Trust women to decide the right time to have a family

Flicking haphazardly through the online press while on holiday, I was struck by the extent of media interest in the rising age at which women have babies - and the obnoxious arrogance of some of the related commentaries. Everyone, it seems, has a view on the right time for a woman to have a family.

Of course there are very important, objective issues to be taken into consideration. Natural fertility undoubtedly declines with age, and national policies (in some cases laws) generally impose limits for assisted conception. But not everything is about biology. And nor is all about society either. Decisions are affected by social and economic provision for parents — but it's easy to forget that the subjective, individual needs and desires that often tell us it's the right or wrong time to have a child tend to be less susceptible to these than the authors of studies might think.

I wish the Dutch academics exploring a mathematical model to help women plan the optimal age to conceive nothing but good fortune (reported in BioNews 813). But I doubt it has much utility.

At British Pregnancy Advisory Service (BPAS) we deal mainly with unwanted, and usually unintended pregnancy. We are used to hearing how difficult women find it to prevent pregnancy, despite the wide range of contraceptive methods and the relatively high awareness of how to use them. It is a myth that unintended pregnancy is a consequence of poor sex education and difficulty obtaining family planning advice. The truth is more difficult to understand, and less easy to resolve: reproduction is difficult to control. It's linked to sex, which is an emotionally complicated business for lots of women; it requires single-minded determination in an area of life that is riddled with ambiguities and nuances; and we imagine we have far greater control over it than in fact we do.

Women's decisions about when to get pregnant are not made in the way they might plan to book a holiday or buy a new car. Sure, you can decide that you want to get pregnant, but that's very different from 'controlling it'. Life has a sneaky way of throwing obstacles in the way — particularly 'relationship' obstacles — that are seldom discussed. Unsurprisingly, most people make a decision about whether to try to get pregnant, or whether to keep a pregnancy, in the context of their broader relationships. This why we sometimes see pregnancies that have started off planned and wanted, but end in abortions when a relationship breaks down, or someone decides they just can't cope with a child right now. Women generally take motherhood extremely seriously — they know it involves driving along a road with no possibility of a U-turn.

Our intimate, private lives are not susceptible to algorithms and models. Most of us need some spontaneity, some give and take in how we manage our views on parenting. Those of us who work in assisted conception or abortion services need to always have at the forefront of our minds that people have lives to live that are not all about pregnancy. Becoming a mother may be an important point of reference for some women (at some time), but when it comes to doling out advice on the 'right time to get pregnant', it would be as well for us to keep our counsel and trust women to make at least that decision for themselves.