The number of children born to women over 40 in England and Wales hit a record 27,000 last year, and has trebled in the last 20 years – a trend that has alarmed medical experts. Philip Steer, a professor of obstetrics, said: "There are two big problems with [postponing children]. First, you are less and less likely to get pregnant. Second, the physical risks of pregnancy, such as pre-eclampsia, diabetes, kidney problems and tiredness, go up from the age of 30." Nobody would argue with any of that; but nor does a simple deduction follow that women over 40 should avoid getting pregnant.
Those risks – pre-eclampsia and gestational diabetes in particular – are related to age at one step remove; they are principally linked to obesity, and obesity is linked to age. Sure, this matters to a statistician; but to an individual, obesity is an observable, controllable factor. You might shudder at the idea of being pregnant at 43, but if you aren't obese, your age alone isn't necessarily a huge risk factor. So now you've just got your kidneys and exhaustion to worry about.
The real reason doctors hate women to delay pregnancy is unintended infertility. They're human beings; they hate to disappoint. And there is simply not that much they can do to help women who are over 40. The social anxiety around the older mother is the opposite of this: there is a fear that medical advances are happening too fast, without paying heed to the reality of late motherhood; and this denatures the mother-baby dyad, making it possible for women in their 60s to bear children they won't live to look after.
It's totally untrue, all this. IVF has made great advances treating younger women with fertility problems, and intracytoplasmic sperm injection success rates, where the chap is the problem (it does happen), improve all the time. But, the treatment of women over 40 has scant impact (a 94% chance of failure), and nobody is talking confidently about great advances in this area. These women over 40 whose numbers have shot up are getting pregnant naturally, by and large.
The mothers, often cited alongside these statistics, who have babies in their 50s and 60s (all four of them) are doing so with implanted eggs. So their age carries no genetic implications; their part in the pregnancy is essentially experiential for them – like a fairground ride. (Very like a fairground ride. It's frightening, and it makes you feel sick.)
Furthermore, even a passing observer couldn't fail to notice that there is no good age for a woman to become pregnant. It was the Blair government in 1999 that elevated the avoidance of teenage pregnancies into public policy. The problems of conception over 34 taint older mothers. Technically, this would give women 15 years from the age of 20 in which they could respectably have children, but all the research on women's loss of earnings following motherhood suggests that the later you leave it, the less your salary will suffer.
From this point of view, 34 is the ideal age. The people who hector mothers in the 35-plus bracket would be (indeed, are) the same people who berate mothers living on benefits because they had children young and can't afford to go back to work. Perhaps the answer is that every woman should concentrate on finding a man to marry and keep her. Pleasingly (for me), Italy – the European country with the least progressive attitude to families, and the greatest accent on marriage – also has Europe's highest over-40 birth rate.
The judgmental tone is all rooted in a timeless anxiety that women are too feckless and/or stupid to be left in charge of growing children – an anxiety I have an ever growing awareness of, the more background misogyny I realise there still is. Propagation is the main work of any species, and if you seriously believe women to be inferior, it must be incredibly aggravating to see them in charge of it.
Furthermore, it's quite true – women are feckless and/or stupid, but only to the same degree as the rest of the population. Some women will have a baby at the last possible moment, just as some people will file a tax return the day before they get fined. Some women will get breast cancer as a result of late-age births, that's just a fact. Some men will get bowel cancer because they don't get enough exercise, and maybe 40 years ago they would have been working manually and got plenty.
The whole debate would be less vexed if it were about a human condition, rather than female frailty. It would be less hostile and competitive, and we could look with clarity at what needs addressing – public information about age and dwindling fertility, and what is just a feature of modern life: the average age of first-time mothers going up from late 20s to early 30s.
Mothers over the age of 40 may have swelled in number (and ankles), but they haven't done anything wrong. It's savagely annoying to see them presented as a social problem. All these reports should start with a simple word: "congratulations".
