Postponing Motherhood: a Demographic and Contemporary Issue

Abstract

Background: During the last decades, the postponement of motherhood became a reality in developed countries, leading to inevitable medical consequences, both maternal and fetal. Fertility preservation techniques constitute a matter of discussion in the context of voluntary delay of pregnancy. Objective: This study aims to analyse the causes, to address the maternal and fetal consequences and to explore solutions to this problem, namely the applicability of fertility preservation techniques. Methods: Bibliographic search of studies published between 2008 and 2020 was conducted in the PubMed database using the MeSH terms "fertility preservation" and "maternal age", among others. Results: The reasons that lead to the postponement of motherhood are the difficulty in establishing stable relationships, the expansion of differentiated education and demanding labor conditions, the diffusion of contraceptive methods, economic insecurity, ideational changes and the lack of information about this issue. The increased infertility, fetal death, chromosomal anomalies, multiple pregnancies, preterm birth and increased caesarean sections are the medical consequences associated. The review of social policies and the provision of information about fertility constitute possible solutions to this phenomenon. Fertility preservation techniques, especially oocyte cryopreservation, appear as an option but cannot totally compensate the age-related fertility decline. Conclusion: Advanced maternal age is a Public Health issue essentially explained by a set of interconnected social factors, involving considerable risks for maternal and fetal health. Fertility preservation techniques, although promising, may contribute to the perpetuation of this reality.