Funding for To The Contrary provided by: This week on To The Contrary: It's not only just for women of color.

Women of all ages are starting to have children at an older age.

And it's not only unique to the United States.

Individuals are realizing that you know what?

You know, we have contraception options that are available even now.

They have contraception options that are available over the counter, that can not only prevent pregnancy, but even for those who have issues with their menstrual cycles, can also have beneficial effects on that as well.

Hello, I'm Bonnie Erbé.

Welcome to To The Contrary, a discussion of news and social trend from a variety of perspectives.

More women in the United States are having children later in lif while teen births are declining.

Experts say the shift is tied to access to birth control career and education priorities, and advances in fertility care.

A new CDC report shows in 2023, for the first time, women over 4 had more babies than teenagers.

Teen birth rates have dropped sharply since the 1990s, while births among women over 40 years of age have nearly tripled.

Doctors and hospitals are adapting, offering more specialized care for older moms while still working to reduce teen pregnancies.

With us to discuss this issue are two experts, Doctor Jonelle Samuel, an Ob-Gyn and Doctor Adjoa Smalls- Mantey, who is a psychiatrist who has followed this issue closely.

Welcome to both of you, an thank you both for joining us.

So what's going on here?

I mean, I have to tell you, when I was a teenager, a long time ago, the idea of teens having fewer babies than women over 40 would have been what?

So, you know, let's star with whoever wants to start out, as to why this is going on.

It is a phenomeno that is new for us in society, and that i because there are many reasons for people to delay their pregnancies.

One of the reasons that you mention that we're having older woman have more births is primarily our fertility technology has advanced, so that option is there.

There is IVF, which is becoming more and more advanced as time progresses.

Another big reason why teenagers aren't having as many babies is because there's bette education around contraception, around having babies, around the advantages and disadvantages of having children earlier in life.

You're thinking a little bit more about the financial implications, and then people are also pursuing education as well.

So that could delay thei timeline for finding a partner or for having a child, for settling down because they want to prioritize their education at this time.

What's different about women's education, and particularly women of colors, education that changes these, that, you know, weighs in on changing these data from decades ago.

One of the advantages that w are having now in education is our education is more supported in different ways.

You have more funding, different types of funding that can help people go on from college to gra school, which is very expensive depending on the field that you're in.

Medical school costs hundreds of thousands of dollars, but we see more medical schools are offering full scholarships for people, which is great.

We need more doctors.

That means more people can pursue medicine.

There's also more targeted programs to have women get into the workforce, to get into education, to get into these higher degree programs.

I know the landscape is changing to a degree at this time, but those are things that have happened that have given women more options when it come to pursuing advanced education.

And with that, with more education, you can pursue more advanced careers, careers that hav better financial opportunities.

So with that with more financial stability, one reason why people sometime may find a partner and pair up is because they find I need help with just my day to day expenses.

You know, but if you are now someone that is able to support yourself independently, that impetus, that rush to now find a partner, maybe it's not the perfect partner, the right person, is not as pressing.

So yes, I'd like to echo, a lot of what Dr. Smalls-Mantey alluded to.

You know, there has been a lot of advancements, you know, in educatio in terms of for women of color.

You know, nowadays we are seeing more women of color obtaining advanced degrees than ever before.

And being able to do that through different funding, through different opportunities.

And so, you know, with that, we're seeing that women are deciding to advance their careers to, you know, to get better careers, right by obtaining advanced degrees.

And therefore, they're able to plan a little bit better as to how they want to move forward in their life, whether it's, you know, family planning or not.

Making sure that they do find the right partner.

And also, too, education is power.

So the more education you have or the more that you know, the better that you're able to make, you know, decisions for yourself or for your future.

Is this true for all groups of women and all races of women or is it mainly women of color?

It's not only just for women of color.

Women of all ages are starting to have children at an older age, and it's not only unique to the United States.

Other countries are as well, seeing this pattern.

You have countries like Japan, the Scandinavian countrie as well are noticing this trend.

And to one extent it does concern the government and society.

You know, decreasing birth weight.

We do want to continue on this Earth as a species.

But there are other just financial and social implications to that as well.

However, what we mentione before, there are more options.

There have been more targeted options that allow people to have more autonomy over when they are having their pregnancy and their advancing care.

And the advance in IVF that has allowed us to take the option of maybe delaying pregnancy, that biological clock that we've all heard about and is very real.

You know, we have a little bit more time on the clock now.

We do.

And that's very interesting because for such a long time, the experts and spokespeople were trying to convince, particularly the youngest women, to delay childbirth.

And now all of a sudden it's come true.

What do you think the biggest factor, Dr. Samuel, let's start with you.

What's the biggest factor slowing particularly very young women, teen moms from having as many children as they used to?

So I would say increased access to information.

So through social media, the fact that more are obtaining education, knowing more about contraception, and being able to make intelligent decisions as to, you know, when they want to have kids.

So I think that, you know, individuals are realizing that, you know what, you know, we have contraception options that are available even now.

They have contraception options that are available over the counter, that can not only prevent pregnancy, but even for those who have issues with their menstrual cycles, can also have the beneficial effects on that as well.

And what do you think the reasons are?

The most prevalent reasons are?

I think, not only just access to contraception itself, but there's better contraception available now.

Before there used to be the pills, condoms, but now we have IUD that are very, very effective.

They stay in your body.

So that definitely reduces the rate of pregnancies.

There is also the access to abortion, although that has been restricted in many states now, that reduce the number of unwanted pregnancies.

And then finally, I'll also say that kids are hanging out with each other a little bit less due to social media.

I mean, we are on our phones, we're in our houses, we are communicating in one way but we're not just hanging out with other people as much.

So there's just literally less human to human physical interaction.

Why are young women now listening more to signals coming from society, listening to teenage girls saying, I don't want children I want to finish my education.

I want to be able to easily afford children when I decide to have them.

I don't want to be a single mom.

What do you think is the most powerful trend that changed so tha these are being listened to now?

Some of these can include lived experiences.

So for some individuals, you know, let's say if they grew up in single parent households and they saw how difficult it was for their parent to raise them or, you know, essentially like raise a child by themselves, that individual may just say, you know what?

I don't want to go through that when I'm older or, you know, just knowing the type of freedom that that individual would have later on in life in terms of being able to and its through social media, being able to travel and do different things that you like.

And you know that if you have children, those things would be restricted.

So I think a lot of that has to play— a role to play in regards to the shifts in trends.

What are other things that teenagers were seeing happen to their peers who did have children?

And, what did they see that they didn't like that convinced them: I need to wait.

I gues for some of those individuals, those children, children having children, they no longer can, you know, have the benefit of just being able to live life the way that they want to now because they have to care for another human being.

And so, you know, I think other children may have noticed like, well, this person's not able to, let's say go and hang out with m or do different things with me because they have other responsibilities.

And so that may have played a major role.

I will ask you, Dr. Smalls, what other reasons are you seeing emanate from the teen community about why they're less willing to have children?

One thing that we're seeing in research studies are that a lot of teens are delaying having sex.

That could be for many reasons.

This is a pattern that they've noticed, and there's not 100% of a reason why.

But that is one thing.

With less sex, you're going to have less babies.

Also, as Dr. Samuel pointed out, seeing other role models, whether they struggled with having children young or being a single parent could be a deterrent.

But also many people are seeing their role models, maybe celebrities having children a lot later in life.

Some people have talked about, what a blessing it was.

They had their career, they were ready when they had their children.

They were able to do it either through IVF, naturally, or by adoption.

So you have people like Tamron Hall or Hoda Kotb that have had childre a little bit later than typical.

But seeing tha and seeing them in a good place of where they are abl to have the children and build a family that they want o their timeline is a little bit, is inspirational to women and just reminds you that you can have more than what we have been told that we can have in the past.

And then the last thing that we have come around to again and again is about education and aspirations.

Peopl want a lot more from their life and people also realize there are trade offs.

So they say, hey, I'm going to go for this advanced degree.

And you're working hard as a teen now.

I mean, when I read the letters of children— not children, theyre children to me, but of young adults that are applying to medical school or that are applying to residency.

I mean, they have done so much.

You are working hard.

And so you say, I'm not going to mess this up and get deterred from my goal by this unexpected event.

So I'm really going to try to look into other methods of contraception and think about, you know, family planning a little bit more because you are going for that bigger goal so you can have a life that you want and also be able to bring a child into, you know, very— Practically, if you're living at a certain lifestyle you want to be ready for when you're having that lifestyle, having met kids so you can accommodate tha lifestyle and keep it up as well financially.

So that's another reason why kids I think, are delaying pregnancy.

How long do you think, before the industry comes up with what I would call a secon method of birth control for men?

I mean, yes, there's abstention, and condoms, but it all has to do wit disrupting the supply of sperm.

When are some brilliant doctors going to come up with shots men could get o some other kind of birth control that would be easier to work into one's life and take a lot less effort and time?

So, I mean, they've been looking into male contraceptive actually for years now and have been doing different research studies and clinical trials on this.

However, we don't have anything on the market as of yet, for contraception for men.

And I just don't think it's honestly been a priority.

Really?

I mean, no male doctors are saying, gee I want to try to come up with— with the kind of contraceptio that men could use more easily?

Yeah.

So, I mean, they have— so there are trials.

There are research studies that they've been doing on contraception for men, but there's not currently anything on the market as of now for that.

How long—do you have any idea?

I know it's looking and— asking you to look into your, you know, crystal ball and make a prediction, but how long before something comes along for men so that the burden is not almost entirely on women?

I mean, that's an excellent question.

I am not entirely sure.

I think it probably would be another couple of years at least.

I will say that I'm not aware of any major new advances in male contraception at this time.

And so, because I haven't heard any peeps in, you know, coming out from the grapevine or preliminary studies, I think it could be a little bit of time until we see that.

Like you said, there are condoms, there is vasectomies and abstinence.

And that's where we are right now.

And that is a bigger question that we have.

The burden has really fallen to women with childcare and also now that they have a little bit more of the ability to choose their future I think, there has been a focus on giving women the power of when they can decide when to have children, and that's one of the reasons why there has been so much more research and more quick advancement an contraception methods for women.

But specifically the climate we're in now.

Ever since the United States elected a new president last year, does that attitude— is that slowing down the look for or the search for a kind of birth control that men can use?

And is that also cutting funds because the Trump administration has cut all kinds of funds to supposedly to save money, but really to hurt what many see as progressive causes.

Yeah.

So I would say, you know, due to the, you know, changes that we're seeing in terms of reproductive health care that primarily affect women, or those who have a uterus, I do not foresee tha there is going to be an emphasis in terms of, you know, mens reproductive health care and the onus being on men.

You know, with the funds, with the cuts to funds and access and decreased funding and, you know, decreased, you know, money that's being, you know, thwarted towards research, it's going to affect reproductive health care in terms of access to contraception, the types of contraception, being abl to afford contraception for all.

And so I think we're going to start to see actually a lot of differences in these numbers in terms of, you know, teen pregnancies.

We're going to start to see probably more teen pregnancies, more unintended pregnancies.

I do think that the amount of wome who are delaying childbearing, that will continue, but I think that that gap between women who are having children a little bit earlier is going to start to decrease.

Dr. Smalls.

And to what Dr. Samuel mentioned, there's not really a focus on trying to reduce men having children because actually, if you'll remember earlier during the new administration, they were floating the idea of offering money to women for having children because the birth rate is dropping overall in America and many countries.

And that has many implications for how society has functioned over decades.

One of the biggest thing that people are concerned of is if you're having less babies, there are less young people in the workforce to then actually pay taxes, to cover the Social Security, the benefits that people are entitled to as they get older.

So what, that is something that really the government is thinking about, how do we keep this system going that we have created where our younge people support our older people.

And right now the baby boomers are aging.

They're at the point where they need the Social Security benefit that have been promised to them.

But there are yet less younger people that might be there to support them.

So I think right now, the administration's priority is not to reduce the number of babies, but actually to increase it.

And another trend I'll actually mention in social media that people are talking about now is the trad wife, about this idea of going back almost to what we thought of as the glamorous homemaker in the 50s, that is, having children young, that are showing a nice domestic life, where you're able to stay at home to provide care for your child.

And that is definitely something that some people are able to do now is considered a luxury to be able to do that, because most families find that they need two income to really support a household.

So while we want t maybe, while the administration wants to encourage a higher birth rate right now, it' really not financially possible for people to have as many children or children so young as it was before.

And what do—do either of you think we're going to just have to start looking to other countries, particularly Europe, which are relatively wealthy countries, in terms of the order of things in the world, to come up with not just a male birth control method, but all kinds of things like Covid vaccines and all these things that America used to be the leader in, but that our current White House doesn't seem to want to get behind.

I'll defer that to Dr. Smalls-Mantey.

I don't have a comment on that.

Okay.

Yes, so I don't think our countr right now is necessarily looking to other countries in terms of their leadership.

It might happen if we are in a situation where we find we don't have the tool or the medications that we need.

Unfortunately, a lot of funding is being cut from medical research, billions of dollars.

So we are not going to b on the forefront of everything.

And that is something that when we get to a point, we might find that, okay, another country has happened to develop this technology.

Now we're going to have to rely on them to maybe share i or rely on their manufacturers to supply the medication, the technique, whatever it is to the American population.

And that could come at a extra cost to us.

Since we're seeing so many older women deciding to get pregnant and have children.

What is the best way that you all could think of to make it appealing to them?

Women definitely would need more support as they're having children at an older age.

Reducing the stigm like we've already talked about.

It's already there, and that's good.

Whether women are having children older or even older and as single women, I think that stigma is definitely reducing.

But it's still there to a certain extent.

So really its the cultural attitude of our society that needs to not be as judgmental and also, for the very practical support that could be there is financial.

So if more—you know, IVF is very expensive, freezing your eggs is very expensive.

So that's not really accessible to, I'm going to say, a majority of the population.

There are some jobs that do cover i through their health insurance.

But all in, a lot of the insurance companies have stipulations, like you have to have tried to become pregnant, have a diagnosis of infertility for specific reasons.

So if, you know, even if people think they want to delay pregnancy, but—and have options a little bit later, if they're not able to take the steps when they're younger because they can't afford it, you know, of freezing their eggs, that definitely could make it so they're not able to have children later on when they are psychologically or financially ready.

So hopefully we see more expansion of insurance coverage for procedures that are proactive about someone's health, about freezing, for freezing your eggs, that cover IVF a little bit more extensively for people as well.

It also should be note in terms of with egg freezing.

So, you know, currently, even though it is an option for fertility preservation, it really isn't indicated for that as of yet.

Like currently, the way that we use it now is more so for cancer treatment.

And it's also too even though it's a great option out there, it's not guaranteed to preserve fertility.

So I think that's also something that, you know, we have to also be aware of is that, you know, it's a great option to hopefully potentially delay, you know, childbearing, but it's not guaranteed that if you were to freeze your eggs, that you would be able to even use tha to have children in the future.

Please, each of you tell me one surprising fact or bit of insight that gets lost in the shuffle in this conversation.

So I would say that, you know, a lot of times when we think about having children later, like in terms of your 40s or what we call advanced maternal age there's a lot of angst and fear because it is considered a high risk pregnancy, but that you are able to have a healthy and joyous pregnancy even in your older years.

You know, with the technolog that we have nowadays and also, you know, if you attend regular prenatal care and optimize your health.

While it's great that women have options to control the tim at which they're having a child, one thing that we need to see is more support fro their jobs from the workforce.

Women are able to delay pregnancy because they have more financial options, more resources.

They're trying to build a career.

However, when they have that career, women might be delaying it even more because they find that they cannot take time off for a job.

All right.

Thank you both.

That's it for this edition of To The Contrary.

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