Those who bash women for 'delaying motherhood' are hypocrites, don't understand human reproduction

Having reached the advanced age of mid-thirties, my attention is called quite often to articles and opinion pieces in the news regarding us stubborn, career-driven harpies who refuse to reproduce until we are good and ready, only to find that after the witching year of 35, things aren't so easy. Your eggs are old, lady! Give up and get a cat. Serves you right, anyway. The Daily Fail is full of these types of pieces - 'personal interest' stories about some poor 40-year old woman who would give up all her success, designer shoes and non-essential organs if only she could go back and have a kid at 20. Or worse: a woman who did manage to have children after 35 or 40, but is now too old and decrepit to chase them up into trees or stay awake during Mommy and Me.

Now I can't be strictly sure that there are more such stories than before, (since when I was a wee sprinbok in my twenties concerned only with non-procreative sex, drugs and rock-and-roll, and that f**king career, I likely would not have noticed them anyway), but from all the apocalyptic yelling going on about it of late, it would certainly seem as if humanity is in decline: no one is having any babies, and the end is nigh, and it's all your infertile fault, thirty-something lady. Except, not so much. In the US, where much of the yelling is happening, infertility rates are on the decline, and not because more people are having fertility treatments; this latter statistic has remained flat since 2002. In the UK, adult infertility numbers are being linked more and more to male infertility, with "male factors now accounting for 30 percent of fertility problems - the same as female factors". Even in Europe, where falling fertility rates (ratio of live births in an area to the population of that area) since 2008 are being flagged as alarming, they are closely linked in the research to the economic recession. That is, countries like Spain and Greece which fared among the worst saw the sharpest decreases in fertility rates, while those with better performance recorded no change or even increases. In other words, it's less about women's 'selfish choices' (whatever those are) and more about real or perceived and/or future financial constraint. Even the Daily Fail is forced to admit the relationship between financial situation and reproductive decisions. A similar argument can be made in Latin America and the Caribbean, where fertility rates are in fact falling, though in general not yet having reached the below replacement levels of 'developed' countries. The region as a whole still reflects Bloom's 'demographic dividend' - with an economically active population that is greater than the dependent population - but this may not last much longer, particularly in the Eastern Caribbean. Still, high levels of migration in the working age population are more likely behind this than Caribbean women's refusal to have children.

And this new debate, if not presented as willful non-compliance in the business of populating the earth, is presented as emerging wisdom to fill some gap in knowledge: women have simply had the wrong information. Hey ladies, I know you thought you could wait forever and carry out your own, selfish lady-business before reproducing, but nuh uh, missy, NEW RESEARCH shows you're about to expire. As someone who has owned a uterus for over thirty years, let me say this: we know. I'm not saying that every woman everywhere is in possession of an identical body of knowledge. In fact, we know this not to be true, which is part of the reason sharing information on sexual and reproductive health and access remains important. But a high percentage of the target audience for this blame-a-thon - professional women with tertiary or advanced technical education - already. Know. They are all too aware of their declining fertility. This is one of those cases in which knowledge on its own cannot translate into action. In simpler terms: even armed with this information, what would you have them do? Certainly not run out and fall pregnant by some random, which itself attracts its own brand of she's-a-witch vilification, and is the basis of much urban legend. Everyone knows someone who knows someone whose dressmaker's neighbour's domino partner was tricked into fatherhood by some desperate thirty-something. Always something with these women - either they're 20 and poking holes in condoms to trap a cricketer (cause we all know how deep cricketers are rolling), or 30 and going off the pill so their boyfriend will marry them goddamit, or 40 and having one night stands with friends/strangers, then spiriting away their sperm. Tricky tricksters.

The thing is, every reproductive choice a woman makes at this age is criticized.
Happily child-free? You're selfish and just want to keep your flat belly and boozing ways.
Unhappily child-free? Your fault. You used to be selfish and just wanted to have your career, flat belly and boozing ways.
Child-free, single and trying to conceive? Hoor! Children are for couples. And what about your poor, fatherless child? Single mothers are everything that's wrong with the world. You're selfish and just want to have a child to love you.

Herein lies the hypocrisy. And even had they had this knowledge earlier, before it was Too Late, the same applies.

Me explico. Growing up in Barbados, getting pregnant was the worst thing you could do. Not just as a teenager, but anytime before you had secured your place as a DoctorLawyerBankmanager. I'm serious. The Worst Thing. Teenage or 'early' pregnancy was blamed for all the ills of society, directly or indirectly. Boys are under-performing in school? Teenage pregnancy (and girls' sexuality). Never mind that the boys' (teenage fathers') asses are sat in classrooms while the girls are the ones run out of school with pitchforks. The dubious problem of society losing its morals? The dubious explanation of teenage pregnancy. Drowning at Miami Beach? Teenage pregnancy. Winston Hall escaped from jail again? Teenage pregnancy. And so on. It doesn't matter what issue is at hand. Invariably, in any meeting anywhere on the island, someone is going to raise his hand confounded that we are four minutes into the session and no one has brought up the scourge of teenage pregnancy.

None of this was lost on the generation of women now in our mid-thirties. In the Caribbean, for children of the working class, education - and I'm not talking just high school I'm talking first or advanced degree - is the handful of magic beans. You had better get it and stick with it until you can prove to people that your family is officially out of the working class. So for women, pregnancy is to be avoided at all costs even into your twenties. Of course, people get pregnant in their early twenties and are not made to wear a scarlet A, but it is hoped in general that you get your papers before you get your pickney. And then there's the whole wedlock business. I noticed growing up that the least Christian of Caribbean people could utter the phrase 'out of wedlock' with the highest amount of reverence - for wedlock. The single mother business was nothing to be admired, so there's another delay. No babies yet. Get your papers, get your husband. And this is what I mean about how reproduction works. In general and for most of history, for a heterosexual woman, if you want a biological kid, you find a man. He has the rest of the genetic material required. One cannot just grow a baby by sheer force of will. So this emphasis on the selfishness and willfulness of women is just silly. Are we supposed to be selective in partner for all other purposes save for that of reproduction? It seems to me the place to be most selective.

At lunch with an older woman friend recently, I saw a man she knew say to her, in disgust: "Why don't you go and get your children? What else you waiting for?" She said, without hesitation, "I going when I leave here. Where they selling?" And that's really the point. Apart from the inappropriateness of commenting on a person's reproductive choices, have we forgotten the several variables involved? Some of which we have all actively enforced throughout that woman's life cycle and until this point? I can't help but consider that in small societies such as ours, we see women who have 'opted for' marriage and/or children by 35 as well-behaved, and we are pleased. Whether that has meant a great, old-fashioned love and family story (I know some) or settling for marriage to some less-than-adequate (in her estimation) dude so babymaking could ensue, or something else, we can more readily live with a woman who has accepted misery as a cost of motherhood, than with one who has, for whatever reason, not chosen motherhood at all.

Most readers could guess my private and public position: child-free by choice? Ok. Child-free and trying at 39? Ok. Adopting? Surrogacy? Platonic co-parenting? Whatever. Not only are the success stats not as dire as the flailing people suggest, but there are several paths to happiness.

But what strikes me is that just as a generation of women hits 35-44 and are grappling with their reproductive choices, we are now, conveniently, getting over some of our puritanism just enough to discover that in fact, 'early' pregnancy is not the worst fate that could befall a woman and society. No pregnancy is. I tell you. If it isn't one thing - and by 'thing' I mean false set of values based on nothing but ascribed to all - it's another.

A right to sound, dignified health care

*Also posted today at BelowTheBelt.

I suspended my work as an economist to, among other things, become the Programme Director of an NGO that I helped found, called the Women's Health Advocacy Network (WHAN). I sometimes get the sense that some people (apart from my family and close friends who are my biggest fans and think me something of a superstar, as I do them) don't understand that: they don't understand creating something because you think it should exist, because it is necessary. The conversation often goes like this:

Person: So what are you doing now?
A_D: I'm a writer, and I work with an organisation called WHAN - Women's Health Advocacy Network.

(The writing part does not register at all. I might as well have said "Oh I'm an eater...and a part-time cougher." So they just gloss right over that part to the other thing that sounds more like a job, with acronyms and such.)

Person: Oh! And whose company is that?
A_D: Well it's not really a company. It's an NGO that looks at issues of women's health and sexual and reproductive rights in the Caribbean, and educates women on their patient rights...how to be agents in their own health care.
Person: Right. And who runs that?
A_D: Well I do. Along with some other very bright women. We started it.
Person: Yourself? But who pays you?

This is where people start to look skeptical and confused. They seem to be puzzled by the notion that I could have the audacity to be dissatisfied enough with the way things are being done to get up off my ass and do something about them myself. They apparently expect me to take a regular job like everyone else, and then spend all my time complaining that I had to wait two hours in the waiting room at the doctor's office, and then another hour waiting naked on his table, after which he spent 30 seconds looking at my vagina and zero seconds looking at my face. Or they expect that if I step out on my own, it should be because I've built an online business or invented some device that I can hawk on QVC, which - don't get me wrong - is never out of the question. Or they also expect that WHAN must be a little group of forlorn women who park our behinds in front of supermarkets clanging our tins for some pennies, rather than the board-run, non-profit corporation that it is.

Now there's nothing wrong with a 'regular' job. I had one, and many people I know have one. In fact, I have one now, it's just that I created it myself because it is necessary, rather than waiting for someone else, someone presumably with more power and influence, to create it and then deign to give me a job. I've decided to first earn - through work I've previously done - and then own, my power and influence. And to seek to grow it on my terms. And also to help other women own theirs. Because that attitude that leads people to believe that I don't have the right to get up and do for myself, as my mother would say, is the same one that has women believing that they don't have the right to demand to be listened to by doctors, and to be treated with dignity and respect. It's the attitude that says that as Caribbean people, as Black people, as women, as Black, Caribbean women, we should only be takers of what is given to us: takers of someone else's job that they've created and offered, takers of someone else's economic policies, takers of someone else's health care that they administer in the way they think we deserve.

I grew up in a time when our mothers were so pleased to be accessing free government health care, that they saw doctors and nurses as gods, and seemed afraid to question them, in part - and this is true of most societies - because they had knowledge our mothers did not have. But they were also afraid to challenge them lest they withhold their care, time and medicine, which many of them doled out as if we were begging, as if it was their own to control, and not the state's. As people have started to do better, and private, paid care has become the standard, that attitude has been slow to change on both ends. Many of us still believe that we're lucky to be sitting in that doctor's office, so we'd better shut up, nod, smile, and try not to cause any trouble. And many doctors still act as if they are gods come down from on high to save the stupid natives from themselves.

Well that attitude is not only annoying as all get out, but it at best potentially delays healing, and at worst, kills people. WHAN now focuses very heavily on HIV/AIDS and other STIs; sexual and reproductive decision-making including abortion; and violence against women. But we were thrust into existence on the basis of patient rights and education, because I, for one, was tired of the assumption on the part of doctors that I had nothing at all to contribute to my own health care, and tired of hearing all the stories from my friends. One of how a doctor failed to diagnose her breast cancer because he saw she was in her thirties and therefore dismissed the lump she had felt; another who eventually almost committed suicide because when she approached her doctor about post-partum depression he asked her why she couldn't just be happy, she had a baby now, and why couldn't she just get over it. And yet another who had to beg her doctor for a prescription to help relieve the symptoms of her genital herpes. Because he said it was no big deal, it's just a sore, and the medication is expensive.

I could go on and on and so much further on. And I know people will sing the old song about patients not being knowledgeable, so doctors assume a blank slate in approaching treatment. In my experience, some doctors don't assume a blank slate: they assume a stupid one. And there is always knowledge to be had from a patient if you use your limited time wisely to get it. In any event,WHAN seeks to work on both ends of the relationship, but primarily to bolster patients' awareness of their own knowledge gaps, to help fill those gaps, and to give patients the tools to make their doctors fill those gaps. You have to know what you don't know, and then you have to claim the right to find out. It is for all these reasons, and so many more, that WHAN exists, works, and grows every day.

Is it coming? 'Cause I am

Viv Groskop writes in The Guardian today about women who climax during labour. The writer talks to Amber Hartnell, a mother whose natural, water-birthing process is featured in the documentary film Orgasmic Birth, and who says she did not actually experience pain during labour, but rather, intense [orgasmic] sensations. The film examines such experiences in the broader context of ""undisturbed birth" - natural labour in a home setting, without drugs, or even gas and air."

According to the article, and as one would expect, the notion of orgasm during birth is meeting with disapproval and opposition in several places [emphasis mine]:

The response to the film has been one of both fascination and horror. For many women the idea that childbirth can be orgasmic is at best hippyish and possibly offensive - a notion that at once piles pressure on to women to find pleasure in giving birth, and seems to deny the pain the vast majority experience. One heavily pregnant blogger writes that she "can understand pain being natural in childbirth and letting your body take over and making it as enjoyable as you can. But orgasmic? No. Whoever finds that orgasmic needs help, in my opinion." Another suggests that they "wouldn't like to think my mother had an orgasm while giving birth to me."

I'm not sure why this would be a problem. What does it mean that my mother may have climaxed while giving birth to me? Does this writer feel like she had sex with her mother? Because if we're counting being forced out of someone's uterus, I need to change the date on that "had sex for the first time today! w00t!" entry in my diary.

The film's producer, birth educator Debra Pascali-Bonaro, says a woman's ability to feel intense physical pleasure during childbirth is "the best-kept secret". So well-kept that many women would argue that the phenomenon does not exist. There is debate over whether these women have really been experiencing a sexual climax, or are simply having some form of sado-masochistic response, mistaking intense pain for pleasure. After some critics in the US wrote the idea off as a "fairytale", one of the film's orgasmic subjects, Tamra Larter, a mother of two from New Jersey, clarified that she "felt something resembling an orgasm" and that the sensations she experienced "were something different than sex, but similar enough I feel OK using the word orgasmic."

G-spots were a 'fairytale' too. In any event, I don't see that this precise definition matters, or why we feel the need to invalidate what women say they experience because it makes us squirmy. Is it that we would only like a woman to achieve orgasm during a narrow set of controlled circumstances in which she is 'being satisfied by' a man either directly during partner sex or indirectly while presumably thinking of a man during self-pleasuring? (People who think this way tend to account for lesbian relationships as man-haters trying to approximate the heterosexual act of sex, so men are pretty much central to that orgasm too.) If so, there are some spin bikes in various gyms around the world that may have to be brought in for questioning.

Or is it that childbirth should hurt, g-dammit. Otherwise, without the fear of (i) being forced to give birth (which is the 'children as punishment' agenda that some pro-life advocates advance) and (ii) the accompanying excruciating pain, what's to stop women from having all the sex they want? The earth would descend into madness!

Perhaps some of us are just plain uncomfortable with mixing sex and childbirth. It's not like they are in any way associated with...oh wait.

Women in the documentary have been criticised online for kissing their husbands too much during labour, which some viewers find distasteful.

So in a scenario where people are coming out of my vagina, it's kissing my partner that you find too intimate to watch. Got it. I'd imagine these are the same people who find swearing during contractions unladylike. You would think that further partner bonding during labour would be encouraged.

British birth specialist Sheila Kitzinger, who was also interviewed for the piece, has an explanation for the discomfort people feel over the issue:

"It crosses the margin of decency - which I think is wrong," says Kitzinger, "We're told that sex is different from childbirth. In the same way, it is considered indecent to experience intense physical satisfaction from breastfeeding."

I agree, as the article acknowledges, that orgasm during childbirth should not be held up as some standard for women to achieve, and of course we don't want to encourage the "Well my ex-wife orgasmed during labour. She loved it. What's wrong with you?" dialogue. That would be insane. But people need to get over the policing. If I ever find myself in labour, and happen to climax when all I'm expecting are paroxysms, rings of fire and general torture, then I say bring on the O.