Every 30-year-old girl who is not yet married will definitely be nagged by relatives during the New Year's Festival:
"Still not looking for a partner?"
"Hurry up and be born when you are young, but when you are old, you will not be able to give birth!"
"Young people must first start a family, then establish a career, and only with children can they have the motivation to work hard."
(Source: Network)
In fact, most girls have heard that "24 to 29 years old is the best age to have children", but a heart-wrenching fact is that many people at this age are just on the right track of their careers, if you choose "birth" at this time, it often means giving up "rise".
Because having children is likely to push working women into a crisis of marginalization.
(Source: Japanese drama "I, to the end of the work")
And after giving birth, women's time will continue to be pulled by work, housework, and children, because most of the housework is currently taken care of by default by women.
(Source: "Home on the Half Slope")
In the TV series "An Jia", the gynecologist mother who needs to work overtime at night can only sit on the toilet and work on the toilet in order not to disturb the rest of the family.
In this dilemma, many girls have to miss the "golden period of fertility", but at the same time, they will also worry about what impact will it have if they miss it?
First, there is a clear fact: as we age, fertility declines in both men and women, the probability of miscarriage and fetal malformations increases, and the risk of pregnancy and childbirth increases.
1. A woman's natural chance of becoming pregnant decreases with age
According to the American Society of Reproductive Medicine, healthy 25-year-old women have about a 25 percent chance of getting pregnant naturally each month. That is, 25 out of every 100 women who attempt to conceive that month will succeed. At 30, the odds are 20 percent, but by age 40, that number decreases to less than 5 percent [1].
This is followed by ovarian reserve function, which refers to the number and quality of follicles left in the ovaries. A woman's ovarian reserve peaks around birth and then declines gradually until menopause [2].
If the egg quality is poor or there is a genetic abnormality, it may not be able to fertilize, and the fertilized egg cannot implant in the womb or cause a miscarriage.
However, there is no direct way to determine egg quality clinically, and the relationship between egg quality and age can only be estimated from the percentage of embryonic abnormalities. It can also be seen that the percentage of embryonic abnormalities gradually increases with age.
Women of virtually every age group face some risk of miscarriage (about 10%-15%), and as they age, the risk of spontaneous miscarriage increases accordingly and rises rapidly after the age of 35 [3].
2. When you have a child from 30 to 34 years old, the risk of serious complications may not be as high as you think
A statistical study of more than 7 million pregnant women in the United States in 2009 showed that young women (≤ 19 years of age) had an increased incidence of preterm birth, chorioamnionitis, endometritis, and mild preeclampsia compared with women aged 25 to 29 years.
However, the incidence of pregnancy and childbirth complications such as preterm birth, hypertension, severe preeclampsia, preeclampsia, and postpartum haemorrhage increases significantly among elderly pregnant women (≥35 years of age[4].
（数据来源：Maternal age and risk of labor and delivery complications）
The horizontal axis of the chart above represents different age groups, and the vertical axis is the number of people per 1000 people who suffer from pregnancy-related complications. It can be intuitively seen:
The probability of complications shows a trend of high at both ends and low in the middle.
In other words, too young or too old will increase the risk, while the intermediate risk is relatively low, and the gap between the 25-29-year-old group and the 30-34-year-old group is actually not too large.
However, after 35 years of age, the probability of complications during pregnancy and childbirth will increase significantly. This is also why the medical system sets the age of 35 as the standard for "advanced maternal age".
In addition to complications during pregnancy and childbirth, everyone is most concerned about the condition of the fetus. Indeed, as we age, the probability of abnormalities in the fetus is certainly higher. But in fact, this absolute value is not as high as we think.
Statistics from a large study in Canada show that the risk of adverse pregnancies and childbirth outcomes increases with maternal age. However, the absolute risk of developing severe fetal and infant adverse outcomes is relatively low (5% to 7%) even in women over 35 years of age [5].
（数据来源：Absolute risks of obstetric outcomes risks by maternal age at first birth: a population-based cohort）
Many women, under the pressure of the "optimal age for childbearing", have to disrupt their life arrangements; many people are anxious because they miss the optimal age for childbearing, as if serious things are about to fall on them.
In fact, when to be "best", there is no optimal solution. From a medical point of view, we comprehensively analyze the above data, considering the health of ourselves and our babies, it is best to be able to give birth at the age of 24 to 29.
But if you missed it, it wasn't that bad either. Even healthy women in their 20s can have some bad outcomes. In general, before the age of 35, there is still a great probability that everything will go well, not that there will be problems after the age of 30.
Fertility and procreation, birth is only the beginning, raising a child also requires time, patience, economy and wisdom to cooperate in all aspects, not only from the perspective of medicine.
In the early 20s, when they first entered the society, they had not yet gained a foothold, and they were forced to choose to have children when they could not be responsible for themselves and their children, and the degree of impact on the lives of girls was not necessarily smaller than the incidence of a few percent.
Ma Yili on balancing family and work (Image: "Extraordinary Way")
For young people, the "optimal age to have children" should not be a bundle of "age", but should be a time when both parties are ready to welcome a new life.
For girls, what they need is not the advice of relatives to "give birth early and be happy early", but the right to choose to have children, but partners can also realize that doing housework and taking care of children is not "helping", but also their own responsibility, but after having children, they do not have to bear the prejudice of society and can compete fairly in the workplace like men.
Review expert: Gong Jing| deputy chief physician of the Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, affiliated to Capital Medical University
bibliography
[1]https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/age-and-fertility/
[2] Wilkosz, Pawel et al. “Female reproductive decline is determined by remaining ovarian reserve and age.” PloS one vol. 9,10 e108343. 13 Oct. 2014, doi:10.1371/journal.pone.0108343
[3] Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. BMJ.2000;320(7251):1708-1712.doi:10.1136/bmj.320.7251.1708
[4] Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Bommarito K, Madden T, Olsen MA, Subramaniam H, Peipert JF, Bierut LJ. Maternal age and risk of labor and delivery complications. Matern Child Health J. 2015 Jun;19(6):1202-11. doi: 10.1007/s10995-014-1624-7. PMID: 25366100; PMCID: PMC4418963.
[5] Schummers L, Hutcheon JA, Hacker MR, VanderWeele TJ, Williams PL, McElrath TF, Hernandez-Diaz S. Absolute risks of obstetric outcomes by maternal age at first birth: a population-based cohort. Epidemiology. 2018 May;29(3):379-387. doi: 10.1097/EDE.0000000000000818. Erratum in: Epidemiology. 2018 Jul;29(4):e38. PMID: 29517506; PMCID: PMC5922259.
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