M.D., Fellow of the Royal College of Physicians of Canada, fertility specialist at the Pacific Centre for Reproductive Medicine (PCRM) in Vancouver, clinical assistant professor at the University of British Columbia.
My patient, Laura, didn't expect to be single at 36. She has spent many years honing her skills and now holds a responsible position with an international accounting firm. But her long-term boyfriend moved out last year after ending their relationship. She spends her weekends going on Bumble dates and attending friends' baby showers or toddler birthday parties. Laura tells me that she is considering a secondment in Berlin to advance her career. She also wants to have a family some day.
As a fertility doctor, I am seeing more and more women like Laura. They come to the clinic to understand their options for having a family immediately or at some point in the future. These women understand that their fertility is limited. Women are born with all of the eggs they will ever have, and these decrease throughout life. Above age 35, egg quality declines more rapidly and by age 44 the chances of pregnancy, even with in vitro fertilization, are less than 2 per cent.
Laura feels like she has to choose between focusing on her personal life or her promising career.
Flextime, salary top-up, paternity leave, sick days for children – these are all family-friendly concessions in the workplace. They have traditionally benefited women who already have a baby. But what about women who are trying to have a baby? Or women who might want a baby in the future? These highly skilled women make up a substantial portion of the work force. But many employers have not realized the potential to tailor employee benefits to this sought-after demographic.
Companies are under increasing pressure to diversify their talent. "Hire women or explain why you refuse to do so" is a recent rubric. The Minerva Foundation grades CEOs with a "Face of Leadership Scorecard" based on their representation of female executives. GE launched a campaign to "Balance the Equation" by hiring 50 per cent women for their entry-level technical positions by 2020. Hiremorewomenintech.com suggests ways that employers can reconstitute job descriptions to include and appeal to women. For example, one could say "community of engineers" rather than "dominant engineering firm."
Competing for the best and the brightest women has become a focal point in human resources. For example, in 2012 the American Society for Reproductive Medicine removed the "experimental" label from egg freezing. Shortly after, Facebook and Apple started offering female employees up to $20,000 toward egg freezing. Google and the American military also provide this option. When the news of this benefit broke, critics protested. The critics claimed that egg freezing was a corporate tactic to keep women working longer by pressuring them to defer pregnancy. Some contended that companies should instead focus on changing society's structure to encourage women to have babies in their biological prime.
There is one big problem with this argument – research does not support it. Studies of women who freeze their eggs consistently show that the number one reason that a woman delays childbearing is lack of a partner, not her career. Telling a woman to "just have children in your biological prime" is not helpful. It is simply not an option for many.
And while it's true that women in Canada are choosing to have children later in life, there are many contributing factors. A common example from my practice is a single woman who spent her time getting postgraduate education, travelling or pursuing her career, all of which kept her busy – too busy to meet that special someone. Sure, she could use a sperm donor and get pregnant at 28 like the critics suggest, but many women I encounter are holding on to their visions of having it all. Others are already in a committed relationship but they are not ready to start a family. They want to get a good education, work hard, have a career, travel and plan for kids later. Who are we to judge their priorities?
A man continues to produce sperm his whole life. He does not face the same biological consequences if he puts off having kids to focus on his career. Nor is he criticized for focusing on that career before starting a family. We should not criticize a woman who wants to do the same thing. These organized, goal-oriented, ambitious women are exactly the same people whom modern companies know will make excellent long-term employees and partners.
Modern corporations like Google consider the needs and futures of childless women in their 20s, 30s and 40s as a distinct group. When recruiting and retaining women in this group, it is important to remember that they may, or may not, want to have children one day.
Of course, only the most forward thinking and financially sound companies will be able to offer egg freezing. But smaller companies too can find other ways to be fertility-friendly. For example, flexible health-care spending accounts could include the option to use the money for fertility treatments. Companies could offer paid leave after a miscarriage or provide women time to attend doctor visits when undergoing egg freezing or fertility treatments. Allow women to be open about their plans to have, or delay having, children when choosing projects or setting performance goals. Part of making a workplace appealing to women means acknowledging that they are, in fact, women.
In the past decade, many companies have made great progress in recognizing the importance of gender diversity, which is to say: recognizing the needs and aspirations of different segments of its work force, particularly women. I believe that it is time to expand our thinking about employee benefits beyond just maternity, so as to establish a fertility-friendly workplace.