Like a Virgin by Prasad, Aarathi (recommended reading txt) 📕

strips women of the key factors in being fertile – for instance, having good quality eggs, ovaries that function so that ovulation happens frequently (and efficiently), and a healthy womb. Medically speaking, thirty-five is the age at which a woman is branded as an ‘older mother’ in maternity wards, where even conventional childbirth becomes necessarily more medicalized. Decline seems to begin from the age of thirty, becomes more obvious between ages thirty-five and forty and increases quite dramatically after that. After thirty-five years of age, even if an egg does become fertilized, the ability of the embryo to implant in the womb decreases by around three percent each year. From the mid-thirties onwards, women are faced with six threats: declining fertility, miscarriage, genetic defects that accumulate with age, high blood pressure (which if unmanaged is very dangerous), stillbirth, and, rarely, death of the mother. Forty-one doesn’t sound old, but it officially marks the point at which fertility stops and sterility begins. By forty-five years of age, there are only one hundred pregnancies for every thousand women having unprotected sex. Even IVF does not escape the age-effect. While a thirty-year-old will have about a thirty percent chance of becoming pregnant with this method, a forty-four-year-old faces a sliver of a chance: about 0.8 percent.

Yet, within the space of the past few decades, more and more women have chosen to have their first child later in life. In 1970, 11,704 American women had their first child between the ages of thirty-five and thirty-nine; by 1986 that number had jumped to 44,427, and by 1997 to 88,501. Twenty percent of women give birth to a first child when they are over the age of thirty-five. The birth rate for women aged forty to forty-five has risen thirty-two percent since 1999, and for women aged forty-five to forty-nine it has more than doubled. In 2008, seventy-one British women aged fifty or older gave birth for the first time. Many of these women were only able to become pregnant with medical intervention.

A similar story has, of course, unfolded in the US. The number of childbirths among women over forty almost trebled between 1989 and 2009, from 9336 to 26,976, and the numbers of first births is even more staggering. In 1970, little more than 2400 women had their first-born child between the ages of forty and forty-four. By 1986, the figure had risen to 4419. In 1997, more than 15,550 women in this cohort gave birth to a first child.

In social terms, having babies later in life is no bad thing. Being able to choose when we have children is now possible because we have access to effective contraceptives, and about half of the rise in the age at first birth is attributed to a rising level of education. Women with higher levels of education are more likely to postpone having a first child, and so as more women have finished university or gone on to pursue postgraduate education, or have attained economic independence, the age of first childbirth has gone up. In 2006, fifty-eight percent of all UK higher education qualifications were awarded to women – just thirty years after the fight to gain admission of women to male-only colleges still lingering at Oxford and Cambridge. It may come as no surprise, however, that if you look at UK birth data, the map of births late in life follows the contours of social class. There is a higher average rate of forty-something mothers in the wealthier south of England compared to the poorer north, a pattern that can even be seen on a city level, between inner London and the relatively cheaper outer boroughs. Late motherhood is as much a marker of the better-off middle classes as a designer handbag. Infertility treatments do not come cheap.

In order to allow women to have children late in life, we have to use medical intervention. That’s because, any time between the ages of forty and sixty, most usually around age fifty-two, the majority of women will stop menstruating. After this happens, becoming pregnant naturally is extremely rare – close to zero percent after age forty-five, even if a woman pumps herself full of hormones to keep her ovaries functioning as they did earlier in life.

As we have seen, a female embryo’s ovaries contain all of the eggs a woman will have in her life. These eggs, immature as they are at this stage, number between four million and seven million. But by the time a bouncing baby girl is born, she will already only have half as many. During puberty, around age thirteen, she will have on average 400,000 eggs remaining to cover her lifetime of fertility. If you do the maths quickly, you’ll realize that should be enough to have one egg every month for thirty thousand years. As it happens, only four hundred to five hundred of this multitude of eggs are released in cycles of ovulation; the rest are unrelentingly destroyed – either literally imploding or dying from neglect if they aren’t in the right chemical environment. The majority of eggs never actually mature to the point where they can be fertilized.

Starting from the age of thirty-five, a woman’s eggs start committing suicide at an accelerated speed. So while at the age of thirty-eight a woman may have around twenty-five thousand eggs, by the time she is forty-five she will have closer to five thousand; by her early fifties, she will have only a few hundred left. So regardless of whether a woman becomes pregnant or uses an oral contraceptive, such as the pill, that stops her eggs from being released, a woman’s supply of eggs is doomed to extinction by then. Importantly, those eggs that linger in the ovaries, taking their time to die, will stop doing what they are supposed to.

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