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Spanish women "leaving it too late to have children" : Report

Source: El Pais - Wed 3rd Feb 2016
Spanish women 'leaving it too late to have children' : Report

“If I could live my life again, I would start having children at the age of 25,” says Gloria Labay, now aged 51, and who waited until she was 38 before trying to become a mother. But after numerous pregnancies, artificial inseminations, and an in vitro treatment while she was single, followed by further therapy with her current partner, four miscarriages, and a failed attempt to adopt, she has finally come to terms with the reality that she will never have children. She now works as a midwife.

As women grow older, their chances of becoming pregnant diminish: at 25, there is a 25% possibility; by 35 it’s 12%.

Gloria’s heartbreaking story will be familiar to many Spanish women over the last four decades: in 1980, the average age for having a first child was 28 years and two months; by 2013 it was 32 years and two months. At present, 33% of children born in Spain are to mothers aged 35 or over. In 2012 there were three times more women giving birth over the age of 40 than in 2000. The country’s birth rate continues to decline, in part because women are leaving it later and later before they have children.

As women grow older, their chances of becoming pregnant diminish: at 25, there is a 25% possibility; by 30 that figure falls to 22%; at 35 it’s 12%; and at 40 it’s 5%; by 45, the likelihood is down to 1%. Nevertheless, each year in Spain, thousands of women in their late thirties and early forties decide that the time has come for them to have a baby. “They assume that if they are in good health, that somehow they will be fertile, like the celebrities who have children at those ages, but what they fail to understand is that those pregnancies are the result of egg donation in a third of cases,” says Isidoro Bruna of the Spanish Fertility Society. “It’s a shame that gynecologists do not tell younger women during their routine checkups that their reserve of eggs is shrinking year by year,” he adds.

Could gynecologists do more to raise awareness ?

Given that the average age of women seeking fertility treatments is 38 and two months, the Spanish Society for Fertility drew up a document encouraging gynecologists to tell women still in their twenties about their declining chances of reproducing as they grow older. “In 2012, we sent a report with information about how to tell women about their ovary reserves,but it didn’t have much impact,” says Bruna.

He says gynecologists should be asking younger women if they have thought about having children. But Tirso Pérez Medina, vice president of the Spanish Gynecology and Obstetrics Society and head of service at the Puerta de Hierro hospital in Madrid, says the question of starting a family has to be treated carefully. “It’s possible these women will feel uncomfortable. What I do is tell them that if they are thinking of having a baby, they shouldn’t wait too long before getting on with it.”

Spain’s state health service will only offer fertility treatment to women under the age of 40, but thousands of couples seek therapies at the country’s 200 or so private clinics. Around 3.2% of children born in Spain are now the result of fertility treatments. In 2013, 27,780 women were subjected to in vitro therapy, each at an average cost of €4,000. Around 10% were unsuccessful.

A 42-year-old architect who did not want to use her own name for this interview, calling herself Laia, says she put off having a child because of work. “I was worried that with the crisis I could lose my job, so I waited a little,” she says. “Everybody around me, including my gynecologist, told me that 37 wasn’t so late. I had no idea what was going to happen.”

After two treatment sessions at a private clinic she was told that her eggs were not of sufficient quality. The clinic proposed subjecting her to several treatments that would create 10 embryos, from which those of the best quality would be chosen, but Laia and her husband decided not to undertake them.

As happens with many couples, the disappointment and emotional pain caused by each failure was too much. “I know it’s possible to be happy in other ways,” she says. “Sometimes I think I threw the towel in, but I find that easier to deal with than the idea I have no chance at all. At my age I can now accept certain things. Maybe I’m a conformist, but now what I fear the most is the future, and ending up as some granny with no energy. I’m terrified of the idea of being alone on Christmas Day. It’s so paranoid.”

Spanish women who leave it until later in life to have a baby tend to have just the one child, which partly explains why, in the first quarter of 2015, more people died in Spain than were born. Cristina, aged 42, had her first child through treatment at a private clinic. At the age of 39 she went back to the clinic hoping to have a second baby, but her egg reserves were too low. The choice was either to accept her situation, or have treatment via donated eggs. “I was aged 41 and it depressed me hugely. We were at the beach and my husband was playing with our son and I couldn’t stop crying. It was a tremendous struggle internally.”

Like many other women in her situation, she looked for treatments online such as acupuncture, meditation, and even one-on-one stress therapy – as offered by Eva Bernal, who had three children after 18 sessions. Eventually, Cristina discovered a method based on diet, created by Virginia Ruipérez, a nurse. “I changed my diet for a much healthier one. She argues that it helps.

I’m not sure. Obviously, it can’t do you any harm and I wanted to do everything I could.” After three months of healthy eating, Cristina and her husband decided to try ovary donation. But after the third attempt, in December, they decided to stop. “I would give everything I have if they could guarantee me a treatment that would get me pregnant, but I can’t go on hoping for something that isn’t going to happen.”

After her fourth miscarriage, the gynecologist at the hospital where Gloria Labay was undergoing treatment carried out a second fertility review. The first looked positive, but in the second, doctors discovered that she had an arcuate uterus, which means her uterine cavity has a slightly different shape and could be why she was unable to become pregnant. She then tried to adopt a child from Nepal as a single parent, but the Spanish authorities subsequently stopped working with the authorities there over procedural irregularities.

Three years later she was offered another opportunity to adopt, but by now she had a partner and was not considered eligible. “Now I am aged 51. Every day in my job I am a witness to the miracle of seeing a baby born and it is hard to accept that for me it is too late, although I no longer think about it every day. But you have to reinvent yourself. Not having children has advantages: you can do what you like with your life, you have more money to spend on what you like. A psychologist told me that perhaps if I couldn’t be a mother, I could be the best aunt a child ever had. Last year I went camping with my three nieces, aged eight, six, and four. This year I’m planning a trip to the Pyrenees. For the moment we get on, but there will always be this feeling of having missed out on being a mother. It’s the wound I carry around with me.”

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