We Need To Protect Options for Women
Guest Author: Dr Madeline DiLorenzo
note - views and endorsements made in this guest piece do not represent the views/endorsements of BMGC - this is an independent platform to share health related opinions
Being a parent is one of the most important roles a person can play in society, but it is often seen as secondary to other types of work. Having a consistent, supportive parent is one of the most crucial influences on a child’s ability to build a healthy self-image, navigate relationships, and conduct themselves well in society (1). Given this, many people are being more thoughtful about when and whether they want to become parents.
Over the past 50 years, there has been a shift among many to have children later - in 2022, the median age at first pregnancy was 30, whereas it was 22 in 1972 (2,3). This is not to say that having children earlier should be viewed negatively - some people know early they want to be parents and assume that role with skill and enthusiasm. But thanks to increased access to birth control, abortion, in vitro fertilization (IVF) and egg freezing, women are now able to make an informed decision about whether and when they want to have children - independently or with a partner - in a way that is fundamentally different than it was over 50 years ago.
For those contemplating parenthood, the road isn’t always straightforward. Maybe you have a health condition that makes it challenging to conceive and you might need to undergo IVF. Maybe you haven't found the right partner yet. Maybe you want to be a solo parent but you are figuring out the logistics of navigating that journey independently. Maybe you just aren’t sure that you want to have children, and having additional time would enable you to thoughtfully make this most important of decisions.
My own thoughts about whether I would like to be a mother have shifted over the years. When I was younger, I imagined I would have kids by my early 30s. As time went on, I realized that having children wasn’t something I wanted no matter what. For me, having children was context dependent. At least for now, motherhood isn’t something I want to pursue independently, but I would consider it with a partner. When I was nearing the end of my medical training, I decided to freeze my eggs to give myself some more time.
I realize how incredibly fortunate I am to have been able to freeze my eggs. It’s a very expensive undertaking - one cycle ranges from $7,500 to $18,000, and some women need to undergo more than one cycle to obtain enough eggs (4). After that, the storage fees range from $500 to $1500 a year. My employer covered most of the costs, but I have many friends who had to pay out of pocket and there remains a larger racial equity gap in access to egg freezing - two thirds of those who undergo the procedure each year are white and among the non-white women who undergo the procedure, most are Asian American (4,5).
Furthermore - for those who do undertake it - egg freezing is no easy feat, even though it’s often discussed as if it’s just one more item to check off your to do list. Nearly every day for two weeks, you have to go to the doctor to get bloodwork and ultrasounds done. Every night (and later in the protocol, in the morning as well) you inject yourself with hormones, some of which require you to mix the medication yourself. Even as a doctor, I found this to be daunting. I gained about 11 lbs of water weight over 10 days which was incredibly uncomfortable. After the procedure, I had a mild case of ovarian hyperstimulation syndrome and was so swollen that I was put on fluid restriction and barely left my apartment for three days. The entire experience made me realize how much we expect pregnant women to do without batting an eye - and I was only doing this for two weeks. It was also something that at the time I didn’t want to advertise - I had told a few close friends, but for the most part went about my days as if everything was normal.
Despite the challenges, I would make the same decision to freeze my eggs again. Egg freezing has given me more time to consider a major life choice and the space now available to me has been freeing. While egg freezing remains a relatively uncommon procedure, more women are pursuing it - from 2020 to 2021, the number of egg freezing procedures in the United States increased by 46% (4). At the same time, IVF is becoming more common and in 2022, accounted for 2.5% of births in the US (6). The Democrats have tried twice now to pass legislation guaranteeing a right to IVF, but Republicans have denied it both times (7,8). While Donald Trump has made sweeping claims that he would make IVF free if elected President, elected officials such as Senator Tammy Duckworth have pointed out that even if Trump were to implement such a policy, it would be effectively useless in states that have laws that bar access to IVF if embryos are considered persons. This is also occurring in the context of increasing restrictions on abortion and, possibly birth control methods, if Trump wins the election and there is a Republican majority in Congress. All of this threatens to reduce women’s agency in their decision about whether or not to become parents.
At the end of the day, pregnancy, egg freezing, and IVF are all incredibly rewarding but challenging. As a society, we must implement policies that make all of these things - as well as -041e axzchildcare and education - more affordable and accessible for those who decide to become parents. Kamala Harris and Donald Trump couldn’t be further apart on these issues. Voting for Kamala Harris is an action that will protect people’s decision-making power around whether to have a family and provide them with support if they do - which is not only an investment in them, but in society at large.
References
Instagram. The Holistic Psychologist. Accessed October 13, 2024: https://www.instagram.com/the.holistic.psychologist/p/C-fzpHZv9xR/
NBC. Motherhood deferred: US median age for giving birth hits 30. Access October 13, 2024, at: https://www.nbcnews.com/news/motherhood-deferred-us-median-age-giving-birth-hits-30-rcna27827
United States Centers for Disease Control. Median age of mother by live birth order, According to Race and Hispanic Origin: United States, Selected Years 1940-1999. Accessed October 13, 2024, at: https://www.cdc.gov/nchs/data/statab/t991x05.pdf
Sussman, Anna Louise. Why Are Women Freezing Their Eggs? Look to the Men. The Atlantic. September 24, 2023.
Guerrero, Jean. I Froze My Eggs to Reclaim My Right to Rest. The New York times. October 14, 2024. Accessed October 15, 2024 at: https://www.nytimes.com/2024/10/14/opinion/latina-egg-freezing.html
American Society for Reproductive Medicine. Press Release. Accessed October 13, 2024: https://www.asrm.org/news-and-events/asrm-news/press-releasesbulletins/ivf-assisted-pregnancies-constitute/
Senate Republicans block bill to ensure IVF access for second time. The Guardian. September 17, 2024. Accessed October 13, 2024 at: https://www.theguardian.com/us-news/2024/sep/17/senate-vote-ivf-bill-democrats-republicans-election
Walsh, Deirdre. Senate Republicans block IVF bill, as Democrats elevate issue ahead of November election. NPR. September 17, 2024. Accessed October 13, 2024, at: https://www.npr.org/2024/09/17/g-s1-23414/senate-republicans-block-ivf-legislation
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