Are you ever too old to have a baby? - The Global Story podcast, BBC World Service

Hello, I'm Katya Adler, from the BBC  World Service this is The Global Story. Around the world, women are having fewer  babies and mothers are getting older and older. More women are having children in their  40s, their 50s and even in their 60s and 70s.

Last week we successfully delivered this lady, 70  years of age, of twins, boy and girl. Previously, we had treated her with IVF, again  the same process, three years ago, and she conceived and delivered a baby girl. Today we're asking why are women choosing to have babies later in life and what  are the consequences for all of us?

With me today is the BBC's Population  Correspondent, Stephanie Hegarty. Hi Stephanie. Hi.

And also, Professor Joyce Harper, she heads up the  Reproductive Science and Society Group at UCL's Institute for Women's Health. Hello. So, let's start since we're talking about  older mums, I think we're all older mums here.

I mean I had my first child at 36  and my third at 42 and I was half laughing, and half horrified at being referred to  already with my first child as a geriatric mum. You know what, I was delighted that that never,  I had my first child last year at 30. .

. was I 37 but nearly 38, and I was delighted that  that never came up, because I scoured the documents I was given by the NHS to see if I  was being referred to as a geriatric mother. I think it might have changed recently.

I had my first at 39, so yeah, and no one said it to me, but then I'm in the field.  I don't think they'd have dared say that. They were scared of you.

I think so. Yeah, I'd like to start off very much by what  do we mean by an older mum? And again, you know, speaking from our own personal experience,  not wanting to offend anybody, but how old Joyce is an older, we won't say old, mum?

I would certainly never put a number on it, but the term geriatric mother did used  to be around, and unfortunately for some people still heard quite recently, and that's  because 10, 20, 30 years ago women were having children at a much younger age. Now it's  become quite normal for women in their 30s, as we see with the world data, there's many  countries where women have their first birth over the age of 30. But this is quite a new phenomenon.

Minds are changing, aren't they? Because I mean, my mum had me when she was 30, that's in the early  1970s at the time, that was quite shocking, but no longer the case. Stephanie, if you take that  global view, that's your job at the World Service, how common is it to be an older mum these days?

So, the average age globally is 28. So that's not that old? No, but it's changed a lot.

I mean, it's hard to tell exactly, say, going back three decades,  six decades, but we have really good data from the OECD countries, so, from wealthy countries  who are generally good at data collection, and 60 years ago the average age was about 22. So, every  decade it's gone up globally by about a year. How common is it to hear of  the much older mums, frankly?

I think Joyce might know more about this. But  what I think I found really interesting is, you know, we're talking about 28 is the average  age for your first child. But people can go on, continue to have children much later. 

And in India, for example, recently, the age that people stop having children is  going down. So that means that they're, I mean, surveys have found that they're choosing not to  continue to have children late into life. So, I don't think that this means that people  weren't having children in their forties before.

I think my mum was 39 when she had me and  41 when she had my little brother. So, you know, I think, Joyce you might know more about how  has the upper barrier moved very recently, or is it just the lower barrier that we're talking  about having moved? No, it has moved.

So, the ONS data for the UK shows now that for under 20s,  we've got, I've written these numbers down, these aren't off the top of my head, but under 20s, in  the last set of data we had 13,739 births, but in the over 40s, 40 to 44, there were over 28,000  births, and there were around 2,000 over 45. Why are women choosing to have babies later?  As you said, Stephanie, it is getting later.

Is it economic factors? Is it specifically  career? Can you talk about global patterns?

I think with anything to do with fertility and  demographics, it's always this kind of confluence of economic, social, and cultural, and they all  interplay so delicately it's hard to pull them apart. But I think, certainly from surveys that  I've looked at and people that I've spoken to, economics is huge. I think this is linked very  closely to urbanisation, when people move to cities life becomes more expensive, space is at  a premium.

Not here in Western Europe or the US, but in Asia education is expensive. So  those things factor in. People want to be further in their careers, they want to  earn more money, they have to, in some cases, before they can afford to have a child.

Well, there's a specific issue in China, isn't there? It used to have that one child  policy. That was scrapped in 2016, but there are lots of people in China who are still choosing not  to have more than one child.

The BBC went around, and asked people and they said it's economics,  they just can't afford a bigger family. I think one of the important things here and  everything about fertility is to do with choice or should be to do with choice. A lot of people don't  want to have children and now they don't feel the pressure to anymore.

It is more acceptable  not to have children and that's a good thing for people who never feel that instinct. Africa, Stephanie, historically has high birth rates but if you look at it sort of  continentally, birth rates per woman are falling there as well. What are the factors?

So, one of the most direct correlations to fertility is education of girls and  women. The longer you stay in education, the later you leave it to have a child and that's  across the board. The effect of one on the other is just very clear.

But also, urbanisation,  because as people move to cities, they tend to have fewer children and that's happening  all over Africa. And access to contraception, education about contraception, all of those  things are having a really profound effect. So even though the rates are still higher than  most of the rest of the world, they are falling.

If I look at my daughter's social media  feeds, when they let me in of course, I do see talk about the environment linked to,  you know, I'm not going to have children because I want to protect the environment. How much of  this is a proclaimed aim? And how much do you actually see people across the world deciding  not to have children because of the environmental damage that a higher population will cause?

Actually, my colleague, Navin Singh Khadka, he wrote about this recently, and I think he  found it difficult to find statistics on this because I think it is still quite niche. And also,  we're talking about people in Western countries, in their early 20s usually, who don't have a huge  stamp on the fertility figures. They're not yet having babies anyway.

So, it's not clear. We did a survey with UK teenagers, so they were aged 16 to 18, and we asked them  what factors may affect them having children. And environment did come up, but also, we did  this around, it was a couple of years ago, so it was quite soon after COVID, and they  definitely felt that the state of the planet generally was something that they were very  concerned about, so that really influenced them.

It would be really interesting to track those  teenagers in 10 years when they're at the age where they're thinking about this again  and ask them then. I think that would be a really interesting time. Yeah, I think so too.

So, I was just wondering, Joyce, can you  take us through the hows of all of this? Well, our fertility does decline, unfortunately.  Female fertility decline is a very real event.

No matter how healthy and going to yoga every  day and eating all the right foods and being vegetarian and everything, it might seem that we  can turn back the hands of our biological clock, but I'm afraid we can't. So, the majority  of women will start to see a decrease in their fertility from age 35 and that's something  that really resonates with women. They're like, "that's so young, I'm just starting and now my  fertility is declining", but that's the facts.

And fertility treatment certainly can help. Now  we do have this process called egg freezing, where if you freeze your eggs when you're  younger, maybe your late 20s, very early 30s, you're basically putting those eggs on hold in  the freezer, and they will stay as they are. So, if you had those eggs back when you were even  45, you would have the fertility basically of a 28-year-old, if that's when you froze  them.

Our womb unbelievably stays fertile, even past the menopause. So even when  we're 60, 70, and as far as we're aware 80, we should still be able to carry a baby. There are  health risks as well we can discuss but certainly, it's really, our fertility is down to  the age of the egg and the quality.

You can't see us Joyce, but Stephanie's  and my collective jaws are dropping as you say that, I had no idea. A donor egg has been around for decades. And so that is a procedure that  can be used if a woman hasn't frozen her eggs or if her frozen eggs haven't worked, egg  donation is certainly a very viable option.

So, Stephanie if we've looked at the how,  when, and where women are having babies later, I now have a what for you which is what  are the consequences of all of this? It means two things, one the later you start  having children the fewer you're going to have, statistically and you know obviously I guess, you  have less time to have a bigger family. But also, when there's a lag, so say a previous  generation had children younger and this generation has children older, there's a lag. 

Both those things mean that that's contributing to population decline and there's all sorts of  worries about population decline which people are probably familiar with. The idea that there  won't be as many people paying into pension pots, there won't be as many working people to pay for  young people who need care and older people who need care, anyone who's out of the workforce,  and that's the real worry for governments. If you have an older population, that's going  to affect innovation and society in a way that, when it comes to election time, older voters  might prioritise different things.

They may not want to invest in ideas that look to  the future because they won't be around for it. Is that being that one of the dangers? And older people vote more than younger people as well, which gives a kind of a snowball effect  to that.

But at the same time, I think we have to, we are going to have to start looking at age  differently because we're living so much longer. One of the big issues with population aging is  we're actually less healthy than we used to, even though we're living longer, our health  is declining, especially in a big country, big developed, rich country like the  US, health outcomes for older people are actually declining. So, I often talk  about this, there's so many problems, but there are also so many potential solutions  and I think a big one of them, when it comes to tackling population aging, is investing in  health care, investing in preventative healthcare.

Surely if you have fewer babies,  mother-baby health should be improving? It is, absolutely. And also, education, access  to education is improving.

Access to healthcare in general is improving in places like  sub-Saharan Africa, which historically didn't have such good health outcomes. So,  there are a lot of positives. And of course, the big one, which a lot of people immediately  think about, is the effect on climate change.

You do have governments scrabbling around  for solutions, don't they? Isn't the most common one to try and essentially  pay people to have more babies? South Korea, Russia, I think China, I know South  Korea and Russia for sure have recently enough instituted these one-off payments for your  first child, more for your second, more for your third.

And they've had almost no effect on  the demographics there and on the fertility rate. What about the so-called Scandi model, the  Scandinavian model, helping sort of beef-up the welfare state for parents, giving paternity  leave as well as maternity leave, for example? Yeah, so that has been proven to work, and  it's this holistic series of policies that were government instituted, but created a kind of  cultural norm where it was okay for mums and dads to leave the office if their kids were sick or  to go home at 4pm for the school pickup.

And it did have an effect, although briefly, on fertility  rates there. But afterwards, that was in the early 2000s, and then they started to kind of level  off again. So, it was kind of widely celebrated in demographic circles as this solution, and  then people were really confused when they started to see that it wasn't having a kind of  cumulative effect, that it was levelling off.

So, what about countries, Hungary for example,  Italy, that sort of almost make it a national priority? Have babies for your country  , so that in Hungary they're Hungarian babies and in Italy they're Italian babies,  this is often governments that are, you know anti-immigrant in their stances, for example. But at the same time, you have those governments making laws against surrogacy, which seems  counterproductive to trying to encourage people to have more babies.

So, I think in general,  the lesson from the Nordic example is that these policies have to be very holistic, and they can't  just be about nationalism or giving people cash. Is fertility treatment, is the private sector a  possibility? Because India's biggest hotel chain, Taj hotels, in 2018 announced plans to help  female staff by paying for fertility treatment.

It's another thing that always makes people feel  uncomfortable, with some companies suggesting that they pay for egg freezing as well. I think we  can't force people to do this. I think one of the problems that the young people have told us  in our survey, we did ask them to tell us in their own words what they feel about having children. 

And a lot of them feel that they've used words like 'loss of freedom', that it would be so life  changing that they wouldn't have their sort of fun time anymore. So, I think in in our culture  we make doom and gloom out of lots of situations such as having children, perimenopause etc and  I think, as you've just heard, the financial advantages that countries have tried to bring  in haven't worked. I think we need to change the narrative.

I think we need to change the  narrative that actually having kids is fabulous and almost everyone that you ask will say it's the  most important thing they've done in their life. And it's fun. And it's not the end of your young life, but we've got to change that.

Yes, I agree, I have to say it was a big surprise for me how much I loved it, I thought it was a  well-kept secret, I kept being told about how it ages you, yes, how you won't sleep again, yes, but  I hadn't been told about how amazing it would be. I guess, I mean everybody needs to be respected  for the choices they make. Some people, of course, as you know so well, Joyce, just unable to have  children.

One of the solutions that I was hearing about is invest more in artificial intelligence,  because if we're worried about productivity in a shrinking labour market, maybe that's the  answer, but that is a whole other Global Story podcast for now. Stephanie and Joyce, thank  you so much for sharing your wisdom with us. Thanks for having me.

Thank you. And thank you for listening. If you enjoyed  this and you want to hear more episodes of The Global Story, you can find us wherever you get  your BBC podcasts.

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