Childbirth economics: What older moms and teenage pregnancy say about opportunity in Ontario

Two Global News online journalists have been honoured for their health reporting by the Registered Nurses’ Association of Ontario.
Two Global News online journalists have been honoured for their health reporting by the Registered Nurses’ Association of Ontario. Getty Images

TORONTO — Jodi Aslin is 41 years old and seven months pregnant.

In Ontario, she’s no longer an anomaly.

Ms. Aslin was in no rush to start a family: She spent her 20s studying social work and teaching English in Korea, and met her husband at 34. A year later, they decided they wanted children.

It took almost five years and more than $20,000 in fertility treatments, but her daughter Jamie is now two years old. Ms. Aslin’s second child is due in April.

“We recognize that we’re in the older crowd, but we’re happy. I feel great,” she told Global News.

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Ontario women are waiting longer to have kids, if they can afford it: Women in richer neighbourhoods are having children later in life, and fewer teenagers are getting pregnant.

But there are huge disparities between postal codes: Teen pregnancy rates in Oshawa, for example, range from 7 to 11 per cent; in rich Toronto neighbourhoods, they’re too small to measure.

Data mapping births from 1991 to 2011 indicate there are roughly twice as many mothers having children after age 35. The information is based on public Statistics Canada data and Ontario Ministry of Health records released to Global News.

Doctors and researchers say these patterns provide a snapshot of a changing province whose birth patterns are closely tied to economic conditions.

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Advances in birth control options and fertility treatments have helped give women more control over their bodies, says Alex McKay, research coordinator for the Sex Information and Education Council of Canada.

“Underlying all of this is that women have gained greater and greater control over the timing of their pregnancies,” he said. “We start to see economic considerations playing an even more important role in that decision-making.”

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The council released its own report late last month that showed teenage moms were on the decline in provinces with flourishing economies.

The study, which covers 2001 to 2010, found fewer teenage moms in Alberta and Ontario.

In Ontario, for example, the teen pregnancy rate declined by 24.8 per cent per 1,000 between 2001 and 2005. They’ve since leveled off. After four decades of decline, McKay said, “at some point, you reach a floor.”

Meanwhile, teen pregnancies spiked in Atlantic Canada – an indicator of economic uncertainty, McKay said: If teenagers feel they have access to higher education and job opportunities, they’re less likely to have babies, and vice-versa.

“Teenage women who are feeling pessimistic about their economic prospects are, as a group, more likely to give birth than those who believe that higher education and a well-paying job are realistically obtainable,” he said.

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Toronto’s neighbourhoods tell the same story: The richest postal codes have the oldest mothers.

This parallel between economic conditions and early motherhood exists in most of the western world, McKay suggests, pointing to the identical trends in the United States and the United Kingdom.

The decision to delay childbirth means women can stay in the workforce, but it also means they’re likely have fewer kids in their lifetimes, says Dr. Sony Sierra, co-chair of the Society of Obstetricians and Gynaecologists of Canada’s reproductive endocrinology and infertility committee. That means a smaller workforce in the future.

Education, options and older motherhood

In the classroom and online, sex education is more readily available to young women. So is birth control, in the forms of condoms, pills, patches, shots and intrauterine devices.

Armed with those options, says Lisa Weston, older women are turning to motherhood later in their lives, after establishing careers and financial stability.

“We’re seeing a huge switch in how people prepare for [motherhood],” says Weston, president of the Association of Ontario Midwives.

This is what sets women today apart from their predecessors in past decades, she said. Advances in medicine and economic opportunities change the ways women can plan for motherhood.

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“More women are delaying childbirth while they finish school, establish themselves in careers, and build partnerships stable enough to have a family,” she said.

Midwives and doctors are seeing older women in delivery rooms – in large part because they have better ways to help them deliver.

Dr. Ari Baratz, a fertility specialist at Create Fertility Centre, treats women between 18 and 45 years old but the average patient is 38 or 39.

“Being an older parent is not as taboo as it used to be and discussing family building in traditional or nonconventional ways is not so taboo either,” he said.

Dr. Sierra estimates 35 per cent of women undertaking in-vitro fertilization (IVF) cycles are over 38 years old.

IVF has come a long way, Sierra notes. In 1998, the success rate for an IVF cycle was about 21 per cent. Jump to 2011 and it’s nearly doubled to 40 per cent.

Other routes now available include fertility drugs to increase egg production, insemination procedures and even egg freezing to help preserve eggs.

But this medical intervention doesn’t come cheap. Experts aren’t surprised that older moms are concentrated in higher-income areas.

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IVF typically comes with an $8,000 price tag, not including medications that accompany the cycle. One round could be as much as $10,000 to $12,000 altogether, Baratz said.

It takes about three cycles for most women to get pregnant.

While the government in Quebec covers fertility treatments, would-be moms pay out of pocket in Ontario.

Aslin came up with more than $20,000 to pay for her treatments with the help of her family. She notes that her costs didn’t include medications, which were covered by her workplace benefits.

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Now, she meets twice a month at group sessions in Whitby, Ont. with women in their mid- to late 30s trying to have babies.

Some women in a second marriage, others were focusing on their careers while some have had medical issues trying to conceive.

Ms. Aslin offers advice and reminds them their numbers are growing.

“It’s a tremendously stressful time that covers every area of your life – financially, emotionally, socially. They know that,” she said.

But she tells them to hang in there.

“Once they make the decision, let the process go. Take support from families and friends.

That applies to every age group of course but especially when you’re older and struggling to get pregnant or adopt, whatever path you take. You need the support.”

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