Lately, there has been quite a bit of hand wringing about babies. Or, more specifically, the lack of babies. So, let’s talk about this debate and get cranky about what is missing.
In a Wall Street Journal curtain raiser on the topic, Jesús Fernández-Villaverde, an economist specializing in demographics at the University of Pennsylvania, breathlessly said, “The demographic winter is coming.”
That seems not good.
The Journal set the conventional wisdom on the drop in births with, “A society wide reorientation toward individualism that puts less emphasis on marriage and parenthood, and makes fewer or no children more acceptable.”
But, but, about a week later, The Economist wrote that, “More than half the drop in America’s total fertility rate is explained by women under the age of 19 now having next to no children. Around a third of the missing births would have been unplanned, and most of these would have been to women on low incomes.”
That seems good.
Either way, birthrates are declining around the world. In India, fertility is below replacement, “Even though the country is still poor and many women don’t work—factors that usually sustain fertility.” The Journal points out that things are changing in Sub-Saharan Africa as well, “The share of all women of reproductive age using modern contraception grew from 17% in 2012 to 23% in 2022, according to Family Planning 2030, an international organization.”
To summarize, women in rich countries have become individuals interested in professional careers or, as teenagers, are making smarter decisions and not having children. In other words, more would rather enjoy a Sunday of bottomless mimosas instead of dirty bottoms.
Meanwhile, in poor countries, women seem to think that childrearing isn’t the only thing in their future.
The audacity.
In response, policy makers are making policy.
After their fertility fell to 1.5 in the early 1990’s, Japan launched a series of programs, including parental leave and subsidized child care. It didn’t really work.
Hungary has tried to increase fertility rates to middling effect; although their efforts to prioritize younger mothers might be increasing births. As The Economist puts it, “Although small families are becoming more common almost everywhere, women who start young still tend to have more children over their lifetime, which is why Messrs Orban, Putin and Xi are focusing on them.”
On the campaign trail, Trump has endorsed “baby bonuses” in what one columnist called “Good ‘Ol Hungarian Tax Policy.” And Tucker Carlson implores his audience to “Have kids immediately.”
(I have a funny feeling Tucker is not encouraging immigrants to fill this baby deficit.)
Meanwhile, over on the continent, “Since the turn of the millennium [France] has disbursed 3.5-4% of gdp a year on a mixture of handouts, services and tax breaks, meaning it has the highest pro-natalist spend in the oecd club of mostly rich countries. But in 2022 fewer children were born in the country than at any point since the second world war.”
Look, I wholeheartedly agree that the social and fiscal challenges posed by shrinking populations are critical to address. And, I have written about the abysmal state of child care in the US. These are real challenges that need smart solutions.
But you know what is missing in all this talk about the babies? Their moms’ health.
Toya was fortunate to have a healthy pregnancy and birth. But, if I am honest, the third trimester and postpartum months rattled my nerves once we realized the health care system was designed to care for Anisa (fabulous), but treated Toya like a mere vehicle. (Of course, this all changed when we were connected to our fabulous midwives at Collective Birth.)
Once Anisa came along, she was put on a schedule to visit the pediatrician every three months. Again, fabulous. Toya’s number of regularly scheduled post-partum visits? Other than a, “Atta’ girl, great job,” checkup at the hospital by a doctor and follow up care by her midwife (who I cannot say enough great things about), zero proactive access to health care. After undergoing a physical and emotional transformation that most will never experience, our health care system leaves mom to seek medical care after something has gone wrong, or pay out of pocket for whatever resources might be available in the area.
Which is nuts given a new study in The Lancet that found based on prevalence data from high-income countries with well resourced health systems:
Many women experience labour-related and childbirth-related morbidity in the medium-to-long term after childbirth (ie, beyond 6 weeks postnatally). Available data show the most prevalent conditions are dyspareunia (35%), low back pain (32%), urinary incontinence (8–31%), anxiety (9–24%), anal incontinence (19%), depression (11–17%), tokophobia (6–15%), perineal pain (11%), and secondary infertility (11%).
And this doesn’t even get into the well documented mortality risks faced by Black moms - even if they are wealthy. In their summary of The Lancet paper, the World Health Organization wrote:
During a literature review spanning the last 12 years, the authors identified no recent high-quality guidelines to support effective treatment for 40% of the 32 priority conditions analysed in their study, and found not a single high-quality guideline from a low- or middle-income country. Data gaps are also significant: there were no nationally representative or global studies for any of the conditions identified through the research.
Since we aren’t asking about maternal health needs, the entire fertility debate blames moms for not having more babies. Let’s be honest, it is a perfectly rational decision to delay - or not to have children at all - if you don’t feel like there is a system to take care of you.
Children are truly a gift and I am so glad Anisa is in our life. But, moms are not disposable. So why does our health care system treat them that way?
Isolation and The Internet
Over at Puck, Baratunde Thurston wrote about how the rise of generative AI is facilitating the end of the internet as we know it. After describing how Meta is positioning its AI chatbot as the dominant search engine gateway to the internet - pushing the content we offer to each other via searches off the screen - Thurston asks two important questions:
If a social network prioritizes users’ connections to its A.I. chatbot over their connections with other people, is it still a social network? Or is this just the next step in the humanization of synthetic people, warming us up to a colder world, in which we really are friends with machines?
In other words, is the end of the internet - for all of its follies - also the end of relationships?
Which made me think about an interview in Politico with Samantha Rose Hill, a leading interpreter of German-born philosopher Hannah Arendt who wrote about the connections between loneliness and totalitarianism.
Hill says that Arendt thought of loneliness as, “An inability to question our beliefs or adjust our thinking to reflect our own experience and the experience of others — a kind of mental isolation and rigidity that one can observe, for instance, in today’s social media pile-ons and pressures for ideological conformity.”
When asked about impact of the pandemic on loneliness, Hill pointed out:
Loneliness is very loud. People often turn on the TV or reach for the phone to avoid the voice in their head, but it is that voice that allows one to think for themselves, hold themselves accountable and make changes where changes need to be made in their lives. Listening is a vital habit for democracy.
Who is Anisa going to listen to? The voice in her head synthesizing the information of the world for her to make decisions, or the voice on the screen, making the decisions for her?
Thoughts and Prayers
Toya is in Jersey for Memorial Day weekend for her brilliant nephew’s high school graduation. (Design schools are tripping over themselves to recruit him to be on their campus - it is pretty awesome.) Which means Baby Girl and I (along with Lady) have the run of the house for the next four days.
Thoughts and prayers for her hair and my sleep.
Had my first baby in 1991 and my second in 92! Not a single question was asked regarding my health (other than how well breastfeeding was going) and certainly no inquiries as to my mental health (there were definite bouts of melancholy). 33 years later My daughter is about to have a baby and I am so grateful that there is finally discussion and (hopefully) practice and policy to address these issues. Hooray for Cranky Dads!
Something nearly always absent from the fertility conversation is that the percentage of women without children (aged 40-44) in the US is less today than it was in 1990, 2000, or 2010. It’s not that more women are choosing not to have children but that more women are choosing to have fewer children.