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21st Century Challenges to Building a Family

(Joshua U. Klein MD is Assistant Clinical Professor of OB/GYN – Mt. Sinai School of Medicine, and Medical Director at Reproductive Medicine Associates of New York — Brooklyn Office)

Historically, the term “family planning” was euphemistically applied initially to pregnancy termination; gradually, it was expanded to include contraceptive strategies as well. However, it seems clear that “family planning” in its broadest sense – i.e. planning the timing and size of one’s family — is an undertaking that most, if not all, 21st century women struggle with at some point in their reproductive lives.

Last month, the National Center for Health Statistics at the CDC released new data confirming the idea that women are getting pregnant later than they used to, even compared with the recent past. A comparison of pregnancy rates from 2008 with data from 2000, demonstrates that pregnancy rates in all age categories younger than 30 declined, whereas pregnancies in women aged 30-34, 35-39, and 40-44 all showed significant increases.

Another recent CDC report highlights the ongoing deferral of childbearing in the US as well as many other developed countries. For example, from 1970 to 2006 in the US, there was an eightfold increase in the number of women having their first child after age 35 (in 1970, 1 of 100 “first births” were to women older than 35; in 2006, 1 of 12 were in this category).

There is no doubt that a woman’s “peak fertility” occurs when she is in her 20’s, and that deferring childbearing till your 30’s or even 40’s can make getting pregnant more difficult. Historical data suggests that the overall risk for infertility — defined as more than one year of regular unprotected intercourse without conception — increases with age, from 6% between ages 20 and 24 to a whopping 64% between ages 40 to 44. Even for women who do not experience infertility in the technical sense, “subfertility” can lead to prolonged duration efforts at conception before pregnancy is achieved.

That said, in light of financial and professional pressures that have been exacerbated by the recent downturn in the economy, women today are often truly “under the gun” when it comes to planning a pregnancy. For example, I recently helped care for a woman who worked as a college professor, and she had to get pregnant before the end of her summer break (which was only 2-3 months of course), since she wouldn’t have enough time to do so during the academic year. Educational and professional timelines – limitations that are often complex and even conflicting between the partners – make timing of pregnancy more challenging than ever.

Taken together, these two elements – deferred childbearing until a less fertile age, combined with the need to conceive as efficiently as possible during the most convenient (and sometime only available) “window” of time – have created a “perfect storm” of pressure on a couple when it comes to planning a family. Even non-infertile couples will benefit from an intelligent and organized approach to getting pregnant; the question couples often face is not just “can we get pregnant?” but actually “can we pregnant within our timeframe?”

If all of the above represents the 21st century challenge to building a family, Kindara represents the answer. Founded on well-established principles of reproductive physiology, Kindara harnesses the ease and convenience of mobile and web technology to help the modern couple achieve their family-building goals.

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