The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Tuesday, February 7, 2017 (Volume 5: Issue: 6)

The Topic: Exporting Childlessness

The News Story: Want to Empower Women Worldwide? Give Them Access to Contraceptives

The New Research: Sterile Fantasies

 

The News Story: Want to Empower Women Worldwide? Give Them Access to Contraceptives

“Like most women I know, I have used contraceptives for many years,” Melinda Gates wrote for National Geographic last week. She and her husband’s decisions about if and when to get pregnant were “made based on what was right for me and what was right for our family.”

But not all women are so “lucky,” Gates continues to say. “There are still over 225 million women around the world who don’t have access to the modern contraceptives they need to make these decisions for themselves.” To remedy this problem, Gates co-chaired a global summit in 2012 that brought together leaders from around the world to commit to a goal of getting 120 million more women access to modern contraceptives by the year 2020. So far, that initiative is failing—at the halfway point in 2016, only 24 million additional women had received the life-changing miracle drugs that Gates so praises. 

One thing that Gates leaves out of the discussion of the wonders of modern family planning is what happens when biology doesn’t cooperate with family plans. And in a recent study of yet another dying Western nation with exactly the type of access that Gates wants, researchers found that the contraceptive mentality can so infiltrate our mindsets that we ignore reality. Perhaps we should pause before we eagerly hand out the pills around the globe.

(Sources: Melinda Gates, “Opinion: Want to Empower Women Worldwide? Give Them Access to Contraceptives,” National Geographic, February 3, 2017.)

 

The New Research: Sterile Fantasies

Affiliated with Denmark’s Copenhagen University, Metropolitan University, and Zealand University, the authors of a new study probe young Danes’ understanding of reproductive biology in large part because of their concern about the number of young people in Western countries, including their own, who are delaying parenthood—often until well into their 30s.

Inevitably, fertility delayed often translates into fertility denied. The authors of the new study understandably highlight delayed parenthood as a reason for the “decline in total fertility rate (TFR) [that] has been seen in OECD [Organization for Economic Cooperation and Development] countries, where the average TFR dropped from 2.7 to 1.7” between 1970 and 2009. With a Total Fertility Rate now at 1.69, Denmark appears quite typical of affluent Western nations with fertility well below the Zero Population Growth level of 2.1 lifetime births per woman.

Beyond the social and economic issues inherent in the sub-replacement fertility it fosters, postponed parenthood brings a number of other troubling problems. The authors of the new study point out that “higher maternal age is . . . associated with an increase in pregnancy-related complications and adverse outcome in the offspring such as prematurity and foetal death” and that higher paternal age predicts an increased risk of “pregnancy outcomes such as miscarriage.” Twenty-first-century medicine does give couples who have delayed parenthood the option of medically assisted reproduction (MAR), but the Danish researchers stress that “the biological decline in fertility by advanced parental age cannot fully be compensated for by MAR, and consequently society as a whole is affected.” What is more, the researchers worry about “the psychological strain of undergoing fertility treatment,” giving as a reason for particular concern a Finish study finding an alarmingly high rate of psychiatric hospitalization among women whose MAR treatment had not resulted in childbirth.

Given the negative consequences of delayed parenthood for fertility and pregnancy, the authors of the new study regard it as desirable to determine whether “general lack of fertility knowledge, including the age-related decline in fertility, may also be a central and contributing factor.” To determine the level of fertility knowledge among young Danes, the researchers surveyed 517 male and female students enrolled at the Metropolitan University College in Copenhagen. The data collected from these students intensified rather than allayed concerns about whether young Danes delaying parenthood really understand the consequences. 

Overall, the researchers find that the young Danes they surveyed “generally lacked knowledge on fertility issues,” with “no substantial differences between the two genders.” This lack of knowledge about fertility surfaces on a number of matters. For instance, most of the young Danes surveyed did not realize how soon and how markedly a woman’s fertility declines. The Danish researchers report that “half of both genders thought a slight age-related decline in female fertility has its onset beyond the age of 30 years (correct answer: 25–29 years).” Even more fundamental misunderstanding appears among the “more than 35% [of students surveyed who] believed that a marked decrease [in female fertility] does not occur until 40 years of age (correct answer: 35–39 years).”  Astonishingly, more than 10% of the Danish students surveyed believed that a marked decline in fertility does not occur until age 45!

Ignorance about natural fertility among the Danish students was matched by their ignorance about possibilities of Medically Assisted Reproduction (MAR): the researchers report that the success rate of MAR was “grossly overestimated” by both male and female students: “the majority [of the students surveyed in this study] . . . overestimated the probability of achieving a child from IVF treatment,” with 55% of males and 69% of students pegging the probability too high, many of them quite markedly too high. (The actual success rate for MAR runs less than 30%.) 

The Danish researchers see this unfortunate situation manifest in “other studies [that] have time and again found similar limited knowledge [about fertility] among university students” in Europe and the United States. The researchers find this widespread ignorance of fundamental fertility issues to be “of particular concern, as a sizable percentage of [young people] intend to have their last child at the age of 35 years or older, whe[n] a marked decline in female fertility is a reality.”

With good reasons, the Danish scholars fear that “both men and women are making the decision to postpone parenthood without being aware of possible consequences.” The authors of this new study call for measures “to increase knowledge and awareness of reproductive health” among young people. Unfortunately, among young people for whom parenthood has become a secondary or even tertiary priority—whether in Copenhagen, Cairo, Cape Town, or Calgary—desire for such knowledge may yield to stronger desire for illusions. 

(Source: Bryce Christensen and Nicole M. King, forthcoming in “New Research,” The Natural Family 31.1 [2017]. Study: Nina Olsén Sørensen et al., “Fertility Awareness and Attitudes towards Parenthood among Danish University College Students,” Reproductive Health 13 [2016]: 146, Web.)