July 03, 2003

Are poor birth outcomes linked to falling birth rates?

From time to time, the Australian Government spouts platitudes about putting "families first" and encouraging women to have babies. There is concern that the birth rate is falling and this has many negative effects on a country's economy and big implications for the community as a whole.

I've been thinking about possible links between the way birth is managed and its impact on women, and wondering if these form part of the story. In Australia the birth rate is about 1.7 children per family and it is about the same in the UK. Ireland and Italy are lower and Spain is 1.2. The average age of women in western countries having their first baby is now 30 years, which means that half of first time mothers are over this age.

Given that research has shown that when birth is traumatic for a woman, she waits for an average of four years before having another child, this fact, in combination with the high average age of first time mothers, may be significant. For example, if a woman was to have her first baby at age 32 years and the birth was traumatic ( a strong chance given that better educated "career" women are more likely to choose obstetric care, with its well documented risks) she may need four or more years to recover to the point where she will consider another pregnancy. A woman's fertility is falling as she ages, so that may then impact on her ability to conceive in her late 30s. If this does take time, she may then decide to give up and leave her family at one child.

Women who have good births are often keen to have more children. This may be anecdotal evidence, I know, but seems logical to me. Perhaps if research could be undertaken that explores the links between poor birth outcomes, delayed conception, reduced fertility and resultant smaller families, we might have strong evidence from a different to convince Governments that ways must be found to reduce birth interventions. Every little bit helps to promote midwifery.....

Posted by andrea at July 03, 2003 03:23 PM

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