May 11, 2013

Thoughts for Mother’s Day

Parenting has greatly changed in the modern world. Throughout human history people had children because of biological urges and unreliable methods of birth control. It was one of the natural developments of life and not one where much choice was involved. In the middle ages, children were a way to protect wealth, status and property for the ruling class and a source of labor for  everyone else. In agrarian cultures and third world countries these priorities usually remain. Those of us living in the first world-in the industrialized world, approach child bearing as a choice.


To ask that question is a very modern and recent question. Reliable birth control and the rising economic power of women is a very contemporary development. Before the 1960’s these options didn’t exist for most women. Without economic clout women had little ability to decide whether or not they wanted children or how many to have. Society was dominated by male power and men had most of the decision making role in that issue. Without access to safe, reliable, and affordable birth control a woman could only avoid child bearing by being celibate or homosexual. Most American women today can make their own decisions about motherhood.

It is not always an easy choice. Economics are very much a part of the equation for many women. In the wealthiest countries, children are a luxury on which women are frequently choosing not to spend their earnings.  Singapore has the lowest birth rate in the world (0.78) and is also ranked as the third wealthiest country in the world on a GDP per capita basis. The countries with the top 20 birth rates are all in Africa, one of the poorest regions in the world. Many of these countries are still highly traditional and highly male dominated so, in addition to poor access to birth control because of culture and poverty, these women have little control over childbearing decisions in their families.

Economics factors are very important in the motherhood decision for poor and middle class families. The US birth rate fell 8% in 2011 at the height of the recession. When there are scarcer resources the decision to limit family size is unavoidable.

The birth rate continues to decline in the United States and most of Europe. Because a very low birth rate threatens economic vitality (too few workers to support the economy) countries have tried some startling approaches to encourage greater rates of procreation as the following article describes 5 Creative Ways Countries Tried To Up Their Birth Rates | Mental Floss.

In our country the stigma against women who choose not to have children is declining and women who forgo childbearing are not necessarily regarded as unwomanly or selfish. The choice whether or not to have children remains a challenge for many women.


Anne-Marie Slaughter’s compelling July/August 2012 article in The Atlantic  Why Women Still Can’t Have It All – Anne-Marie Slaughter – The Atlantic. attracted enormous media attention. Slaughter a Princeton and Harvard professor left her high level and highly desired job in the state department after two years because of her sense of responsiblity to her children. Women continue to struggle enormously with a work/family balance and will never be able to “have it all” until men and society make the adaptations and changes that will allow women to have the same opportunities as men.  Most baby boomers grew up in traditional households where Dad was the primary breadwinner. If we had good fathers we love and admire them despite their fairly minimal day to day child rearing responsibilities. The love we feel for those fathers should show us that giving baths, changing diapers, being home after school, reviewing homework and driving carpools is not the only way to create secure, confident and successful children. Modern women continue to anguish over these choices. I hear the guilt and pain among my patients who always fear they are not doing enough, not spending enough time with their families.

I strongly believe that women can have it all but society will require continued adaptations. Wealthy women, as the richest and best educated countries in the world teach us, are voting with their bodies and are giving birth to fewer children every year. Poorer women in wealthy countries also are having fewer children because of limited family finances. As with most things, we appreciate resources more when there is a greater scarcity. As the most prosperous societies become more and more alarmed about the decline in birth rates they will develop real strategies that support both men and women in their ability to choose to be parents and raise families. We know many of those solutions already, we just need the will to implement them: universal pre-school, universal health care, expanded access to college,higher minimum wage, generous family leave policies and flexible work schedules.

A society where only those who truly want children and can afford to give them love and opportunity is a better society for all of us. Healthy, happy and successful children lead to benefits for all of us. Happy Mother’s Day.

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