Monday, August 11, 2008

Skipping a Generation

It's baby mania! Who can resist the cuddly cuteness of a baby? It inspires only gushes of awe at the miracle of birth and hope for another generation. And what about twins? So cute! Triplets? Cuter! Sextuplets? Can we take them home? How is it that babies of multiple births are more like kittens of a litter than people? A discussion for another time. There are two trends in pregnancy that are making headlines more and more frequently. The first is that women are waiting longer to have babies. This means that more and more women are older when they have their first child. The second is that there are more and more women having multiple births--twins, triplets, quadruplets, sextuplets, etc. From the individual woman's standpoint, it makes sense--establish your career and other dreams while you're young, then have a child that you can comfortably raise in this financially troublesome world. From a sociological standpoint, there are broader ramifications on the balance of society.

First let us clarify some points. I don't know if the average age of first pregnancy is rising or falling. That more and more women delay pregnancy into their thirties and forties would suggest that the average age should be climbing. But taken with the data that the average age of first sexual experience is falling over time, you would expect that many females are getting pregnant earlier as well. I would believe that the average age of first pregnancy is not changing much at all. I would believe that the ranks are swelling at both extremes of the spectrum--younger and older.

There are also data that demonstrate a large increase in the incidence of multiple births. Looking at twins alone, which is obviously the most common multiple birth outcome, that incidence has increased over time. Within twins you can have monozygotic and dizygotic twins. Monozygotic twins come from the same egg, and dizygotic twins from different eggs. With the coming of age of fertility medicine, and with more and more older women using fertility drugs to get pregnant, you can guess that the incidence of dizygotic twins has increased, whereas the incidence of monozygotic twins has not. Fertility drugs to increase ovulation results in a higher chance of fertilization of not just one egg but multiple eggs. Also, implantation of multiple fertilized eggs increases the chance that not just one but multiple zygotes will attach and thrive in the uterus.

Let's look at the celebrity news. Celebrity baby news has always been a front page story. I don't remember when there were this many multiple births among celebrities--Angelina Jolie, Marcia Cross, Julia Roberts, the list goes on and on. It seems that these twins are also dizygotic or fraternal twins as well. Now I can't comment on whether or not these celebrities had fertility treatments, nor do I care what their publicists tell the magazines, but the data implies the answer. And while not of the same gossip caliber as celebrities, older women all over are seeking fertility treatments to help them have children. It is not just for women who have had severe endometriosis or intrapelvic scarring or primary hormonal imbalances anymore. It's become the botox of obstetrics.

What is the ultimate impact of all this? If we accept that there are more women getting pregnant at both extremes of age--teens and late thirties to older, then you would have a very interesting scenario. Let's follow two hypothetical females, Andrea and Betty, both are 17 years old, making them Millenial-Gen Yers. Andrea gets pregnant on her prom day, while Betty waits until much later and gets pregnant at age 37. That puts their children in two separate generations. While that may not seem so unusual these days, it was quite rare just a few decades ago. But with the advent of fertility medicine and the increase in women delaying childbearing, you can see that it will become more and more likely that there will be a wider and wider generation gap between parents and their children. We can already see some of this in families that must maintain a two income stream in order to survive. Many of these families rely on their parents for daycare, resulting in childcare by a generation two steps back.

It is difficult to predict how this will affect family and societal dynamics, but one thing is for sure, it will something that neither Norman Rockwell nor the latchkey kid have experienced.