there a way around?

One of the day-to-day observation as well as media coverage is, women are getting older at the time of their first attempted childbirth.

Now, the question is, is it biologically appropriate? Or has the woman left it too late?

If the woman knew these consequences, would she have attempted to achieve pregnancy sooner?

My own observation among junior doctors, is that, there are lot more junior doctors falling pregnant now than before in their late 20s. This could be attributed to their own knowledge of challenges of delayed motherhood.

Is delaying motherhood good for the unborn? Or from a bigger perspective, is it good for the society? In this discussion, I mainly focus on medical aspects,

• Chances of harbouring fibroids (benign smooth muscle tumour) increases with increasing reproductive age

• Age related weight gain, i.e., older the woman, higher the risk of overweight and obesity as well as morbid obesity. This could in turn put them at risk for blood pressure problems, diabetes in pregnancy, as well as obesity related infertility (PCOS)

• The ovarian reserve starts showing downward trend from mid 30’s . Usually women start seeing shorter cycles especially the luteal phase. Moreover, both quality of eggs as well as quantity of eggs will decline from mid 30’s

• Chance of chromosomally abnormal pregnancy becomes higher from mid 30’s

• Lifetime number of sexual partners increases longer the women wait to achieve pregnancy. This in turn increases their risk of abnormal smears. Small minority of women do need surgical procedures such as cone biopsy, which in turn predisposes them for a second trimester miscarriage because of cervical incompetency.

• More the number sexual partners, higher the risk of asymptomatic/symptomatic tubal damage.

• Also, what the general public is not aware is, that, a small minority of women can suffer premature menopause by age 35. As things stand, there are no tests to foresee or forecast looming ovarian failure in small percentage of women. It is not unusual for minority of women to end up with missed chances of having their own baby rather than exploring the options of donor egg route

• I know Apple, Facebook and Google have launched egg-freezing facility available to their women employees. But, one should be aware that, this programme is incentivised, mainly to benefit the company in a bigger way and their women force in a smaller way. This technology does not come without risks.

I end my discussion by repeating one of my favourite professor’s statements, i.e., there is nothing like right time to have a baby. There is always a reason to delay or not being ready. Biological clock will continue to tick…