This is how it usually plays out: You’re on date #4 with that cute guy Craig from Bumble,
and it seems to be going really well.
Then he casually slips in a comment about your ovarian future:
“That’s a great salad.
So are you at that age where you’re thinking about freezing your eggs?”
That look on my face is a mix of horror and realization, and both are linked to Craig’s
f*cked-up idea that I and I alone carry the burden of healthy fertility with an aging body.
And that idea is rooted in the ever-dreaded “biological clock.”
The biological clock is a phrase that's had a few different meanings over time, but it's
typically used to refer to how female fertility specifically declines with age.
Hey guys, I’m Sana, and this Sunday we’re going to talk about the history of the biological
clock – and how capitalism has a lot to say about my eggs.
And if you like this video and the other stuff we do here at Because Facts, don’t forget
to hit that subscribe button and that bell to get notifications.
Do it right now, right before we get into it.
The actual phrase “biological clock” wasn’t always used to refer to how long women had
until their reproduction ability plummeted.
It used to refer to the human body’s circadian rhythm: how you sleep, when you sleep,
when you wake up. That sort of stuff.
Moira Weigel, author and scholar of gender and sexuality, notes that that phrase came
to mean something very different in the 1970s.
The phrase “biological clock,” in the sense that we use it now, enters the popular
imagination, the popular lexicon, in a very particular moment in American history.
It's the late 1970s, it's sort of after this period of real flourishing and advancement
for the feminist movement and the women's movement.
In fact, Weigel even pinpoints the day it enters the popular imagination:
March 16, 1978.
That’s when Washington Post columnist Richard Cohen wrote a piece in the Metro section called
“The Clock Is Ticking for Career Women” about how, even though the career women seem
to have it all, they’re still not fulfilled until they can have a baby.
To a certain extent, the biological clock is naming that real phenomenon, but I think
that the purchase that it gains in culture generally cannot be separated from changes like the
entrance of large numbers of middle-class, college-educated women into parts of the workforce
that they had historically been excluded from, women using contraception
and abortion to delay motherhood.
So it’s no big coincidence that the year Cohen used the term “biological clock”
to refer to women’s declining fertility is also the same year that we see the first so-called
“test-tube baby” conceived through in vitro fertilization.
So at the same time that you have this increasingly widespread discourse in the American media
about declining female fertility and anxiety about the biological clock, there are major
advances taking place in assisted reproductive technology and in vitro fertilization.
And we’ll talk about the fertility industry and IVF in just a moment, so hold on.
Now, the idea of a woman’s fertility competing with her ambitions in life continued to develop
in the media and pop culture throughout the ’80s …
“You’re 31 years old--”
“And the clock is ticking.”
“No, the clock doesn’t really start to tick until you’re 36."
… the ’90s …
“The daughter of my sister is getting married. My biological clock is ticking like this!
And the way this case is going, I ain’t never getting married.”
… and the 2000s.
“A lot of women today, for whatever reason, are starting their family a little later.
So they want to know: How much time do I have?”
And there's something very chiding, something very scolding, I would say, about this discourse
– saying that women who thought that they could have it all, who thought that they could
have education, have careers and still have families, are taking a serious risk
of ending up alone.
Now, Dr. Lynn Westphal of Stanford Medical School does note that the focus on women’s
reproductive aging is fair when we compare women’s fertility to men’s.
The focus on fertility has to focus primarily on women, because all women will eventually
become infertile if they live long enough.
There's no way to prevent menopause.
Eventually, all the eggs will be depleted from the ovaries, and that usually happens
around age 50.
And at that point there are no more eggs and a woman cannot get pregnant naturally.
While there’s a chance that men can reproduce in their 80s or 90s, that doesn’t necessarily
mean that their sperm is in great health.
People are not as efficient at reproducing as a lot of people think.
We know that a normal, fertile couple in their twenties has probably 20,
maybe 25 percent chance of getting pregnant each month on their own.
By age 40, that falls to about a 5 percent.
We have focused a lot on the health of the woman, but the health of the male is very important, too.
Research from 2012 found that male reproductive aging mattered for the mental health of the
child, specifically increasing the risk for schizophrenia and autism.
Relatedly, but not connected to aging, research from 2017 found that between 1973 and 2011,
sperm count in men from 50 different Western countries had fallen between 50 and 60 percent.
Studies have shown a decline in sperm counts around the world.
The decline in sperm count is not a problem with our technologies – so we can overcome that.
The aging of the egg and decreasing quality of the egg, we don't have a way to correct at this point.
And while Dr. Westphal makes the point that the focus on women’s reproductive aging
is warranted because we do have an end date – aka menopause – it’s worth exploring
when and why that became such focus in the media.
The emergence of the biological clock as something that specifically refers to women’s fertility
came about in the context of the women’s rights movements making significant gains
in the ’60s and ’70s.
We’re talking about the Equal Pay Act of 1963, Roe v. Wade in 1973 and the Pregnancy
Discrimination Act of 1978.
American women, especially white American women, not only had the opportunity to control
their reproductive future, but also enter the workforce in greater numbers than ever before.
In her seminal book “Backlash,” Pulitzer Prize–winning journalist Susan Faludi describes
the era of Ronald Reagan’s presidency as an undeclared war against American women.
One of the problems threatening the American family, and therefore the fabric of society,
was that women were having children at later ages.
According to the Centers for Disease Control, between 1970 and 2000, the median age of a
first-time mother rose from about 22 to almost 25.
And the national birth rate had been falling for almost two decades.
In 1957, the average American woman had three and a half children; by 1976, that number
had fallen to one and a half.
While women in the United States, in particular, were and are still choosing to have children later
in life, the conversation has focused on that being the result of this competition between
motherhood and ambition.
And that’s very much still the case.
Take, for example, Anne-Marie Slaughter’s viral Atlantic piece “Why Women Still Can’t
Have It All,” and Sheryl Sandberg’s book “Lean In.”
But recent research indicates that women who are delaying motherhood might not be doing
it because of their careers.
Medical anthropologist Marcia Inhorn found in a recent study, women who are freezing
their eggs aren’t doing it out of career ambitions, but because they can’t find the right partner.
And if they are delaying motherhood because of their career, that’s because corporate
America by design was meant for men – not for women – as Weigel points out.
The idea, again, that we see again and again throughout the history of this biological
clock conversation, is that if women are having trouble balancing work and life,
or fitting the patterns of their lives – their personal and biological lives – to a corporate system
that was not designed to accommodate women, the solution is not paid leave,
more generous childcare benefits.
The solution is an expensive technological fix – and that is beyond reach for many people.
That technological fix has given birth (no pun intended) to an entire industry that ultimately
works off the fears of college-educated working women.
OK, pun intended.
I mentioned earlier the first IVF baby was born around the same time that the biological
clock metaphor entered the American imagination.
And it was a huge deal, by the way.
Women who previously were unable to bear children because of blocked fallopian tubes, fertility
issues or even survivors of ovarian cancer were able to finally have kids!
Today, thanks to other technological advances like egg freezing, fertility is a huge industry
estimated to hit $4 billion in 2018.
But while the fertility industry is growing, it’s also been criticized for overselling.
While IVF and egg freezing are presented as part of the solution for career-oriented women
who want it all, their success rates do decline with age.
Around 40% of IVF cycles result in babies for women aged 32 and younger.
Not even 10 years later, for women aged 40, that success rate is cut in half, to less than 20%.
And even then, these treatments are financially out of reach for many, if not most women.
Freezing your eggs can cost around $11,000 for a single round of retrieval.
Plus there’s the storage fees to keep your eggs safely frozen,
anywhere from $250 to $1,500 annually.
Then there’s IVF, which can cost around $12,000 per round,
plus $3,000 to $5,000 for the necessary hormonal drugs.
70% of women who get fertility treatments actually go into debt.
And while sperm freezing and storing – different from sperm banks – is becoming a thing among men,
due to concerns about sperm count and aging, it’s nowhere near the same industry
as it is for women.
So is this really a solution?
And is there really a competition between ambition and motherhood?
And is the biological clock real?
Sana, can you just say yes or no?
Well, it’s complicated.
Because women do have an expiration date on their fertility.
But as Weigel points out, we can’t divorce the way we talk about the biological clock
in this country from the history of women’s labor.
This idea that professional women, educated women, are going about their lives wrong and
that they're organizing their lives the wrong way, prioritizing the wrong things, not setting
enough stock in traditional ways of doing things, is yet another expression of this
cultural anxiety that we see throughout the history of dating, about people of all genders,
but women in particular, getting more control over
their personal, professional, intimate reproductive lives.
So have any of you guys actually had any kind of sperm freezing or egg freezing ads targeted
towards you on social media or anywhere?
Let us know in the comments, and don’t forget to like, share and subscribe
– and let us know if there are any other health stories you want us to cover!