In celebration of Labor Day, here’s a blast from the past on this blog.
It’s my take on the many aspects of Women’s Work–both in the home and outside it, in honor of the close conjunction of Women’s Equality Day (the suffrage anniversary) and Labor Day.
See you at the pool!
Today is Women’s Equality Day – the 93rd anniversary of the passage of the 19th amendment to the US constitution. My op-ed in today’s Houston Chronicle.
Women Voted in Texas in 1918 – from the Carey C. Shuart Women’s Archive & Research Collection, UHouston
How about full equity by the 100th anniversary in 2020?
Women’s suffrage Texas-style
Ninety-three years ago, when the 19th Amendment to the U.S. Constitution granting women the vote passed on Aug. 26, 1920, it was old news in Texas. Back then, Texas was at the forefront of positive political change for women; lately, we’ve had some setbacks.
In 1920, women had already been voting in Texas for two years, since Texas Woman Suffrage Association president and New Waverly native Minnie Fisher Cunningham and her co-agitators in 1918 had won women the right to vote in primaries. As the Democrats dominated Texas at the time, voting in the Democratic primary meant women had their say in state politics. As with any group, voting supplied the only means by which female citizens’ interests would be represented in policy-making.
In 1919, Cunningham was recruited by the National Woman Suffrage Association to lobby Congress, and her efforts paid off not just for her state but for her nation. Soon after, women won the national vote, and “Minnie Fish” as she was sometimes known, was among the founders of the national League of Women Voters.
Minnie Fish’s activism was born of bold ideas and hard experience. In 1901, she’d become one of the first women to receive a degree in pharmacy in Texas; she worked as a pharmacist in Huntsville for a year, but, finding that she made half what her male counterparts did and having other options, she quit, noting later that the inequity in pay “made a suffragette out of me.”
As we know, even after women got the vote, the pay-equity problem didn’t disappear; it’s still causing controversy here and nationally. Pay discrimination by gender became illegal in 1963, but that law has no teeth because there’s no oversight mechanism to ensure that people are paid fairly (in many businesses, it’s a firable offense to ask your coworkers what they’re paid) or for punishing in state court those who pay women less.
The recently vetoed Texas Lilly Ledbetter law didn’t directly require evidence that employees were paid fairly; it gave women the right to sue if discrimination was discovered to have occurred for more than 6 months after it began. But even that limited recourse seemed too threatening to some businesses. Will pay inequity make activists of enfranchised 21st-century Texas women, as it did with Minnie Fish? Stay tuned.
Fertility Politics
Terms like “woman suffrage” sound antique today, but the issues debated 93 years ago are very current. Though they may seem separate, reproductive rights, economic rights and voting rights are intimately linked and affect whole families, not women only.
Texas still is at the feminist forefront in some respects. For example, while neither New York nor Los Angeles has ever had a female mayor, and Chicago had one for one term in the early ’80s, Houston has had one for 14 of the past 32 years. But in other respects, we’re losing ground.
The 2011 cuts in poor women’s access to birth control through the drastic reductions in funding for the Women’s Health Program in Texas is predicted to result in thousands of unplanned births in the next year, at a cost of millions to taxpayers. Likewise, the expansion of “safety” rules in abortion clinics will drastically cut reproductive health services of all kinds to poor women across the state. Pharmacist Minnie Fish would not be proud of us. Unplanned births increase poverty levels by drawing young parents away from their educations into lifetimes of multiple low-wage jobs to support their kids, who themselves may repeat the cycle, and reduce the state workforce skills level when increased skills are needed.
When women who already have all the children they want are denied access to reproductive services, all the members of their families suffer. Older children’s hopes are diminished as each unsought new arrival depletes the resources of the group. And their parents, being busy and often uninformed about civic issues, are less likely to vote.
As Minnie Fisher Cunningham knew almost a century back, “social issues” (aka, women’s lives) are serious political and economic stuff. As proud heirs to the fairer world she helped realize, it’s the responsibility of Texans – male and female – to continue her tradition and move us forward.
The Minnie Fisher Cunningham papers live in the Carey C. Shuart Women’s Archive and Research Collection in the University of Houston Library.
I have a story up on theAtlantic.com site about birthrates and childcare: here.
The story was published with a confusing title, which was soon changed to the current title (same as here), so got some confused comments in response initially.
My concern: There’s lots of recent talk about raising the birthrate, as though that were a question apart from women’s lives and careers, which would be most directly affected by any “family policy” decisions. The fall in the rate was overwhelmingly due to declines in births to younger women, going to college in larger numbers and positioning themselves to better afford kids later. Putting pressure on young women to have kids and step out of the education pipeline would not be a good strategy, nor is it likely to be successful.
Argument: Instead of attempting to re-produce old social scripts, policy-makers could learn from the new scripts that women are writing and enacting, which allow women to participate more consistently in the workforce and in social decision-making. First step: good, affordable childcare for all. As I’ve argued previously, this will not only assist with skills development for kids and their parents, it will create jobs.
Such new jobs would intersect interestingly with the issue of how many workers are needed to run (and reproduce) the world once gender stops operating as a work stratification system (which it has always been and still is in major measure, but that dynamic is what’s in flux now). All the parts of this equation are morphing fast. What gender are robots?
The NY Times‘ Room for Debate online forum asked “Should women delay motherhood?” That’s a problematic question, presuming that “experts” know what women “should” do better than they do themselves. Here’s my reply along with those of six others: http://www.nytimes.com/roomfordebate/2013/07/08/should-women-delay-motherhood/delayed-parenting-can-empower-women
My book on the biology, politics, economics and sociology of later motherhood begins with an Atlantic magazine article urging women who want a career to delay their families until they have completed their educations and established at work. The date? 1934.
Since 1960, hormonal birth control has allowed millions to do so. The average age at first birth for American women is 25.6, a new high (30 for college grads). Many wait longer.The birthrate’s at an all-time low, largely because of big declines among young women – many of them college bound. The only age group in which birth rates rose in 2011 was women 35-44.
There is no “should” in this story: women are delaying, globally. The “experts” are just catching up to explain why. Women figured out early that delay provides a shadow benefits system in our family-unfriendly world: higher salaries, more flexibility and higher marriage rates, as well as more interest in staying home at night.
Along with personal benefits, delay has been an engine of feminist social change because it allows women – who for millennia were kept busy, uneducated and out of decision-making circles by early and unending fertility – to begin to have a voice in policy. Change creates pushback, as today’s harsh fertility politics demonstrate.
Delaying is not without risk; eventually fertility wanes. But as Jean Twenge and I have documented, the odds of becoming pregnant in your late 30s are much betterthan the media reports. Conversely, the odds after 42 are worse than stories about celebrity late-40s births suggest. We’re told simultaneously that nobody’s fertile after 35 and that everybody can be at 45. Egg donation and egg freezing can extend fertility sometimes, but they are costly and not guaranteed.
Part of the blame lies with (some) fertility doctors, who benefit from tick-tock anxiety among younger women and inflated hopes among older ones. News media are also culprits in fertility scaremongering.
Women should have clear fertility data to make informed decisions. Without that, it’s no use knowing that later moms are happier, better off and longer lived, and that their kids do better. On the other hand, treatments do work for some, and many women adopt, foster or enjoy volunteering with kids. Others find they’re fine without children. (Full disclosure: I’m a mother of two, one biologically at 39 and one adopted when I was 48; no IVF experience.)
The bottom line is that late fertility works for many now, but isn’t itself the goal. Many of our infertility issues would be best addressed through pay equity, a good, affordable national child care system and shared parental leaves, so people wouldn’t have to wait to afford kids. Federally mandated fertility coverage would help too. To date, birth control has allowed some women to trickle up into policy roles. But because the support infrastructure hasn’t changed, women haven’t been able to move up in sufficient numbers to change it much. Lately though, the discussion has intensified. It’s up to us to decide when we’ve waited long enough.
Last week the CDC issued its final report on birth data for 2011. That includes final adjustments and new charts, but no major changes from the preliminary report issued last October. The final confirms that the general fertility rate for 2011 was the lowest ever reported: 63.2 births per US woman aged 15-44.
It confirms too that the number of births fell in all age groups except women 40-44.
On the birth rate side, the rate fell 8% –in one year!– among women 15-19, to another historic low. The rate fell 5% among women 20-24 (also to an historic low), and 1% for women 25-29. It held steady for women 30-34 and rose 3% among women 35-39 and 1% among women 40-44.
One new datum is the average age at first birth for US women: 25.6–a new high.
CDC Provisional Brief on 2012 Births
In June, the CDC released a two-page summary of the number of births in 2012, not broken out by age, race or other factors. They report a rise of 4407 births over 2011 – and no change in the general fertility rate (still 63.2).
CDC Figure. Births and fertility rates: United States, final 2005–2010, preliminary 2011, and provisional 2012
NOTE: The 2012 number of births and fertility rate are based on 12 months of provisional counts ending with December 2012.
SOURCE: CDC/NCHS, National Vital Statistics System.
For egg freezing, a new procedure, there’s limited success rate data available because few of those who’ve frozen their eggs have come back to have them fertilized and implanted, but here’s a link to an info and advocacy website called Eggsurance.
A May 2013 study finds that to date “Women whose SF [slow frozen] eggs were preserved before age 30 had a greater than 8.9% likelihood of implantation per embryo which declined to 4.3% for embryos from eggs frozen after 40. For vitrification [VF] cycles, implantation success declined from 13.2% for embryos from eggs frozen at 30 to 8.6% for embryos from eggs frozen at 40.” Success rates may change as procedures evolve. This is only the first layer of data, assuming these eggs have formed embryos, so there’s lots more to explore in thinking this through for yourself. Cost: in the $10,000 range, plus meds and annual maintenance fees.
CDC ART report, 2010 (latest final data available) & 2011 preliminary data
ART (Assisted Reproductive Technology) currently assists the conception of about 1.55% of US births. In 2011 (preliminary data), that was 61,610 babies born to 47,849 mothers (or maybe a few less mothers, if one woman had two deliveries in one year). 163,038* ART cycles were performed, with a success rate of 29.3% overall, and a failure rate of 70.1%.
Snapshot (detailed chart below): success rates per cycle with woman’s own eggs within the population of people trying (who generally have not succeeded on their own without IVF for some amount of trying, so it’s not representative of success rates at getting pregnant on your own at those ages): Under 35: 41.5% / 35-37: 31.9% / 38-40: 22.1% / 41-42: 21.4% / 43-44: 5% / over 44: 1%
Success rates per transfer to womb, of embryo made with your own eggs (a smaller set than the cycles): Under 35: 47.6% / 35-37: 38.3% / 38-40: 28.1% / 41-42: 16.7% / 43-44: 7.4% / over 44: 1.8%
Success rates per transfer with donor eggs at any age: Fresh: 55.8% / Frozen: 34.9%
To track annual success rates on IVF attempts by age (with non-donor eggs) and overall (with donor eggs), go to the National Summaries on the CDC ART (Assisted Reproductive Technologies) site.
They give you some helpful info, but it’s broken down by the number of cycles, not by the numbers of people involved (so you can’t tell when a person is attempting several times, or what proportion of the set of people trying end up with a live birth).
Success rates for women working with their own eggs are broken down by age, but not the rates for women working with donor eggs — because “patient age does not materially affect success with donor eggs.” The drawback there is that you don’t see what numbers of women in each age range are attempting egg donation — but I assume the majority are over 40 (let me know why if you presume otherwise).
While the success rates for these technologies have improved over time overall, especially for younger women, the numbers of attempts and of births declined between 2008 and 2009, along with the total number of US births, but have resumed their rise since then. (Chart data.)
Pools of attempters are limited to people encouraged (or allowed) by their doctors to proceed (so again, it’s people having issues with fertility, but not too many, so it’s not the set of all people), as well as by funds available.
About.com lists the current cost of an egg donation cycle at $25,000-$30,000, not including medications, and the cost for non-donor IVF as $12,000-$15,000 per cycle.
2010 Summary CDC National ART Pregnancy Success Rates
| Type of Cycle | Age of Women | |||||
|---|---|---|---|---|---|---|
| <35 | 35-37 | 38-40 | 41-42 | 43-44 | >44 | |
| Fresh Embryos From Nondonor Eggs | ||||||
| Number of cycles | 41744 | 21369 | 21741 | 10122 | 4501 | 1347 |
| Percentage of embryos transferred resulting in implantation | 36.5 | 26.9 | 17.7 | 9.6 | 4.2 | 1.7 |
| Percentage of cycles resulting in pregnancies | 47.6 | 38.8 | 29.9 | 19.9 | 10.6 | 3.2 |
| Percentage of cycles resulting in live birthsb | 41.5 | 31.9 | 22.1 | 12.4 | 5.0 | 1.0 |
| Percentage of retrievals resulting in live birthsb | 44.4 | 35.4 | 25.3 | 14.8 | 6.3 | 1.4 |
| Percentage of transfers resulting in live birthsb | 47.6 | 38.3 | 28.1 | 16.7 | 7.4 | 1.8 |
| Percentage of transfers resulting in singleton live birthsb | 31.4 | 27.3 | 21.5 | 13.7 | 6.6 | 1.6 |
| Percentage of cancellations | 6.6 | 9.9 | 12.8 | 16.4 | 20.6 | 25.5 |
| Average number of embryos transferred | 2.0 | 2.2 | 2.6 | 3.0 | 3.2 | 2.7 |
| Percentage of pregnancies with twins | 32.9 | 27.3 | 21.6 | 15.0 | 8.1 | 2.3 |
| Percentage of pregnancies with triplets or more | 2.6 | 3.1 | 3.7 | 3.0 | 0.6 | 2.3 |
| Percentage of live births having multiple infantsb | 34.0 | 28.7 | 23.3 | 18.0 | 10.2 | 2 /14 |
| Frozen Embryos From Nondonor Eggs | ||||||
| Number of transfers | 12631 | 6195 | 4682 | 1591 | 710 | 432 |
| Percentage of transfers Resulting in live birthsb | 38.4 | 34.7 | 28.4 | 21.5 | 16.8 | 13.0 |
| Average number embryos transferred | 2.0 | 1.9 | 2.1 | 2.2 | 2.2 | 2.0 |
|
All Ages Combinedc
|
||||||
| Donor Eggs | Fresh Embryos | Frozen Embryos | ||||
| Number of transfers | 9866 | 6665 | ||||
| Percentage of transfers resulting in live birthsb | 55.8 | 34.9 | ||||
| Average number of embryos transferred | 2.0 | 2.0 | ||||
A recent article in the Atlantic by Jean Twenge on fertility rates among women 35-39 has lots of people talking about later motherhood again. Her data and argument echo a lot of the points I made in Ready, with particular focus on the disconnect between the data cited in the many tick-tock media stories on fertility decline after 35, and the reality that most women have kids with no problem in the 35-39 age band.
Here’s her good data summary:
One study, published in Obstetrics & Gynecology in 2004 and headed by David Dunson (now of Duke University), examined the chances of pregnancy among 770 European women. It found that with sex at least twice a week, 82 percent of 35-to-39-year-old women conceive within a year, compared with 86 percent of 27-to-34-year-olds. (The fertility of women in their late 20s and early 30s was almost identical—news in and of itself.) Another study, released this March in Fertility and Sterility and led by Kenneth Rothman of Boston University, followed 2,820 Danish women as they tried to get pregnant. Among women having sex during their fertile times, 78 percent of 35-to-40-year-olds got pregnant within a year, compared with 84 percent of 20-to-34-year-olds. A study headed by Anne Steiner, an associate professor at the University of North Carolina School of Medicine, the results of which were presented in June, found that among 38- and 39-year-olds who had been pregnant before, 80 percent of white women of normal weight got pregnant naturally within six months (although that percentage was lower among other races and among the overweight). “In our data, we’re not seeing huge drops until age 40,” she told me.
The new 2013 data from Rothman and Steiner supports Dunson’s data, which was also much more in line with my own experience and the experience of women I knew and interviewed. Here’s my discussion of Dunson’s “European Fecundability” data in Ready:
If you’re 35, you’re probably fertile: A study from the 1950s indicated that, while 11 percent of women could have no babies after 34, the rate rose to 33 percent after 39, and 50 percent after 41. Though this data may not accurately reflect the current fertility scene, no more reliable data for women 35 to 50 is available today. Some recent results do corroborate the general trend of the 1950s study for women 35 to 39, however. Data collected at seven European natural family-planning centers in the late 1990s (the European Fecundability Study) indicate that about 90 percent of women not already known to be infertile due to pre-existent issues like endocrinal disorders or surgery who try to conceive between ages 35 and 39 will become pregnant within two years. That’s if they use natural family-planning methods (charting temperature and cervical mucous to more accurately predict when ovulation happens and to shorten time to conception) and have sex at least two days per week. [1] Roughly 82 percent will become pregnant within one year.[2] (From Ready, chapter 6 “Sarah Laughed: Who’s Fertile & How”)
The natural family-planning info echoes Toni Weschler’s fertility awareness method in Taking Charge of Your Fertility and the Creighton Method, used for both avoiding and finding fertile times, and endorsed by the Catholic Church.
Important to note that becoming pregnant is not the same as carrying to term, and that miscarriage rates of established pregnancies (not in the first few days) among women in their late 30s and 40s occur at higher rates than among younger women (Twenge cites a figure of 26% for women 35-39, and another study indicates a rate of 30% among women over 40).
Even including these qualifiers, 35-39 fertility rates are much higher than those indicated in Sylvia Hewlett’s Creating a Life, which cited “the Mayo Clinic,” without any further documentation, claiming
“Fertility drops 20 percent after age 30, 50 percent after age 35, and 95 percent after age 40. While 72 percent of 28-year-old women get pregnant after trying for a year, only 24 percent of 38-year-olds do.” (pp. 216-17).
Completely untrue. But this kind of “data,” along with anecdotal stories from women who haven’t gotten pregnant when they wanted to–not to be ignored but which give you no sense of the big picture–have filled our narrative about fertility ever since (see Ready 2012 for more on fertility scaremongering).
Twenge joins me in wondering why such too-low or otherwise distorted data are allowed to appear unquestioned on so many fertility sites and reports. Certainly anxiety generates profits for doctors and media, and there may be an unwillingness among media reps about overstating fertility, so that people understand that waiting does not work out for everybody (I ran into some of that with Ready).
These reports also feed into the fierce political debate about fertility, birth control, and abortion going on across the nation, by problematizing later fertility inaccurately–as well as the decision to have no children that some women may be comfortable with, but which becomes more difficult to articulate in a context focused on the misery of infertility. No question that fertility does decline, but give women the facts, and they can figure out how that fits with their own sense of what’s important for them and when.
Overstating infertility also carries risks for women and their families. One woman I spoke with figured it was time to get busy when she heard a news report on how a woman’s “loses 90% of her eggs by 30,” even though she and her new husband had planned to wait a few years to establish in their jobs and their relationship. Given the story, she figured it would take a while. A year later she was working freelance from home with baby, unable to afford good care otherwise, and not happy with the situation that had sidelined her career. (College Grads See Big Wage Gains from Delay)
On the other hand, in spite of the tick-tock narrative, many women have figured out for themselves, by observation of people around them and deduction, that delay is possible and that it makes sense for them.
Thus in 2011, with the birth rate at an all-time low, the only age group in which births rose was women 40-44. While birth rates among women 15-24 fell markedly in 2011, and rates to women 25-29 fell 1%, rates among women 30-34 held steady, and rates rose 3% among women 35-39, 1% among women 40-44, and held steady among women 45+. One in 12 first babies had a mom 35+ in 2011, as did 1 in 6.8 overall. 580,357 babies were born to women 35 and over in 2011, including 463,849 to women 35-39, 108,920 to women 40-44, 7,025 among those 45-49 and 585 to women 50 or more.
The low birth rate held steady in 2012, with break outs by age, race and other factors due out in November.
May the fertile discussion continue!
[1] Bernardo Colombo and Guido Masarotto, “Daily Fecundability: First Results from a New Data Base,” Demographic Research 3 (2000): article 5; David Dunson, Bernardo Colombo and Donna Baird, “Changes with Age in the Level and Duration of Fertility in the Menstrual Cycle.” Human Reproduction 17 (2002): 1399-1403; David Dunson, Donna Baird, and Bernardo Colombo, “Increased Infertility with Age in Men and Women,” Obstetrics and Gynecology, 103 (2004): 57-62; Bruno Scarpa, David Dunson, and Bernardo Colombo, “Cervical Mucus Secretions on the Day of Intercourse: An Accurate Marker of Highly Fertile Days.” European Journal of Obstetrics Gynecology and Reproductive Biology 125 (2006): 72-78.
[2] This study estimates infertility (the diagnosis if a couple has been trying consistently to conceive for a year without success) at 8 percent for women aged 19 to 26, 13-14 percent for women aged 27 to 34 and 18 percent for women aged 35 to 39. (The study didn’t look at women over 40.)