The Italian newspaper Domani and The Why Wait Agenda are continuing their collaboration with a series of reports on the issue of choosing to have children. This seventh article was published in Italian in Domani in September 2023.
Everyone deserves the freedom to have children when (and if) they choose, without pressure or judgement. Every woman has a limited period to have children, outside of which conceiving is impossible. Both sentences are true, but they create a short circuit: because biology limits the freedom of choice.
Pregnancy is dependent above all on two factors, spermatozoa and ova: men continue to produce them throughout their entire lives; women, on the other hand, have a finite reserve, which deteriorates and diminishes as the years go by, until it is exhausted with menopause. At that point, the only possibility is to use a young ovum (from a donor or – a very rare circumstance – one frozen years earlier).
The best age from a biological perspective Female fertility is at its peak between the ages of twenty and thirty; yet the average age of having one's first child is rising all over the world, and in advanced nations, this is a problem. Italy has the oldest mothers in Europe: on average the first child arrives at 31.6, when in the1950s it was less than 26, and as recently as 1995, at 28. This is also why the fertility rate today has fallen to 1.24 children per woman. “And you feel that there is something wrong, something untrue, you feel perhaps it is paradoxical to render yourself sterile during all your fertile years and then desperately try to be fertile when you are barely fertile anymore,” says Giò, one of the four protagonists of the play CallForWomen, written by screenwriter Ippolita di Majo and staged on March 8, 2023 under the direction of Paola Rota at the Mercadante theatre in Naples (where an extraordinary Caterina Guzzanti played Giò) and in four other Italian theatres to celebrate Women's Day.
“The impetus to write came out of anger,” says the author, at “this lie that is told about women's bodies”, at the world of work that discriminates against them if they have – or merely want – children, at all those forced to put their plans for motherhood away in a drawer. When that drawer opens again, it is sometimes too late.
The show is a bombshell that deserves to break out in theatres and festivals, especially feminist ones: it highlights the difficulties of combining motherhood and a career, the truth about how the body works. Because no, at thirty-five one is not 'still young' as many would have us believe. Not from a reproductive point of view.
The spectre of infertility
The reasons for putting off having children – the theme underpinning, right from the name, The Why Wait Agenda project – may be professional or economic, but there are others too. Among the most common is infertility. “I started trying to have a child when I was twenty-one,” says Elena. “Between homologous, heterologous, and embryodontic procedures, I must have made a total of twenty attempts at medically assisted reproduction.”
In the end, Elena had to travel all the way from Tuscany to Milan to finally find doctors able to identify the cause, a coagulation problem. After heparin treatment and yet another unsuccessful attempt at assisted reproduction, Elena became pregnant naturally at the age of 41: “If they had discovered my problem earlier, I wouldn't have lost twenty years,” she says, but with no anger.
Not least because her story has a further happy ending. Having ended her relationship with the father of the first child she had sought for so long, Elena met a new man, seventeen years younger. There was no desire to start over with fertility treatment: “I wanted a child with him, but I didn't feel like going through the entire process again”. But after four years in the relationship, Elena surprisingly became pregnant again: “According to the doctors, my partner's age helped”. Today, at 52, she is the mother of an eleven-year-old girl and a three-year-old boy: “I am aware that I have experienced a miracle, and I am not to be taken as an example! Sometimes people tell me 'ah, but I am 45, so I still have hope'. I don't want to take away anyone's hope, but my advice is to get moving, look for the right doctor”.
Because after the age of 42-43, the chances of conception are anecdotal and the risk of miscarriage is “extremely high, because of embryonic chromosomal abnormalities, which are directly proportional to maternal age,” confirms gynaecologist Daniela Galliano, head of the Ivi fertility centre in Rome.
Assisted Reproduction and the secret of heterologous conception
It is not uncommon for pregnancies over 40 to be brought about by heterologous fertilisation. Such was the case with Nina, who, after trying in vain for a child since her thirties, adopted a baby girl at 40. Seven years later, she had a second child thanks to the egg from a Spanish donor: “Given that I was 47 years old, they gave me a 10-15% chance of success; but it worked for us on the first try!”.
Nina is not her real name, because she and her husband have told no one that they have had an egg donation. They live in a small town in Northern Italy and fear people's judgement: “There is so much ignorance,” says Nina, who had already faced comments drenched in “misinformation and preconceptions” with the adoption, “'but she's not your child!' they told me”. For her, however, it's a nonissue: “They are both my children, anyway”. Not even their grandparents know the truth. And the child? “We will tell him the truth in adulthood. Maybe”.
People often hide the fact that they have turned to fertility treatment “out of fear of those who believe that nature should decide when, how and whether to bear children,” explains Galliano: “But the less we talk about it, the more alone we feel.” Finding love later in life Across Europe, people over 40 who have children have more than doubled in the last 20 years: newborns with 'older' mothers accounted for 2.4% of the total in 2001, by 2019 they had risen to 5.4%. In Italy, the share is as high as 8.4%; on social networks, one now finds many groups dedicated to 'mothers over 40'. Sometimes it depends on having found the right partner late. As happened to Sara, whose previous partner“'was very childish and had no desire for children”. At 38 she met her current husband, and “we would have had a baby right away”, but a medical examination showed diabetes that had to be treated before seeking a pregnancy. For Sara, having a baby just before she turned 44 was no picnic. “I got backache, carpal tunnel, anxiety problems”.
As a freelancer, she had to stop working for long periods. “Now I have started again, but I still have to give up a lot of jobs” because looking after the child rests almost entirely on her shoulders. There is also “a sense of guilt about the fact that he will have elderly parents: maybe at twenty-five he will find himself alone”. That is why she and her husband have taken out insurance, opened a savings account for the child, and bought the house they live in “so that he's got a secure base. I try to be as healthy as possible, but I have this worry”.
Isabella, born in 1972 and today the mother of a seven-year-old girl, also met her soulmate late in life. There had been, in her case, no desire for motherhood beforehand. She had been pregnant twice, in her twenties and thirties, with two different partners, and both times she had ended the pregnancy: “A child binds you forever”, she explains, “and I already knew I didn't love the men I was with at that time”.
Then at 44, with some bitterness at the experience of missing out on motherhood but no longer harbouring any expectations in that respect, she began a relationship with a childless man in his late forties. They did not take too many precautions when it came to intimacy: “We only saw each other once a week, and he was 'careful'”. Yet within six months, Isabella found herself pregnant. This time, not even for a moment did she think of having an abortion: “For me, it was a gift. The gynaecologist told me: 'you've got the blood parameters of a teenager'. But we never thought of having another one, also because the only person to help us is my mother-in-law, who is now in her eighties”. Before all this, Isabella had thought of tattooing the name she would have given to her missing daughter on her body. She never got the tattoo: now there is a real live baby girl bearing that name.
The problem with the birth rate in Italy “does not hinge on the right to abortion, but on a system that is completely inadequate in supporting motherhood”: with these words Ippolita di Majo's play closes. If the system changed, and motherhood was supported, perhaps many people would stop putting off the choice to become parents. And the curve of the average age of mothers, which has been rising for decades, might change trajectory.
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