Wednesday , August 4 2021

Fertility, children Gynecologist Kirsty Brenden helps women get pregnant:

The reproductive rate is constantly falling in Norwegian women. Experts warn against the idea that children are an order that you can wait until everything else is in place.

– During the 30 years I worked as a gynecologist, I saw that young people are more and more worried about having control. “I would get more pregnant on June 28, 2022. “That is the date that suits me best.”

Gynecologist Juron Thuring laughed a little on the phone from Trondheim. Of course, no one is planning a date for fertilization, but to a greater extent than before, she meets young couples with the expectation that they can order a baby at the right time.

– Some will control absolutely everything. Education must be in place. The loan has been repaid, the car in the garage and the apartment have been renovated. Only then can you have children.

Turing receives direct support from gynecologist Nina Willumsen at the Nimo Clinic in Dramen.

– Young people today are perfectionists. First, they must have the perfect partner, and then education, work and finances must be fully in place – and then they can get pregnant. But the baby does not care about good work and good love, but about love.

The trend described by gynecologists, however, is fully in line with what women have been encouraged to do for many years: Educate themselves, find a good job, be financially independent, and find a partner with values ​​and goals similar to theirs.

And, is there really a problem?

According to politicians, this is certainly the case. It has been almost two years since Prime Minister Erna Solberg asked Norwegian women to have more children so that the Norwegian model of well-being can be continued.

READ ALSO: What Erna Solberg did not say directly in her New Year’s speech

But despite the prime minister’s call to increase, the birth rate is falling. In 2019, 54,495 children were born in Norway. Gives a fertility rate of 1.53 children per woman – the lowest ever.

In northern Norway, the birth rate has dropped by 35 percent since 1995. At Finnmark, the number is almost halved. If the trend continues, it will eventually become empty north of Trondheim.

But in their daily work, gynecologists do not deal primarily with settling or maintaining the welfare system. They are concerned about being able to help their patients and want to avoid situations where women who want children cannot get them.

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Hence, they convey an important aspect, which they consider to be somewhat communicated at the time of self-realization:

– Age is the most important factor when it comes to fertility. And we experience that many people think they are having a good time, but that is not always the case, says Willumsen.

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Restriction of 38 years

The age of first-time mothers increases with decreasing birth rates. In the last two years alone, the average age has increased by half a year and is now 29.5 years on a national basis, according to statistics from Norway.

Fertility varies greatly from woman to woman – and from couple to couple. But in general, someone works with 35 years as a magic limit for women. Fertility then drops, and at age 38 it drops significantly, according to the NHI.

Women over the age of 35 who have not become pregnant after one year of trying are advised to seek medical help from the health service. In some places it is recommended to seek help only after six months.

For some, assisted reproduction is a solution, but here the public health service sets the limit at around 38 years.

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If you pass 38 as involuntarily childless, you must transfer to the private sector. Gynecologist Kirsty Brenden at the Fertility Clinic, Livio IVF Clinic in Oslo, met many women who want children at an age where it is starting to get difficult.

– It is a challenge that many are waiting for – and a good number are waiting too long. They may have been told that they were having a good time, but then they received an alarm when they came to us.

Although most people know that age determines your fertility, Brenden finds that many people are surprised by the seriousness.

Half of those treated with assisted reproduction in the 35-40 age group fail to have children.

– If a woman is 35 years old, it is relatively likely that she can get pregnant. But some expect that they will have three children, and that does not have to be realistic. Many people go through a long period of pregnancy with test tubes and have to go through several attempts, says Brenden.

Show how much time they have

In order to avoid situations when you start too late, the Livio IVF clinic offers so-called fertility advice.

“Are you wondering how long you can wait to have children?” The fertility consultation can give an indication that everything is fine, » stands on the clinic website.

– Then we take blood samples and do an ultrasound, as well as do a survey through conversation. We also look at lifestyle factors that may be important in this context and that may be advised to change or adjust in relation to future pregnancies, Brenden said.

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– It can be argued that such offers allow for detailed planning and potentially increase the need for control. What do you think about that?

– I think it is positive with such offers. It is not the case that we can give a definite answer as to how long it is fertile or when a woman should get pregnant. “But we can say something about the prospects, and then we can also avoid situations where women wait too long to start and try,” Brenden said.

We women have our own eggs from the moment we are born, and some are born with a smaller or larger number. You may think you have a few eggs, and then you may have to start trying before you really think about it.

Full house housewives

Professor Ann Eskild, chief physician at the Clinic Clinic in Ahus, is often referred to by journalists as “women have fewer children” on the block. She herself does not find it strange that Norwegians wait a long time to start a family.

– Norwegian women have learned for three generations that they should not have children – and that never works.

Eskild also clears up the misunderstanding that often arises when discussing declining birth rates: It is not a case of having much more childless women in Norway today than 30 years ago, but it is fewer and fewer who have more than two children – and at least more than three.

– It is not so strange either, because if you have three or four children, you should start before you are 30 years old. The only problem is that we have a parenting scheme that discriminates against young parents, Eskilde said.

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Because parental benefits are based on your salary, women wait to have children until they are paid for work, research shows.

– The parental assistance scheme in Norway today is on a course of conflict with biology. In addition, it is contrary to the intention of social assistance, because it gives more to those who already have the most, says Eskild.

She believes that we have a parental benefit scheme that is more appropriate for 50-year-olds in well-paid jobs than for young women at the beginning of their working life.

These women, who are about 20 years old, are the most physically fit to have children. And if the government wants to increase the birth rate, this group must be facilitated, Eskild said.

– If you want to do something about the problem, you could, for example, introduce a full salary for mothers who want a lot of children and who want to be home with their children for a certain period. We must consider it a deed in itself.

– Aren’t we jumping 70 years back in time by introducing such a thing? Do you think that women in present-day Norway want to be housewives?

– Well, there is hardly another profession in Norway that has a lower status than being a housewife today. And then it is clear that no one wants, says Eskild and continues:

– In the academic community in Oslo there may not be many who dream about this, but there are many who think differently. And those who really want a lot of children, and who want to dedicate a few years of their working life to caring for their children, at least should not be fined!

Risk of disease and complications

In Oslo, mothers are the oldest when they become mothers, averaging 31.5 years, while in Finmark they are the youngest, 27.4 years.

In 2018, the number of women giving birth was over 45, which is the largest number of birth control pills in Norway in 1967. Over 40s still make up only three percent of all Norwegian-born people.

“The burden on the health care system is greater financially if you give birth at an older age, with fewer normal births and a higher risk of disease and complications,” Eskild said.

READ ALSO: More and more people are giving birth in their late 40s. One reason stands out

Anna Britt Vika Nielsen, midwife and university lecturer at Bergen University College, has done a lot of research on why Norwegians wait longer and longer to have children – and the consequences.

– Our numbers show that many overestimate a woman’s fertility. “You gamble on a woman’s biology,” Nielsen told about his 2014 doctorate.

The study showed that the risk of premature birth or stillbirth increased at the age of 30-34 years. If a woman passes the age of 35, the risk increases further and is compared to the risk factors associated with overweight, obesity and smoking.

Should the gynecologist address the issue?

From a physiological point of view, the conclusion is relatively unequivocal: A long wait to have children makes pregnancy difficult and increases the risk of disease, complications and stillbirth.

When the government also encourages more children, why is this not a permanent point of any consultation with a gynecologist with women who explicitly want children?

“It is quickly perceived as crossing the border if you, as a gynecologist, completely unwantedly encourage women to consider getting pregnant,” said Jorun Thoring.

– Young women are enlightened, they know they have a biological clock. If my patient has a condition that affects fertility, then I go to him naturally. But if I have a woman in her mid-20s for a cell sample who does not address the subject of children at all, then many will feel uncomfortable saying, “Have you thought about having children?”

– Even in cases when you mapped that the woman is in a relationship and that she wants children?

– Yes But this depends entirely on the situation and the patient, sometimes the conversation flows so that you enter it. And although women who want children must know that they should not wait too long, we should not stress them either.

READ ALSO: Does Dad’s Age Matter? Yes, research shows

Gynecologist Nina Willumsen agrees.

– I take it if I notice that the patient is receptive to it and if I know that it is a woman in a relationship who wants children.

Brenden at the Livio IVF Clinic considers it positive that gynecologists address topics with young women when appropriate.

– It is very different from a gynecologist to a gynecologist how much they inform about this, but I think it is important. You may hurt someone or worry, but that’s much better than knowing later that you did not have as good a time as you thought.


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