Let's remember, there is a best-before date for getting pregnant

I've been friends with Shannon for about 10 years, and she has always seemed to have things figured out.

She went to big Ivy League schools in the States, dated unconventionally cute guys, always had cool apartments and funny roommates, and was usually working on something hopelessly glamorous like a TV show or a script for a Hollywood producer. You get the idea.

Shannon also travelled the world — India, Africa, Europe — and was decidedly bohemian about life. She didn't collect things. She collected experiences and travelled light. Holly Golightly looked like a sherpa compared to her.

When I asked her 10 years ago, when she was in her early 30s, did she want a child, she said hell no. Five years later a bit of doubt had crept into her voice. And then I didn't talk to her for a while.

The next time I saw Shannon, she had a baby in her arms. She said she had fallen in love with a man and realized life was meaningless unless you changed the ratios a bit — more love, less ambition.

In pursuit of that ratio, she had spent $20,000 unsuccessfully on in vitro fertilization at a Toronto clinic. ("I might as well have set that $20,000 on fire," she said.)

She then went to Beverly Hills, to a clinic where there was soft music on the stereo and cucumber infused water in the waiting room, spent another $15,000, and boom. She was preggo.

Biology

Shannon is like so many women of my generation, or just a little older, that I have been meeting lately. They are smart, talented, cool and bursting with intelligence and optimism.

They are the reason their mothers burned their bras and skipped classes to demand Women's Studies programs. They are the reason mothers before that starved themselves to get the vote, and they are the reason why people like me can look to the future with a sense of optimism instead of a narrow corridor with three doors: Nurse. Teacher. Wife.

But so many of them, too, when they decide to have babies in their late thirties, are finding that there are certain biological realities that even the most industrious, BlackBerry-wielding Wonder Woman can't explode.

After 35, a woman's chances of getting pregnant plummet. According to Health Canada, 91 per cent of women can get pregnant at age 30. The proportion drops to 77 per cent by age 35 and to 53 per cent by 40.

For those who go the IVF route — planting a fertilized egg, usually a woman's own — the live-birth rate is 27.1 per cent and almost a third of those (30.3 per cent) will be multiple births.

The problem with IVF

The high multiple-birth rate is easily explained: Many women show up at an IVF clinic desperate to conceive, and when their doctor offers them the option of implanting several fertilized eggs in the womb at the same time (the better the chance one will make it), they tend to say yes.

"By the time you have mortgaged your house and your car, you are ready to take on the risk of twins and triplets," says Dr. Renda Bouzayen, a professor of obstetrics and gynecology at Dalhousie University in Halifax.

But the often untold story here is that the babies from these multiple births are very likely pre-term and low birth-weight and will suffer health problems.

The Canadian Institute for Health Information estimates that the average lifetime cost of a multiple-birth child in Canada is $520,000. As Bouzayen puts it: "The province picks up the costs of these 'miracle' babies."

Earlier this year, Quebec became the first jurisdiction in North America to fully fund IVF treatment, for up to three cycles, for infertile couples. As a result, the pressure is now on for other provinces to follow suit.

But without a smart strategy, the problems with IVF — the impossibly high expectations, the potential for multiple births and the costly health issues that follow — may only become more pronounced.

So what's the solution?

Best before

One part of it is that governments need to fund IVF treatment. Period. But with strings attached.

If IVF is publicly funded, it can be closely monitored and tied to single embryo implantation, as some European countries are doing.

At this point, Quebec is anticipating a limit of three implants per cycle. But that is not good enough.

Finland introduced publicly funded IVF tied to single embryo transfer and the multiple-birth rate there dropped from 24 per cent in 1996 to 14 per cent in 2002. Belgium and Sweden have reported similar results.

Obviously, if women decide to have their children in their 20s or early 30s, IVF wouldn't be so in demand. But, let's face it, women today are not likely to retreat from the gains they have made in the workplace and rush back into domestic enslavement.

Between 1976 and 2002, the proportion of first-time mothers 30 years and older increased from 9 to 34 per cent in Canada, a trend that is expected to continue.

These changes have many positive elements: Those who delay reproduction benefit from increased education and income, says a 2005 report by Health Canada on changing fertility patterns, while later parenting is associated with a lower risk of marital separation.

But IVF policies can't be the entire strategy here.

I'd like to see every family doctor start speaking frankly to their female patients about infertility, while these women are still in their twenties.

I want them to tell us honestly that, while the feminist revolution has granted us options, the choice to have a baby generally has an expiration date on it.

I want my doctor to pull out those scary looking charts where the fertility rate arcs up high and clear until 35 and then takes a nosedive. I want my doctor to tell me how much IVF costs, and how it will be years before provincial governments fund it like Quebec or even Manitoba, which offers a fertility tax credit to help offset the cost of private treatments.

And, you know, I wouldn't mind a massive public education campaign as well. Ads in Chatelaine. Posters in buses.

Health authorities went all out to tell us to get vaccinated against HPV. Why not go all out to warn us of the dangers of late pregnancy?

Some might view that as a repressive patriarchal state meddling in the affairs of young women. Well, I'm speaking for myself here, but I'd rather be educated and slightly offended than find out too late and be in anguish.

For my kind of feminism, that's what empowerment really means. Getting all the facts, not just the info that makes you feel good.