The Why Wait Agenda Podcast

How Can We Know and Protect Our Own Fertility, The Why Wait Agenda Meets Karin Hammarberg

Approximately one in every six people experience infertility in their lifetime. In this episode of The Why Wait Agenda podcast we discuss the main causes of infertility – a disease of the reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse – with Karin Hammarberg, an Australian fertility expert and Senior Research Fellow at Monash University. «Infertility, no matter if primary or secondary, is pretty devastating» says  Hammarberg, a registered nurse with twenty years of experience as clinical co-ordinator of in vitro fertilisation programs: «Sometimes people with secondary infertility feel guilty about wanting to have another child, when people might tell them "well, you're lucky, you've got one child – or two children – already". But if you actually had a real hope of having two or three children and you only have one, the grief you feel is pretty profound, and I'm not so sure it's even helpful to try and compare the two». As Hammerberg stated in an article about late pregnancy storylines in tv dramas, previously featured in the Why Wait Agenda – "Mothers over 40: it seems easy enough on TV, but what about real life? [https://www.thewhywaitagenda.org/en/post/mothers-over-40-it-seems-easy-enough-on-tv-but-what-about-real-life]" – the chance of pregnancy is lower for women in their late thirties and forties. «Infertility has a range of causes, but one cause often under-reported is what we call age-related infertility» stresses Hammarberg: «It's becoming a more and more common cause, unfortunately». Hammerberg doesn't think that people know enough about infertility – nor about fertility, for that matter. That's why her «strong passion in life» is to work on «what people can do to actually promote and protect their own fertility, and to make sure they give themselves the best chance of conceiving without having infertility treatments».  And that's precisely what she's doing by collaborating with the website Yourfertility.org.au, a national public education program managed by the Fertility Coalition and funded by the Australian Government's Department of Health and the Victorian Government's Department of Health. «Often infertility is presumed to be a women's problem, but in fact one in three cases of infertility is because of a male factor» points out Hammarberg, who's also Deputy chair of the International Reproductive Health Education Collaboration and a member of the scientific committee of the European Fertility Society: «I hope that with more and more advocacy and information and awareness raising, we can reach a point where everybody understands that it's no one's fault. It's just sometimes biology, sometimes a disease, but it's not a personal responsibility – and no one should be blamed or shamed» fo it.

When gender discrimination is blessed by the Constitutions: The Why Wait Agenda meets Carla Bassu

What have Constitutions got to do with people’s decision to have babies or not? Well, for example, the Italian constitution has an article that states: «Working conditions shall allow women to fulfil their essential role in the family», placing working women in a subordinate position to working men, who are free to work without being forced to fulfil any «essential role».  And an unequal household division of labour and attitudes about egalitarian roles can influence the timing of first births, according to the paper “Why do people postpone parenthood?” by professor Melinda Mills (also a guest of our podcast, twice!) amongst others. «Working conditions shall allow women to fulfil their essential role in the family», then. It wasn’t all that shocking seventy years ago, when the Italian Constitution was written. But it's quite different now. The guest of this episode is Carla Bassu, one of the youngest full professors of Comparative Public Law in Italy, and an ambassador for egalitarian roles. For years she fought – and recently won – a major battle: the one to empower both parents to give their surname to their children in Italy. «We need to consider the contest [our Constitution] has been formulated in»  professor Bassu says, «It reflects the historical and cultural background: in 1948, when our Constitution came into effect, most people found it hard to recognise a position for women away from domestic work». So, being an historical document as all Constitutions are, the Italian Constitution simply reflects the spirit of the time. But a lot can be done now, Bassu explains, «by interpretation» of the said Constitution, and «through education» of the younger generations towards gender equality and equal parenting. Because, even if it's probably a bit of a stretch to blame the Italian Constitution for the fertility gap – the imbalance between how many children people would like to have and how many children they actually end up having – it's fair to say that it certainly hasn’t helped.

Reproductive Science Is An Incredible Thing, But It Hasn't Been Able To Beat Biology: The Why Wait Agenda Meets Jessica Hepburn

Becoming a parent is first and foremost a decision to make. A choice. But what happens when our mind and our heart long for a baby, and our body simply does not cooperate? When it comes to fertility, wanting is not enough – choosing is not enough:  only 85% of couples will conceive naturally within a year of regular unprotected sex. No less than 25 million citizens are affected by infertility just in the European Union. This episode's guest is Jessica Hepburn, the author of the memoir "The Pursuit of Motherhood" and of “21 Miles: swimming in search of the meaning of motherhood”. Her books focuses on the need to talk openly about the stigma of infertility and unsuccessful IVF, that Hepburn experienced firsthand going through multiple rounds of in vitro fertilisation, suffering miscarriages and even an ectopic pregnancy. There was no happy ending for her: that's why her voice is different, maybe less sugar-coated than your typical fertility ambassador, but honest. Jessica Hepburn has come to represent the people who have not and will not be able to conceive, even with all the medical aid currently available. And she's living proof that infertility can be overcome not just in the obvious way – by having a baby – but also by finding other ways to fill that void. Hepburn is now a fertility activist and ambassador: she has been a trustee of the charity Fertility Network UK; a patient adviser to the HFEA, the UK’s independent regulator of fertility treatment; and a member of the Fertility Education Initiative. In this episode of the podcast she discusses with Eleonora Voltolina, founder of The Why Wait Agenda, the huge effect of infertility on relationships, the difficulties of sex after a round of failed fertility treatment, the secrecy and shame that still surrounds infertility, and the need to raise awareness about this topic.

Delaying Parenthood, How Can the Trend Be Reversed? The Why Wait Agenda Meets Melinda Mills

Postponing parenthood is now a strong trend. The average age of women giving birth to their first child is steadily increasing: in the EU in 2020 it was 29.5 years, peaking above 31 in four European countries – Italy, Spain, Switzerland and Luxembourg. The rise in the average age at first child recorded worldwide does not favour women wishing to become mothers: the higher the average age when the first child is born, the smaller the window of fertile years the potential mothers has. This, combined with the lack of fertility awareness, may cause – and does cause – a lot of suffering and frustration among people. The “fertility gap”, indeed. In this episode of The Why Wait Agenda Podcast Eleonora Voltolina, founder of The Why Wait Agenda, asks professor Melinda Mills, author of the paper “Why do people postpone parenthood? Reasons and social policy incentives” back in 2011 and now director of the Leverhulme Centre for Demographic Science at the University of Oxford, to assess the social policies – baby bonus payments, family allowances, tax exemptions, child tax credits, maternity and paternity leave… – that can affect the timing of the first birth. “Baby bonuses”, for instance, are simple and may seem a good option, but in fact they do not work as well as one could think: «In Quebec they did that, and there’s little evidence that it worked». It seems to increase the fertility «of those who already wanted to have children, or already had large families»; it did allow them to have them slightly faster, «but not necessarily more children». Voltolina also discusses with Mills the frontier of egg freezing – «It’s not the first thing most women in their twenties are thinking about», also because «it’s really expensive»: so «at the age you would want to engage in that technology you don’t have the money for it, and if it’s not covered by insurance, you’re not going to do it» – pro-natalist doctrine – «We’ve seen it in Hungry, in Italy, even in Sweden more recently: this movement is not new, and it continues to happen» – and certainty in the labor market as a key-factor to make young people feel comfortable with the idea of starting a family. A heartfelt thanks to Matthieu Mantanus for the amazing theme song, especially written for The Why Wait Agenda podcast!

“Why Do People Postpone Parenthood? Look at the household division of labor”: The Why Wait Agenda Meets Professor Melinda Mills

Why do people postpone parenthood? Well before being the driver of The Why Wait Agenda, this question underpinned an academic paper published by a group of researchers to present the findings of their study of the causes, consequences and possible solutions of the significant delay in childbearing. Melinda Mills, now Director of the Leverhulme Centre for Demographic Science of the University of Oxford, was one of those researchers; in this episode of our podcast she discusses with journalist Eleonora Voltolina the most common reasons for the postponement of first births. In the last few decades there has been a drop in fertility worldwide, «particularly in Europe, North America, and East-Asian countries». This is «very much related to the timing of fertility», according to Mills, for on average the age at first birth in Europe is now «around 29.5, but it’s much later in countries such as Italy and Spain, where it’s over 31». Having children seems more and more challenging, almost out of the question unless one has sorted out their  professional, housing, economic situation. Even when all the pieces of the puzzle match up, it's often still not enough. Putting off the decision of having a baby when the desire to become a parent is strong is a painful choice, though – that may come with risks attached. A heartfelt thanks to Matthieu Mantanus for the amazing theme song, especially written for The Why Wait Agenda podcast!