We recently discussed in the VOICE on a number of occasions this country’s declining birth rates but the subject suddenly made headlines in May, with practically all news outlets reporting on the subject. The reason is obvious: starting with the Great Recession of 2008, fertility rates have fallen precipitously, in 2017 reaching 60.2 births per 1000 women of childbearing age. This represented a further 3% decline from already very low rates in 2016, the lowest birth numbers since 1987.
The declines have been the steepest among minorities, with Hispanic birth rates over a decade dropping by almost a third, for women of African descent by 11%, Asians by 5% and for Caucasian women by 4%. The only good news in these reports was that teenage pregnancies also significantly declined.
A nation’s birth rate is an essential predictor of its economic future. Especially too low rates can have very negative effects since, going forward, they reflect a declining work force at a time when population ages increase and, therefore, fewer working people have to carry retirement costs of elder people. In some countries, like Japan and Russia, these effects and their consequences have already become quite visible. The U.S. has been somewhat protected from consequences of declining birth rates due to the additive effects of immigration.
One of the more interesting articles on the subject appeared in USA TODAY on May 19, authored by Kim Painter under the heading, “As births decline in young women, they keep rising in 40-something. Here’s why.” In that article she pointed out that 114,730 out of 3.8 million births in 2017 occurred in women between 40-44 years old. Even more remarkably, 9,325 women above age 45 had babies in that year. The trend of ever older women having babies, which CHR has been witnessing and writing about for many years, therefore, not only continues but does so at even accelerated pace.
Most pregnancies in older women are, of course, pregnancies from donor egg-recipient cycles, though, as a recent paper from the Cornell group and a study from our group, which is in press, demonstrated, some older women, up to even quite surprising ages, can still conceive and deliver children with use of their own eggs.
Why birth trends in older women diverge has quite a number of reasons. In the above-cited article, the author noted the usual themes: Women wait longer because they want a career, divorces lead to second families later in life, etc. A more refined analysis has been recently reported by Marcia C, Inhorn, PhD., MPH, the William K. Lanman, Jr. Professor of Anthropology and International Affairs in the Department of Anthropology at The Whitney and Betty MacMIllan Center for International and Area Studies at Yale University. In an investigation of women who ended up using donor eggs, she and her co-workers (among those CHR’s Medical Director and Chief Scientist, Norbert Gleicher, MD) for the first time discovered that a principal reason for delays in conception are not so much career-mandated deferrals but inability to find the “right” partner (Inhorn MC et al, J Assist Reprod Genet 2018; 35(1):49-59).
There are, however, also good things to report about older women having children: Aside from the fact that being able to have children at older ages must be liberating for many older women (men have fathered children at older ages since Biblical times), studies suggest that offspring from older women do just fine, and so do their mothers.
This is a part of the June 2018 CHR VOICE.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
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