The world we live in: Spinning multiple plates at once

Today women are creating families later in life. The number of mothers in their 40s has doubled in England and Wales since 1990, surpassing that of under-18s (1). There has also been an increasing reliance on fertility treatments to overcome a natural age-related decline in fertility, which may occur much sooner than most women (and men) expect. For example, in Israel, IVF is available for women up to the age of 45 and is used frequently with women over 35. One may apply for IVF using donated eggs until 54-years-old.

Yet, the workplace may offer little support for those who wish to become mothers. There may be fewer job opportunities and career advancement may be conditional on the pursuit of higher education and/or women providing their full undivided attention to workplace requirements.

In addition, some women may find it difficult to find the 'right' partner, and one or both partners may find it difficult to commit to the relationship and to each other, delaying becoming a parent.

Life can become a juggling act between finding a compatible mate and becoming a parent, while maintaining workplace commitments and furthering a career, and yet being able to set aside enough time, energy and resources to enjoy oneself. It is hard enough to do so as part of a couple, and even more so as a single parent.

As a clinical psychologist, I have had the opportunity to observe many different people meeting the challenges of everyday life as best they could, often with exemplary courage and sometimes with a wry sense of humor. Some have needed to resolve or circumvent inner and outer obstacles encountered when building a family.

Since early childhood experiences indelibly colour the nature and quality of later relationships, a preparatory period devoted to an exploring and refining of the capacity for intimacy and being part of a couple may be necessary. Early experiences are now understood to set the stage for what has recently been described as 'emotional immunisation' (2) - a critical innate developmental process that unfolds as we learn to adapt to the extra-uterine world from birth onwards.

Emotional immunisation is based on an inborn attraction to sensations recognised as familiar (which we wish to repeat) and the simultaneous rejection and avoidance of 'foreign' sensations that may trigger signal anxiety and other unpleasant affects. At the heart of healthy narcissism, emotional immunisation affects our decision-making and choice of partners. 

Age related infertility: 'prevention' vs. treatment

It seems to me that perhaps the 'best' solutions to problems of age-related infertility may not be medical, but socio-educational ones promoting 'prevention' rather than treatment.

I'd like to propose that an early exposure to pluralism, to there being a range of choices and alternative life styles rather than one set path, may broaden our horizons by refining our tolerance for otherness. An increased and nuanced tolerance for otherness means we become less threatened by and more immune to a wider range of sensations and perceptions, representations and images, behavior, affects and meanings.

Moreover, as our tolerance for and appreciation of a range of affects expands, we become better able to touch upon them with words and share more of our inmost feelings with our children and partners. All of this improves our ability to use our relationships with others productively, enriching our attachments and intimate relationships (3).

Parents and school staff alike might invest more in teaching children, adolescents and young adults to:

• express and share a range of feelings and be able to say 'no' without feeling guilty about it;
• build emotionally meaningful relationships with friends, partners, family members, work colleagues;
• develop a view of sexuality in which the expression of sexual feelings and intimacy is expected to unfold naturally within a mutually satisfying and emotionally meaningful love relationship;
• encourage thinking and facilitate discussion regarding what is 'family';
• explore the pros and cons of becoming a single mother/parent;
• consider ways for alternative family building through adoption, donor insemination and surrogacy, while not losing sight of the civil rights of  the children in these ‘new’ families.

Special focus should be given to how to go about juggling a career and family without losing sight of the woman's biological clock, hopefully instilling a greater appreciation of natural fertility age, and exploring the numerous ways one can build a family.

While there may be a significant gap between chronological age and emotional age that may account for delaying family building, I believe that early and repeated exposure to the advantages and importance of being a young-enough parent (for both parent and child) may eventually help reverse the current trend of becoming a parent in later life.

Clearly, one such advantage is obviating the need for fertility specialists. Another is giving ourselves and our children the opportunity to relish being/having parents and grandparents when most needed, and with the health to enjoy it.

Since most employers are also parents, perhaps together with the people working for them, they can work out adequate solutions to help allow people to start building families at an earlier age, should they choose to do so.