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Making Time for a Baby
For years, women have been told they could
wait until 40 or later to have babies. But a new book argues that's way
too late
By Nancy
Gibbs
Listen to a successful woman discuss her failure to bear a child, and
the grief comes in layers of bitterness and regret. This was supposed to
be the easy part, right? Not like getting into Harvard. Not like making
partner. The baby was to be Mother Natur e's gift. Anyone can do it; high
school dropouts stroll through the mall with their babies in a Snugli.
What can be so hard, especially for a Mistress of the Universe, with modern
medical science devoted to resetting the biological clock? "I remember
sitt ing in the clinic waiting room," recalls a woman who ran the infertility
marathon, "and a woman-she was in her mid-40s and had tried everything
to get pregnant-told me that one of the doctors had glanced at her chart
and said, 'What are you doing here? Yo u are wasting your time.' It was
so cruel. She was holding out for that one last glimpse of hope. How horrible
was it to shoot that hope down?"
The manner was cold, but the message was clear-and devastating. "Those
women who are at the top of their game could have had it all, children
and career, if they wanted it," suggests Pamela Madsen, executive director
of the American Infertility Associatio n (A.I.A.). "The problem was, nobody
told them the truth about their bodies." And the truth is that even the
very best fertility experts have found that the hands of the clock will
not be moved. Baby specialists can do a lot to help a 29-year-old whose
tu bes are blocked or a 32-year-old whose husband has a low sperm count.
But for all the headlines about 45-year-old actresses giving birth, the
fact is that "there's no promising therapy for age-related infertility,"
says Dr. Michael Soules, a professor at the University of Washington School
of Medicine and past president of the American Society for Reproductive
Medicine (asrm). "There's certainly nothing on the horizon." This means,
argues economist Sylvia Ann Hewlett in her new book, Creating a Life: Professional
Women and the Quest for Children (Talk Miramax Books), that many ambitious
young women who also hope to have kids are heading down a bad piece of
road if they t hink they can spend a decade establishing their careers
and wait until 35 or beyond to establish their families. Even as more couples
than ever seek infertility treatment-the number of procedures performed
jumped 27% between 1996 and 1998-doctors are lear ning that the most effective
treatment may be prevention, which in this case means knowledge. "But the
fact that the biological clock is real is unwelcome news to my 24-year-old
daughter," Hewlett observes, "and she's pretty typical."
Women have been debating for a generation how best to balance work and
home life, but somehow each new chapter starts a new fight, and Hewlett's
book is no exception. Back in 1989, when Felice Schwartz discussed in the
Harvard Business Review how to creat e more flexibility for career women
with children (she never used the phrase Mommy Track herself), her proposals
were called "dangerous" and "retrofeminist" because they could give corporations
an excuse to derail women's careers. Slow down to start a fam ily, the
skeptics warned, and you run the risk that you will never catch up.
And so, argues Hewlett, many women embraced a "male model" of single-minded
career focus, and the result is "an epidemic of childlessness" among professional
women. She conducted a national survey of 1,647 "high-achieving women,"
including 1,168 who earn in the top 10% of income of their age group or
hold degrees in law or medicine, and another 479 who are highly educated
but are no longer in the work force. What she learned shocked her: she
found that 42% of high-achieving women in corporate America (def ined as
companies with 5,000 or more employees) were still childless after age
40. That figure rose to 49% for women who earn $100,000 or more. Many other
women were able to have only one child because they started their families
too late. "They've been m aking a lot of money," says Dr. David Adamson,
a leading fertility specialist at Stanford University, "but it won't buy
back the time."
Recent Census data support Hewlett's research: childlessness has doubled
in the past 20 years, so that 1 in 5 women between ages 40 and 44 is childless.
For women that age and younger with graduate and professional degrees,
the figure is 47%. This group c ertainly includes women for whom having
children was never a priority: for them, the opening of the work force
offered many new opportunities, including the chance to define success
in realms other than motherhood. But Hewlett argues that many other women
did not actually choose to be childless. When she asked women to recall
their intentions at the time they were finishing college, Hewlett found
that only 14% said that they definitely did not want to have children.
For most women Hewlett interviewed, childlessness was more like what
one called a "creeping nonchoice." Time passes, work is relentless. The
travel, the hours-relationships are hard to sustain. By the time a woman
is married and settled enough in her care er to think of starting a family,
it is all too often too late. "They go to a doctor, take a blood test and
are told the game is over before it even begins," says A.I.A.'s Madsen.
"They are shocked, devastated and angry." Women generally know their fertil
ity declines with age; they just don't realize how much and how fast. According
to the Centers for Disease Control, once a woman celebrates her 42nd birthday,
the chances of her having a baby using her own eggs, even with advanced
medical help, are less t han 10%. At age 40, half of her eggs are chromosomally
abnormal; by 42, that figure is 90%. "I go through Kleenex in my office
like it's going out of style," says reproductive endocrinologist Michael
Slowey in Englewood, N.J.
Hewlett and her allies say they are just trying to correct the record
in the face of widespread false optimism. Her survey found that nearly
9 out of 10 young women were confident of their ability to get pregnant
into their 40s. Last fall the a.i.a. conducted a fertility-awareness survey
on the women's website iVillage.com. Out of the 12,524 respondents, only
one answered all 15 questions correctly. Asked when fertility begins to
decline, only 13% got it right (age 27); 39% thought it began to drop at
40. Asked how long couples should try to conceive on their own before seeking
help, fully 42% answered 30 months. That is a dangerous combination: a
couple that imagines fertility is no problem until age 40 and tries to
get pregnant for 30 months before seeing a doctor is facing very long odds
of ever becoming parents.
In one sense, the confusion is understandable: it is only in the past
10 years that doctors themselves have discovered the limitations. "I remember
being told by a number of doctors, 'Oh, you have plenty of time,' even
when I was 38," says Claudia Morehead, 47, a California insurance lawyer
who is finally pregnant, using donor eggs. Even among fertility specialists,
"it was shocking to us that ivf didn't work so well after age 42," admits
Dr. Sarah Berga, a reproductive endocrinologist at the University of Pittsburgh
School of Medicine. "The early '90s, to my mind, was all about how shocked
we were that we couldn't get past this barrier." But even as doctors began
to try to get the word out, they ran into resistance of all kinds.
One is simply how information is shared. Childlessness is a private
sorrow; the miracle baby is an inevitable headline. "When you see these
media stories hyping women in their late 40s having babies, it's with donor
eggs," insists Stanford's Adamson, "but that is conveniently left out of
the stories." The more aggressive infertility clinics have a financial
incentive to hype the good news and bury the facts: a 45-year-old woman
who has gone through seven cycles of ivf can easily spend $100,000 on treatment.
But even at the best fertility clinics in the country, her chance of taking
a baby home is in the single digits.
In hopes of raising women's awareness, asrm launched a modest $60,000
ad campaign last fall, with posters and brochures warning that factors
like smoking, weight problems and sexually transmitted infections can all
harm fertility. But the furor came with the fourth warning, a picture of
a baby bottle shaped like an hourglass: "Advancing age decreases your ability
to have children." The physicians viewed this as a public service, given
the evidence of widespread confusion about the facts, but the group has
come under fire for scaring women with an oversimplified message on a complex
subject. "The implication is, 'I have to hurry up and have kids now or
give up on ever having them,'" says Kim Gandy, president of the National
Organization for Women. "And that is not true for the vast majority of
women." Gandy, 48, had her first child at 39. "It was a choice on my part,
but in most ways it really wasn't. It's not like you can create out of
whole cloth a partner you want to have a family with and the economic and
emotional circumstances that allow you to be a good parent. So to put pressure
on young women to hurry up and have kids when they don't have those other
factors in place really does a disservice to them and to their kids."
To emphasize a woman's age above all other factors can be just one more
piece of misleading information, Gandy suggests. "There are two people
involved [in babymaking], and yet we're putting all the responsibility
on women and implying that women are being selfish if they don't choose
to have children early." She shares the concern that women will hear the
research and see the ads and end up feeling it is so hard to strike a balance
that it's futile to even try. "There is an antifeminist agenda that says
we should go back to the 1950s," says Caryl Rivers, a journalism professor
at Boston University. "The subliminal message is, 'Don't get too educated;
don't get too successful or too ambitious.'" Allison Rosen, a clinical
psychologist in New York City who has made it her mission to make sure
her female patients know the fertility odds, disagrees. "This is not a
case of male doctors' wanting to keep women barefoot and pregnant," she
says. "You lay out the facts, and any particular individual woman can then
make her choices." Madsen of A.I.A. argues that the biological imperative
is there whether women know it or not. "I cringe when feminists say giving
women reproductive knowledge is pressuring them to have a child," she says.
"That's simply not true. Reproductive freedom is not just the ability not
to have a child through birth control. It's the ability to have one if
and when you want one."
You can trace the struggle between hope and biology back to Genesis,
when Abraham and Sarah gave thanks for the miracle that brought them their
son in old age. "She was the first infertile woman," notes Zev Rosenwaks,
the director of New York Presbyterian Hospital's infertility program. "It
was so improbable that an allegedly menopausal woman could have a baby
that her firstborn was named Isaac, which means 'to laugh.'" The miracle
stories have fed the hope ever since, but so does wishful thinking. "It's
tremendously comforting for a 34- or 36-year-old professional woman to
imagine that she has time on her side," says Hewlett, which can make for
resistance to hearing the truth.
This is the heart of Hewlett's crusade: that it is essential for women
to plan where they want to be at 45 and work backward, armed with the knowledge
that the window for having children is narrower than they have been led
to believe and that once it begins to swing shut, science can do little
to pry it open. And Hewlett argues as well that employers and policymakers
need to do more to help families make the balancing act work. "The greatest
choice facing modern women is to freely choose to have both, a job and
a family, and be supported and admired for it, not be seen as some overweening
yuppie."
As it happens, Hewlett knows from personal experience. She says she
didn't set out to write about how hard it is for professional women to
be moms. She planned to do a book celebrating women turning 50 at the millennium
and to look at what forces had shaped their lives. Then she discovered,
in interview after interview with college deans and opera divas, a cross
section of successful women in various fields, that none of them had children-and
few of them had chosen to be childless. Many blamed themselves for working
too hard and waiting too long-and waking up to the truth too late. "When
I talked to these women," she recalls, "their sense of loss was palpable."
Hewlett had spent most of her professional life writing and lecturing
on the need for business and government to develop more family-friendly
workplaces; she has a Ph.D. in economics from Harvard. And she has had
children and lost them and fought to have more. As a young Barnard professor
with a toddler at home, she lost twins six months into her pregnancy: If
only, she thought, I had taken time off from work, taken it easier. A year
and a half later, she writes, she was turned down for tenure by an appointments
committee that believed, in the words of one member, that she had "allowed
childbearing to dilute my focus." Hewlett was lucky: she went on to have
three more children, including Emma, to whom she gave birth at 51 using
her own egg and infertility treatments. Hewlett says she understands "baby
hunger."
At least she understands it for women. Men, she argues, have an unfair
advantage. "Nowadays," she says, "the rule of thumb seems to be that the
more successful the woman, the less likely it is she will find a husband
or bear a child. For men, the reverse is true. I found that only one-quarter
of high-achieving men end up without kids. Men generally find that if they
are successful, everything else follows naturally." But that view of men
doesn't quite do justice to the challenges they face as well. Men too are
working harder than ever; at the very moment that society sends the message
to be more involved as fathers, the economy makes it harder-and Hewlett's
prescription that women need to think about having their children younger
leaves more men as primary breadwinners. They would be fathers as far as
biology goes, but they wouldn't get much chance to be parents. "A lot of
my friends who are men and have had families are now divorced," Stanford's
Adamson admits. "When you ask them what happened, the vast majority will
say, 'Well, I was never home. I was working all the time. I didn't pay
enough attention to my family. I wish I had, but it's too late now.'"
Hewlett still insists that men don't face the same "cruel choices" that
women confront. "Men who find that they have no relationship with their
adult kids at least have a second chance as grandfathers," she argues.
"For women, childlessness represents a rolling loss into the future. It
means having no children and no grandchildren." While her earlier books
are full of policy prescriptions, this one is more personal. She salts
the book with cautionary tales: women who were too threatening to the men
they dated, too successful and preoccupied, too "predatory" to suit men
who were looking for "nurturers." The voices are authentic but selective;
taken together, it is easy to read certain passages and think she is calling
for a retreat to home and hearth, where motherhood comes before every other
role.
Hewlett replies that she is simply trying to help women make wise choices
based on good information. She is not proposing a return to the '50s, she
says, or suggesting that women should head off to college to get their
MRS. and then try to have children soon after graduation. "Late 20s is
probably more realistic, because men are not ready to commit earlier than
that. And the 20s still needs to be a decade of great personal growth."
She recommends that women get their degrees, work hard at their first jobs-but
then be prepared to plateau for a while and redirect their energy into
their personal lives, with the intention of catching up professionally
later. "You will make some compromises in your career. But you will catch
up, reinvent yourself, when the time is right."
The problem is that Hewlett's own research argues otherwise: in her
book all of the examples of successful women who also have families gave
birth in their 20s. These women may escape the fate of would-be mothers
who waited too long, but they encounter a whole different set of obstacles
when it comes to balancing work and family. Biology may be unforgiving,
but so is corporate culture: those who voluntarily leave their career to
raise children often find that the way back in is extremely difficult.
Many in her survey said they felt forced out by inflexible bosses; two-thirds
say they wish they could return to the work force. Much would have to change
in the typical workplace for parents to be able to downshift temporarily
and then resume their pace as their children grew older. Hewlett hopes
that the war for talent will inspire corporations to adopt more family-friendly
policies in order to attract and maintain the most talented parents, whether
male or female. Many of her policy recommendations, however, are unlikely
to be enacted anytime soon: mandatory paid parental leave; official "career
breaks" like the generous policy at IBM that grants workers up to three
years' leave with the guarantee of return to the same or a similar job;
a new Fair Labor Standards Act that would discourage 80-hour workweeks
by making all but the very top executives eligible for overtime pay.
Hewlett calls herself a feminist, but she has often crossed swords with
feminists who, she charges, are so concerned with reproductive choice that
they neglect the needs of women who choose to be mothers. In the history
of the family, she notes, it is a very recent development for women to
have control over childbearing, thanks to better health care and birth
control. But there's an ironic twist now. "In just 30 years, we've gone
from fearing our fertility to squandering it-and very unwittingly." The
decision of whether to have a child will always be one of the most important
anyone makes; the challenge is not allowing time and biology to make it
for them.
Reported by Janice M. Horowitz, Julie Rawe and Sora Song/New
York
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