Regular Gript readers will be more than aware that birth rates are plummeting, not just here in Ireland but across the entire western world.
Indeed, with somewhat depressing familiarity, nation after nation now report annual cliff edge statistics with respect to the number of children being born, often alongside a parallel rise in the number of children denied the opportunity of birth because of abortion.
To prevent your eyes from glazing over dear reader, let us just say that it is no longer hyperbole to state that many nations are now on the express track to unrecoverable population replacement levels
Of course, we are also familiar with some of the possible causes of this phenomenon.
For some it is the inevitable outcome of a culture characterised by hyper-individualism where the even the possibility of having one’s options or freedom ‘curtailed’ has come to represent the child as an assault on personal autonomy that must be avoided at all costs.
For others the existential drop in birth rates can be attributed, at least in part, to the lack of financial or tax supports from functionally anti-child, anti-family governments that effectively penalise couples for choosing to start a family.
There is no doubt that these, along with high so-called deferred pregnancy rates and the unrealistic reliance on technology (frozen eggs-embryos etc) are all contributing factors, perhaps decisively so.
But maybe we also need to start talking a little bit more about another element of this debate that has often been lacking to date; and that is the rise in obesity among both men and women.
Alarm bells were sounded on this issue in Ireland as far back as 2011 when the National Taskforce on Obesity issued its final report.
That report was stark and unambiguous about the dangers of obesity for both pregnant women and those trying to have a child, as obese women were often confronted, then as now, with the high probability of outcomes such as maternal death or severe morbidity, gestational diabetes and preterm births among others.
For the baby, the risks associated with an obese mother were higher rates of stillbirth, neonatal death and prematurity.
This is why the Taskforce recommended that “where possible, obese women should be helped to lose weight prior to conception or receiving any form of assisted reproductive technologies (ART).”
The evidence is clear therefore around the negative impact of obesity on mother and baby. But the evidence is also pretty unambiguous when it comes to the ability to conceive.
This is important, I think, because these are factors that individuals (and couples) can change in a relatively short period of time, especially when compared to the long and weary battle one would have to engage in with governments in an attempt to have them refocus their policies to generate more positive child-friendly outcomes.
This is especially true where the standard reply from many governments is now some version of ‘get your Orbanesque ideas out of here, mister.’
Interestingly the causal connection between obesity and (in)fertility has also been defended recently by the Minister for Health Stephen Donnelly.
When he was asked by one TD if he would consider changes to the body mass index limits for fertility treatment in the context of assisted human reproduction, he stated in his reply that specifically in relation to the clinical parameter of BMI, “it should be noted that women presenting with high BMIs are at a high risk of reproductive health complications, as are their babies. “
He then went on to note that the risk of “sub-fecundity and infertility, low conception rates, miscarriage rates, and pregnancy complications are increased in women with raised BMI, in both natural and assisted conceptions.”
Furthermore, “reproductive outcomes for all fertility treatments are poor in this cohort. Obesity may impair reproductive functions by affecting both the ovaries and endometrium. It is because of these safety concerns and poor outcome facts that it is recommended, in line with the UK, the BMI parameters for intending birth mothers are a minimum of 18.5 kg/m2 and a maximum of 30.0 kg/m2.”
Now we can certainly have a debate about the ultimate usefulness of BMI as an indicator of overall health, but that does not mean that in a very real and accurate sense being heavily overweight works against fertility and conception not for it.
As the rate of obese people rises in our society so to will there be a corresponding rise in the number of children exposed to an increased risk of premature death alongside a rise in the number of women and men who will face enormous challenges in conceiving naturally and artificially.
There are of course exceptions to the thoughts outlined above. Take Japan, for instance, which has one of the lowest rates of obesity internationally but also one of the most pronounced and disastrously low birth rate levels.
This should make it clear, I hope, what I am not saying; if we solve obesity the birth rate crisis will be solved.
But I am saying that the phenomenon of obesity, and a compassionate approach to its reality in the lives of women and men seeking to conceive, should figure a little bit more in our discussions of the issue.