"We asked ourselves, ‘Do we want to live comfortably or do we want to have a child?’ If we’d chosen to become parents, we worried that we wouldn’t be able to give the child, or ourselves, the kind of life they, or we, deserved. In the end, the mortgage crisis made our minds up.” Thirty-eight-year-old charity worker Lauren sighs as she recounts the various calculations that she and her partner, a solicitor, did when they began discussing the possibility of parenthood.
“Our income is fine but I also care for my mother, who is disabled, so, all in all, we run into debt most months. When my partner and I sat down about 18 months ago to do all the sums we realised that with childcare being as expensive as it is, it wouldn’t make sense for me to work if we did have a child — but then we’d barely be able to cover the mortgage. When the rates went up after the Truss mini-budget, we knew that was that," says the south Londoner. "We can’t move somewhere cheaper because it would disrupt my mum’s care too much. I definitely had this out-of-body feeling when we were going through it all, it felt wrong to be talking about budgets and spreadsheets and all that clinical stuff in the same breath as a baby but I suppose that’s just the truth of living in a city like London.”
When we partnered with Peanut, the app and online community for mothers, to conduct The Standard’s first fertility survey, we expected that reproductive health and access to fertility treatment would be top of the agenda for those who were trying to conceive. We expected to get a glimpse into the many health anxieties that this process can bring up. And while those issues did come up, we quickly realised they weren’t the main concern for most would-be parents.
Far from health or age or the IVF postcode lottery, a huge proportion of respondents said that in 2023 their fertility choices, like Lauren’s, were being dictated by the economy. Many told us that reproductive health wasn’t as big a worry as affordability — and the questions that would-be parents were asking themselves were often along the lines of ‘how do I have a child when I can’t afford my mortgage?’ or ‘how can we try for a second when I can barely afford childcare for one baby?’ In the midst of a cost of living crisis, the spectre of financial security hovers just out of most people’s grasp — and it is having a profound impact on our fertility.
Of the almost 400 people who responded to our questions, many were like Lauren, they felt they simply couldn’t try for children — or try for more children — because of the astronomical cost of living. Alison*, 34, for instance, already had one child but was put off trying for another. As she pointed out: “With the rising cost of everything, it worries me if I will be able to afford to give my children the lucky life I had — and that my parents expect me to provide for my kids. Sometimes I feel that love is the most important thing [when it comes] to raising a family, but I’m feeling the pressure from family telling me that we need money too.” Many were like 38-year-old Jules*, who had been trying for her first baby for less than six months but found the process stressful because “the more I think about it, the more that I realise costs are ridiculous at the moment. I earn an average salary — how will I afford a child?”
I've been put off having children. Childcare is so expensive and has a giant waiting list at every nursery, and I’m so broke. Maternity pay is just not enough. And housing is so expensive. I’m still living with my parents and even that is expensive
Just over a third of respondents (34.3 per cent) had felt pressured to remain childfree, even though they wanted to start trying for a baby; most attributed that pressure to money worries, lack of access to childcare and saving for a house deposit. As one 35-year-old Londoner told us: “I feel that [financial instability] is like invisible pressure, particularly during the cost of living crisis where the cost of our food shop has gone from £60 to £110 per week with no difference in the products.” Or, as another childfree respondent in her thirties put it: “Childcare is so expensive and has a giant waiting list at every nursery and I’m so broke. Maternity pay is just not enough. And housing is so expensive. I’m still living with my parents and even that is expensive.”
These answers drive home the multifaceted nature of the fertility question, and paint a bleak picture of the many and varied pressures that prospective parents face in 2023.
The findings follow a well-worn pattern — multiple studies over the years have shown that economic instability impacts the birth rate. After the 2007 banking crisis and the global recession which followed, for instance, there was a marked decline in births across most affected countries, putting a sharp halt on the rising fertility rates of the decade before.
34 per cent felt pressured to remain childfree, even though they wanted to start trying for a baby — most attributed that pressure to money worries, lack of access to childcare and saving for a house deposit
Researchers at the Brookings Institute (a US-based non-profit organisation) noted that the trend was borne out on both macro and micro scales. “State-level comparisons provide a direct link between an economic downswing and birth rates,” they wrote. “States in which the recession was more severe experienced greater declines in birth rates.” The fact is, having children is expensive and when resources are squeezed many are forced to think twice about even trying. In 2020, Brookings predicted a similar decline in birth rates, thanks to the economic instability caused by the pandemic — and indeed, last year, the number of babies born in England and Wales dropped to the lowest level in two decades, according to the most recent data from the Office of National Statistics.
Interestingly, even fluctuating house prices have been linked to fertility rates. In 2014 researchers at the University of Maryland, working in conjunction with the US Federal Reserve, mapped fluctuations in house values across one Metropolitan-sized area for the period 1997-2006. They found that increases in house prices correlated to an increase in birth rates — but only for homeowners. In fact, as house prices in an area increased, the birth rates for renters in that area went down. They wrote: “A $10,000 increase leads to a 5 per cent increase in fertility rates among [home]owners and a 2.4 per cent decrease among non-owners.” Given London’s wildly overheated housing market (the average property sells for £698,550, according to Rightmove, while the average rent is £2,179 a month — an increase of 12 per cent in the past year), it’s little wonder that those who don’t already own their home might be put off trying for a baby.
When Gemma Bolton and her husband started trying to get pregnant, they thought they’d done everything in the right order. “In my twenties I was never particularly desperate for kids,” says Gemma, now 37. “I just always assumed I’d have them at some point. But, of course, I turned 30 and I was still living in a flatshare in London so I didn’t feel financially ‘there’ yet, or emotionally, to be honest. It didn’t really worry me. But then 31 came, 32, 33, and my partner and I were still renting in Bethnal Green. I wanted some kind of stability before we started trying for a baby.” Realising they’d never be able to save enough to buy in London, they decided to decamp to Kent. "As soon as we had the house it felt like the last piece of the puzzle, like ‘Okay, now it’s time to start trying.’”
Many who responded to our survey told us that, like Gemma, they were waiting until they’d managed to save a deposit for a house before trying for a baby. Of course, this wait alone can have a major impact on a person’s chances of getting pregnant — according to a study released in July by the campaign group Generation Rent, on average, first-time buyers in the UK must now save for almost 10 years to build-up the necessary pot. The average Londoner saves for 18.3 years before getting onto the property ladder.
Sadly, for Gemma and her partner, the path to parenthood has not been an easy one. “I’ve had three miscarriages in the past three years and I look back now and bitterly regret our decision to wait — it feels like those three years have just vanished, it all feels so cruel. Deep down I can’t help but think ‘F**k, we should have tried earlier’; it does send me into a mental spiral. I end up berating myself, thinking it was hubris, or naive, to think that everything would just work out when I wanted it to. Thirty-seven suddenly feels so old but then, at 30 or 31, I just didn’t feel like I could start trying. I didn’t feel like the stability was there.”
77 per cent of respondents were actively trying to conceive but way more than that — 89 per cent — were already worried about their fertility
In our survey, housing came up again and again as having a major impact on fertility choices. Forty-three-year-old Londoner Francis* told us that she had one child already but had stopped trying for a second. Despite living in a two-income household, she explained that thanks to London’s housing market “we simply can not afford to have multiple children. Our two-bedroom house is not big enough and given the cost of housing now, we don’t have the finances to up-scale.”
Interestingly — and despite the countless headlines about low sperm counts and fertility that falls off a cliff at 35 — the majority of survey respondents (56.1 per cent) said that they thought that there was no cut-off age for having a child. This even applied to many who listed ‘age’ as a contributing factor to why they personally weren’t getting pregnant.
Still, fertility anxiety was clearly high: 77 per cent of respondents were actively trying to conceive but way more than that — 89 per cent — were already worried about their fertility. And, overwhelmingly, respondents wished they had more access to free fertility testing before they were actually at a point of needing it. A whopping 91.3 per cent thought that the NHS should offer fertility testing free to everyone and 77 per cent felt that they did not have enough access to NHS-funded fertility treatment when they needed it.
Though she’s grateful for the kindness and support she’s received over the past three years, Gemma found that the NHS offers little in the way of answers for sufferers of recurrent miscarriage. “After the first miscarriage I was told, ‘Oh, yes, it’s quite common. It happens to one in four’ — basically I was told I’d be fine. Then I had the second one and I found myself in this strange grey area. It was like, ‘Oh, that’s bad luck’ but for them to do any kind of testing, you had to have three miscarriages in a row which seems kind of cruel, really.” After her third miscarriage, though, she was disappointed to find that the testing she was offered was fairly rudimentary. “They tested for diabetes, for blood clotting, and for thyroid problems, and my results showed that I wasn’t affected by any of those things. The thing that finally made me realise that I had to go private was meeting with this one doctor — and on the whole, NHS staff were overwhelmingly kind and patient — but she just didn’t seem to have a particularly good bedside manner. And she was basically like, ‘Oh, we don’t know why this is happening and there’s nothing we can do for you. But good luck!’ I just couldn’t face sleepwalking into more miscarriages.”
Gemma has since undergone treatment with a Harley Street miscarriage specialist, though, like the majority of respondents to our survey (a third of whom were undergoing fertility treatment), she is finding the process grindingly expensive. “We’ve been having the treatment now for three months — and we had to pay £2,500 upfront for initial tests. I did cry when I saw that bill. Like, I just burst into tears in this Harley Street Clinic, because I thought, I’m on Harley Street but we’re not Harley Street people, you know? We don’t have that kind of money. But what choice do we have? I feel like the NHS can’t help me and I’m over a barrel.”
Indeed, NHS fertility treatments are vastly oversubscribed. The number of NHS-funded IVF cycles that a person is entitled to depends on where they live — but according to the Human Fertilisation and Embryology Authority, entitlements have been going down nationwide since 2019. And even where it is available, our survey found that fertility treatment on the NHS was rarely plain sailing. As one 28-year-old respondent, who’d been trying to get pregnant for four years and had been undergoing treatment for six months, found: “NHS criteria is a huge barrier [to accessing fertility treatment]. NHS doctors were rude and unhelpful and have little knowledge on PCOS or women’s health in general. It needs more research and understanding.”
For Gemma, going private has been both financially and emotionally tough. “I feel a lot of shame around it because so many women have normal pregnancies, without having to spend all this money on supplements and drugs and reflexology and all the other stuff they recommend. It sounds weird but it feels like this thing that I should just be able to do. So yeah, I feel ashamed… I feel like a failure.” Despite all this, she doesn’t think that the answer to our fertility woes lies in unlimited free testing or treatments. “Even testing, for instance, wouldn’t have helped me much because I can get pregnant — so nothing would have come up on a fertility MOT. The one thing that would have changed the outcome for me was if I’d felt more empowered earlier in my life to try for a child.”
And indeed, overwhelmingly, our survey paints a picture of a society that is so inhospitable to would-be parents that it’s making many put off parenthood - sometimes indefinitely. Unstable housing, ungenerous parental leave policies and the astronomical cost of childcare have all coalesced to create a situation where the decision to have a child requires the balancing of many equations and, often, a tacit acceptance that your life may end up much more precarious. For some people, that’s simply not a risk worth taking.
“I think more and more people nowadays are embracing the joy of being childfree,” says Lauren. “And it certainly has its up-sides. The freedom to travel, to prioritise yourself or your career or your partner - these are all things that I’ve really enjoyed since we made the decision to not have children. But I guess because of how it happened for us, I’ll always have that thought in the back of my mind — that the decision was effectively taken out of my hands. That we are victims of circumstance. We’re making the most of it - but it shouldn’t have been this way.”
