When time runs out: reconciling permanent childlessness after delayed childbearing

Objective: This study aimed to examine the experience of permanent childlessness after delayed childbearing.

Background: More women are delaying childbearing while they pursue a career, gain financial stability and seek an appropriate partner. However, given that fertility declines with age, there is concern that more women will end up permanently, unintentionally childless after postponing childbearing. There is little known about this growing and invisible group.

Methods: An interpretive phenomenological analysis was used to conduct the study. A purposive sample of 15 women who identified as being permanently childless after delaying childbearing participated in the study. Data were collected using in-depth semi-structured interviews.

Results: Themes included feelings of grief, loss and isolation; a need to make sense of their childlessness; and a need to rebuild and refocus their lives and identities regardless of whether they had actually tried to conceive during their childbearing years. Women struggled with feelings of regret and the need to reconcile the reality of their choice to delay childbearing based on their values and beliefs about the ideal conditions within which to raise a child with feelings of powerlessness to pursue motherhood when they were likely still fertile.

Conclusion: Women who are permanently childless after delaying childbearing experience similar feelings to those who are childless after infertility and failed fertility treatments regardless of whether they tried to conceive during their reproductive years. However, this group has unique needs based on their feelings of regret, powerlessness and responsibility for their childlessness.     

Further HFEA restrictions on egg donation in the UK: two strikes and you're out!

The UK and Europe have lagged far behind the USA in the number of egg donation cycles performed over the past two decades. This disparity has been largely attributed to governmental restraints placed on the method within these locales, combined with the lack of regulation in the USA. Severely limiting donor compensation and requiring donors to be identified 18 years or more after their participation will undoubtedly lead to the demise of egg donation as the UK now knows it. Throwing more money at the problem, in the form of increased donor compensation, is unlikely to fix the shortage of participants that is to come. As already witnessed, increasing numbers of women and couples will probably seek treatment outside their native borders to escape the unreasonable demands placed upon their personal liberties by government. Regulation will promote 'reproductive tourism' as patients seek care in areas of the world where self-determination is protected by law.     

When the womb is no longer safe: chorioamnionitis

Intrauterine infections are a leading cause of preterm birth, cerebral palsy and neonatal sepsis. This article investigates current ideas about prevention, diagnosis and treatment from a midwifery point of view.     

The Care of Older Children When a Sibling is Born

This study into the care of a child when his/her mother is hospitalized has shown that most care is given by the father and the grandparents. However, about 10% of mothers do not feel or recognize their child's need to understand why she is not at home, where she is, nor to visit her in hospital.     

When cancer of the endometrium is not a good cancer

Two groups of endometrial carcinomas (EC) are described: group 1 with associated adenomatous hyperplasia (AH) and group 2 without. Group 1 tumors are better differentiated, less invasive and almost never metastasize. Histologically, they are mostly glandular and well differentiated. Stromal foam cells were often present supporting the association with hyperestrogenism. Progesterone receptors (PR) were present in all tested cases, and their levels were high. The patients were often obese, nulliparous and had histories of estrogen intake; group 2 are less well or poorly differentiated EC, showed papillary, clear cell and anaplastic patterns, often invaded the myometrium and metastasized. PR were present in less than half of the examined cases, at low levels. The patients in this group were rarely obese, often multiparous had no history of estrogen intake; they were older than those in group 1. None of the patients of group 1 died of the disease, while about one fourth of the patients of group 2 died of EC. It was concluded that EC with no associated AH, therefore not hormonally "dependent" are cancers of higher virulence.