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Part one: Barren in the New World


IF THERE IS A 1990s version of the moral blame that befell women in the 19th Century, it's criticism for postponing a family.

In the 1970s, an increasing number of American women planned to wait until their late 20s or 30s to start having children. For some, that meant waiting so long that pregnancy became biologically difficult--if not impossible. Historian Sara Evans complains that there's a popular perception now--partly encouraged by political conservatives--that feminism tricked women into focusing on careers.

Evans says the message is: "See what you did? You should have been having babies and you went off and got a Ph.D. instead, or you started a business, or whatever. And now you deserve what you get."

University of Minnesota historian Elaine May explains that infertility remains a difficult stigma in America. LISTEN

Public anxiety over infertility is fueled by countless magazine articles and television programs warning couples not to wait too long to start a family. A woman's fertility does, in fact, decline as she ages. In couples where the woman is 35 or older, about a third will have fertility problems. The rate jumps to two-thirds at age 40. But the truth is, male infertility occurs in nearly half of couples who can't get pregnant.

Philadelphia author and gynecologist Wanda Ronner says too many of her patients are "pre-infertile," assuming they'll have trouble conceiving before difficulties actually arise.

"A thirty-five-year-old who has a baby will say, 'I have to have a baby next year again because if I wait two years, that'll be it and I won't have my chance again,'" Ronner explained. "And trying to convince them otherwise, even though they may not be able emotionally to handle having these two children right away is impossible. Because it's this generally held belief that it's either now or never."

Ronner argues that American infertility rates have actually decreased overall since the 1960s. Infertility among married, middle-class couples appears to have stayed at 10 to 13 percent for more than a century, she says. A 1995 report by the National Center for Health Statistics shows that 2.1 million married couples were infertile in 1995, down from 2.4 million in 1982. While the number of Americans seeking infertility treatment is up, the percentage of infertile Americans is down.

"There's a myth out there that infertility is a disease or epidemic among the affluent, the privileged, especially professional women who postpone childbearing and bring it on themselves," May says. "Absolutely not true. Infertility has always been and continues to be much, much more common among the poor, much more common among women of color and people of color. Because it has to do with health care."

According to a 1988 congressional study, the only group to suffer a rise in infertility rates since the 1960s is women under 24 years old. The cause: a spike in the rate of sexually-transmitted diseases that can damage the reproductive system. Studies show that overall poor health can also lead to infertility. Meanwhile, less-affluent Americans are usually unable to pay for expensive infertility treatments, which can easily surpass $10,000 and are generally not covered by health insurance plans.

In the past 20 years, in vitro fertilization, egg and sperm donation and other high-tech procedures revolutionized the field of reproductive medicine. Infertility, a condition that colonial Americans thought a moral weakness, suburban Americans see as a scientific problem. Yet stigmas live on.

In Columbus, Ohio, a 34-year-old pension manager named Carol says she can't comfortably talk about her infertility with other women in the office. It would be nice, because the shots and other treatments can strain on a career. But Carol says because infertility is linked to sex, the subject makes colleagues blush.

"To say the word uterus is like, Oh! My Gosh!" Carol says, mocking their alarm. "So I would never be able to explain to them what I've gone through and how painful it was. They know I have doctors appointments, they know I take shots, but they absolutely do not want to hear the gory details." LISTEN

Other says they detect the same kind of suspicion of their character or virtue that childless puritans endured more than 300 years ago.

Steve, a 31-year-old account manager in Chicago, remembers a time last summer when a young niece came to visit. During her weekend stay, Steve says he and his wife felt the unexpected warmth of smiling strangers as they walked to the park holding her hands.

"Having a child is like a right of passage, " Steve says. "Now you are considered responsible, an adult, part of society and more concerned about the community." LISTEN

In other words, to be a real American, it still helps to be somebody's parent.

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