Women's Labor and Infertility

We ladies have a special relation to the word labor--it names the work we do for pay outside the house, the work we do for free at home, and that transitional, and frequently painful, hard physical work through which many of us directly produce the next generation for the nation.

The relation among all three realms of women's labor has been in flux for decades. New farm technologies and our expanded life-spans mean the world just doesn't need so many babies. Our understanding of women's work has been especially mobile since the arrival of hormonal birth control in 1960, in concert with rising education and employment options.

Given the choice, women and their partners have opted to have fewer kids, delay their arrival, or decide against them altogether. Released from old biological constraints, women have flooded the universities and climbed career ladders, redefining "women's work" by expanding it to include just about every field of endeavor, and doubling our national talent pool.

Absent supportive work policies, delay of kids has provided a shadow benefits system. Many women waited until their salaries and their on-the-job clout had grown and they could negotiate family-friendly schedules they wouldn't have been able to get earlier on. As a result of their trickle up, women as a group have a new status in policy discussions, a status directly linked to their use of contraception to delay the arrival of kids--some by a few years, others by many.

In 2007, 612,000 babies were born to women 35 and over (that's 1 in every 7 babies), of which 105,071 were to women 40-44 and 7,349 were to women 45-54 [up from 1,375 20 years prior]).* But while some delay works for most, long delay brings difficulties.

Fertility wanes, and especially quickly between 40 and 43. But the desire to form a family often increases with age, especially now that women can hope to continue fit and healthy into their 80s; they're better off financially; they're more likely to be in a long-term relationship; they've accomplished many of their work ambitions and are ready to focus on family. Though they're ready, their bodies don't always cooperate.

In 15 states, women who encounter infertility for whatever reason** get some degree of insurance coverage for treatments - variously including IUI, IVF and egg donation, on a model similar to health-plan birth coverage. The infertility advocacy group Resolve states on its website that two thirds of infertile couples who seek medical intervention end up with a birth. In addition, many infertile couples and singles build happy families through adoption, while others end up without kids though they had hoped to have them - a situation full of ongoing sadness even when the people involved do move on to a revised life plan with happiness of its own.

In states that mandate full coverage, the average addition to everyone's annual health bill was $3.14 in 1995, made low through economies of scale. In the other 35 states, you're on your own and prices are high. Some can afford to pay $12,000 each for an IVF cycle or two, others can't.

But society as a whole benefits when all citizens who want them can have kids when they're ready-at the most basic level because we need a next generation of workers, but at another level because we want our citizens to be happy-for charitable reasons and more pragmatically because families are often what people work for, at whatever point they start them. In the end, it's all about the labor force. Do we want educated couples excluded from the group of parents? Among those who encounter infertility, do we want only people who can afford the high cost of treatments to procreate?

In the past 50 years women have expanded their contributions in the workplace, and their education has grown the human capital of the nation. If sufficient numbers of women trickle up and change government support systems and business practice, future generations won't have to delay in order to have both a family and a career to support them, though they may delay for other reasons.

There are lots of complexities to the modern fertility scene, and there's plenty of room for misuse of new technologies as well as positive use. Which is which may not always be clear at first glance. As we move forward with health care reform, the expansion of infertility insurance to meet the needs of our expanding group of citizens who want to start their families later as well as people who encounter infertility from all causes should be part of the discussion, within a wider culture of care that assumes that all our citizens and families deserve basic supports, because we are our common wealth.

*The US birthrate to women 35-39 was 47.5 in 2007 and 26.2 in 1987; to women 40-44 it was 9.5/4.4; and to women 45-54 it was 0.6/0.2 (the rates are figured per 1000 fertile women).

**Female infertility isn't just about delay--it can occur in younger women as well and is linked to increases in STDs, to PCOS (polycystic ovary syndrome--think Kate Gosselin), to endometriosis, to male factors, to environmental toxins, stress, and to other, unknown factors.

Follow Elizabeth Gregory on Twitter: www.twitter.com/egregory

Comments

[AverageJill]

You're assuming that all the children brought up in religious and conservative homes stay religious and conservative when they grow up. Many of today's liberals chose to be liberals because of the hypocrisy they saw in their conservative homes growing up.

In America, a household usually needs two incomes. If the mother does not work, the father has two jobs. Sometimes that means the children do not see their father for days every week. (At seven, I would secretly set my alarm for midnight and pretend I was up to use the bathroom in order to be able to see my father every night when he came home from his second job.)

Also, of my father's three children, now ages 46-55, I'm the only one to have any children.

Things do not always turn out the way you would expect.

[huffmuch]

"Further discussions might change views that man have on adoption"

That last line doesn't make much sense, now does it?! It was posted in error.
I thought I erased it, but there it is. Sorry. Oops.

(I guess some might say that none of it made any sense - Ha! I hope that's not the case, but I'd understand if others don't agree with my comment, of course. And I really hope it is not offensive, I just want to see and participate in more probing discussions on this issue.)

[huffmuch]

I really appreciate this column.

I have to admit that I struggle with the high cost associated with infertility assistance.

I know the inability to have children is extremely painful, but I struggle with this issue because I am also aware of the high number of children in need of parents, children who likewise struggle in pain and agony.

I personally would like to see in our society more discussion and meditation on the personal reasons why we, women and men, want to have children and raise a family.

Perhaps if there was more focus and talk on the "why" and the "to what ends" the priority of raising children that share our genes and look like us might fall for some.

Further discussions might change views that man have on adoption

[Elizabeth Gregory - Huffpost Blogger]

These are big questions - and ones we only have to address as a human race now that not having kids is an option. I think of it as an evolutionary change for us all, that we're having to redesign all our basic assumptions to accommodate. All the baby- madness in the tabloids seems to be part of it, as do the debates over birth control, abortion, pay equity and who can do which jobs. And the adoption/fertility tech discussion is part as well. Individuals respond differently to both options - but they might respond yet differently if the two options - along with the option not to form family - were discussed more fully. And of course there are critiques of adoption as well.

[Lilabell135]

Elizabeth, I am a 41 year old woman who spent 7 years in the throes of infertility. We were very fortunate to have limited infertility coverage through our health insurance, even though those medical efforts failed. We went on to adopt our oldest son, the first miracle of our lives, and then went on to have two biological sons - through no ART. We started trying to have a family when I was 32, having only gotten married when I was 30. Not ancient in terms of fertility, but certainly not young. Our family is complete and wonderful.

But there are millions of women and men out there, who through whatever circumstances, are facing the very same issues I once had: the inability to bring children into this world to share their life and love with, trying so hard to achieve what others take for granted. I stand in solidarity with these people now and always in pushing for infertility coverage for all. Infertility is a disease and should be treated as such. Thank you for advocating on behalf of all people who desire to raise a family, whenever that may be in their individual lives, and for whatever reasons.

LordMoon: Your post sickens me. Your feigned piousness is honestly, deplorable, and is only outshone by your smugness. It is people like you who bring the goodness and light in the world to a standstill, through self-righteous judgement of others. Shame. On. You. Shame.

[LordMoon]

What you say is probably true on the face of it. But there are draw backs.

Yes, liberal women have forsaken the family for the work force, but not the religious right, and not conservative catholic families. While liberal families are shrinking, fundamentalist families have been growing.

In fact they are the fastest growing demograhic in our country, and while they reproduce, liberals decline. In a generation, they will dominate politics because they will be the largest voting block.

Their conservative religious views, will predominate, they will create the laws, appoint the supreme court justice's, and fill the senate and congress.

Liberalism will shrink to the point of non existence, the social movement you describe will disapear.

Because, liberalism cannot reproduce itself. Marriage is a liability for the left, in so many ways.

[Elizabeth Gregory - Huffpost Blogger]

Sounds like you're making an argument for expanded fertility insurance!

[SarahSarah]

Is this why the Republican party shrinks every year? Also, the so called red states have higher divorce rates.

[huffmuch]

Have you ever seen/heard of the movie "Idiocracy"? The premise of the movie runs rather close to the views shared in your comment.

Please do me the fine favor of watching the opening scene here
http://www.metacafe.com/watch/2682654/idiocracy_opening_sequence/

I hope you will find it amusing.