Thursday, May 01, 2008

Parents-Tell Your Adult Children: Don’t Delay Childbearing by Dr. Alan Singer

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Too many parents approach issues in their adult child’s life with the unspoken rejoinder, close your mouth and open your wallet. Parents often give no advice, even when they have serious concerns. Thirty years as a family therapist and 28 years as a father, have taught me that parents should voice their opinion to their adult child about two specific issues: getting married and not waiting numerous years before having children.

The Domino Effect
In recent years, the trend of delaying marriage has caused a domino effect on other trends which have a significant emotional cost for families and an enormous financial cost to society. The dominos are: delayed marriage—delayed childbearing—augmented infertility—elevated multiple births—increased rates of pre-term births and caesarian sections. My goal in this column is to describe these decisions to delay marriage and childbearing and the resulting consequences. I will offer some suggestions that parents might use in dealing with their adult child.

Of the 4.1 million births registered in the U.S. in 2005, 37 percent were born to unmarried women (CDC). Some of the reasons that couples cohabit include: convenience, economy of savings, preparation for the marriage commitment, and apprehension about the high divorce rate. But these couples are actually practicing non-commitment. Even if they eventually marry, they have less satisfying marriages and higher divorce rates than spouses who did not first live together (National Marriage Project). If the unmarried biological parents go their separate ways, where does that leave the children?

If I am perhaps describing your adult child, don’t you want the best possible family environment for your grandchild? Wouldn’t you consider voicing your opinion to your son or daughter, knowing the irrefutable research finding: the best environment to raise children is two biological parents in a low-conflict marriage? You might respond that you don’t want to “meddle” or times have changed and it’s not like the old days when parents spoke their minds. My response mirrors a recent mass e-mail: don’t be so open-minded that your brains fall out.

Adult Children Do Listen
Please don’t misunderstand me: Parents should not tell their grown child everything on their minds. But, in matters that are crucial for their well-being, they must speak up. My three decades of research into family size decisions have shown that adult children are aware of and appreciably influenced by the attitudes of their parents. One of my own survey research findings is the importance of family-of-origin family size as a predictor of total family size. The decisions our parents made about family size tend to have a significant impact on our own decisions.

In fact, reliance on the advice of parents has been described in the National Survey of Student Engagement (2007) which questioned 313,000 randomly selected college students. The survey revealed that young adults follow the advice of both parents more than twice as much as they listen to friends. So, if your son or daughter informs you that he/she wants to live together with a “significant other” for a few years, possibly even have a child or two, don’t respond with that 1960’s expression, do your own thing.

The First Two Dominos
Couples, who do choose to marry, are waiting longer to do so.
According to the Census Bureau, between 1970 and 2000, the median age at first marriage for women increased by 4.3 years to 25.1 years; for men the increase was 3.6 years to 26.8.

In tandem with the later age at first marriage, is the decision to delay childbearing. The mean age of mothers in the U.S. was 24.6 in 1970 which increased to 27.2 in 2000 (CDC). Approximately 20% of women wait until after 35 to begin having children ( Consider that birth rates for women 35-39 and 40-44 years (which have risen steadily in recent years) each increased 2% in just one year, 2005 (CDC).

Why do these delays occur? Education and career, which are positive trends, are important factors in women’s decisions to delay marriage and motherhood. From 1970 to 2000, the percent of women having completed four or more years of college nearly tripled and the female labor force participation rate increased by 39% (CDC 12/11/02). The availability of contraception allows couples to delay childbearing while strengthening their relationship, establishing careers, and amassing enough assets to settle down for a secure and comfortable future. But how emotionally secure and financially comfortable are they going to be down the road? Will their marital bond be able to withstand the stress imposed by infertility, multiple births, and pre-term infants?

The decision to delay comes with consequences that take their toll on spouses and society. The miscarriage rate (34%) is triple for women 40-44, compared to those ages 20-29 (10%). The risk of having a Down Syndrome child increases from one in 1250 for a 25 year old mother, to one in 30 for a 45-year-old mother (ASRM). Infertility, the next domino, affects 7.3 million people in the U.S., representing 12% of the women in the reproductive age population (CDC). A healthy 30 year old woman has a 20% chance each month to get pregnant; a healthy 40 year old woman has a 5% chance each month (ASRM). Secondary infertility, which can follow the birth of one or more biological children, is more prevalent than primary infertility. The emotional toll from the long-term inability to conceive a child can be devastating to spouses. Common feelings include: frustration, jealousy, anger, isolation, sadness and guilt. Self-image and self-confidence are affected as well.

Frequent visits to physicians interfere with careers and regardless of which spouse has the physical problems, most of the tests and treatments focus on the woman’s body. People typically assume that infertility is the woman’s fault and that adds to the stress (Abby, Andrews and Halman. Journal of Marriage and Family, May 1992). The financing of infertility treatments is considerable. Each in vitro fertilization cycle costs more than $12,000 with many couples requiring multiple cycles. The total cost for all types of fertility treatments exceeds $3 billion per year.

Remember when your child was young; you didn’t want to spoil her by giving her everything she asked for at the mall. But you knew which gift she really wanted and you waited for the right occasion to give it. Now, imagine your feelings of helplessness, when your adult child wants nothing in this world more than to parent a child. You can be supportive and optimistic, but there is no department store that sells what you wish you could buy.

Multiple Births
The huge number of couples undergoing fertility treatments has tipped another domino, multiple births. About 45% of Assisted Reproduction Techniques pregnancies result in twins and 7% in triplets or more (March of Dimes). The birth rate for twins in the U.S. rose steadily between 1990 and 2004, climbing an average of 3% annually for a total increase of 42% since 1990, and 70% since 1980. “Two related trends have been closely associated with the rise in multiple births over the last two decades: the older age at childbearing (women in their thirties are more likely than younger women to conceive multiples spontaneously) and the widening use of fertility therapies” (CDC 12/5/07).

Increased fetal risks include: higher chance of miscarriage, birth defects, and the mental/physical problems that can result from a premature delivery. Fetal mortality rates are higher for a number of groups, including: women who are 35 and over, unmarried women, and multiple deliveries. “Twins are 5 times and triplets are nearly 15 times more likely than singletons to die within a month of birth” (CDC 12/5/07). Maternal risks include high blood pressure, diabetes, and hemorrhaging”. Multiple gestation is associated with more depression, lack of sleep, financial difficulties, and marital discord (ASRM).

One method of reducing the risks is Multi-fetal Pregnancy Reduction. When there are four or more fetuses present, the number is reduced to one or two. This technique is used in an effort to increase the likelihood that the pregnancy will continue.

Remember when you taught your child decision-making, such as which friends she could invite for a sleepover or how she should spend her hard earned allowance. Did you imagine that one day you might be giving support to your child in her decision to proceed with multi-fetal pregnancy reduction?

Pre-Term Babies
More than half of twins are born pre-term and approximately half of twins and almost all higher order multiples start life with a low birth weight. Data from 2005 indicates the premature birth rate is continuing to rise, with more than 525,000 babies or 12.7% born prematurely (March of Dimes 12/5/07).

Preemies tend to encounter these difficulties: low birth weight, breathing problems, underdeveloped organs, risk of infection and risk of cerebral palsy (NICHD). Researchers, writing in the New England Journal of Medicine (1/17/02) concluded, “Very low birth weight participants had a lower mean IQ; educational disadvantage associated with very low birth weight persists into early adulthood.” And the emotional toll? Preemie families face a stressful new world. Parents may only enjoy a brief encounter with their baby before she is whisked away to the NICU for weeks, even months. And the financial toll? More than $26.2 billion per year. “Direct health care costs to employers for a premature baby average $41,610—15 times higher than the $2,830 for a healthy, full-term delivery. Additional costs to employers in lost productivity average $2,766” (March of Dimes, Cost to Business).

Remember when you taught your child patience, such as waiting for a mail-order gift to arrive or standing in line at Disney World. Now, imagine how you may need to give strength to your child as she waits patiently for her baby to come home after months in the NICU.

Caesarian Sections
The last domino is the soaring number of caesarian deliveries (1.25 million per year). The current c-section rate of 30.3 percent is triple the 10.4% c-section rate of 1975 (ACOG Stats and Facts 2007). Mothers of multiples are more likely to have c-sections and a growing number of doctors and patients are scheduling c-sections for their own convenience. The cost of a c-section ($13,441) is twice that of a vaginal delivery, with the national total exceeding $17 billion per year (ACOG). And the human price tag? Risks for mothers include: anesthesia, increased bleeding, chance of infection and blood clots in legs, pelvic organs, and lungs. Risks for the baby are inactivity from the anesthesia and possible breathing problems (March of Dimes).

The trends described above are not small blips on the radar screen; they are continents. They are years in the making and would take a major upheaval to reverse by even a percent or two. My real hope is that these trends will not continue to increase. I also hope that with the catastrophic divorce rate in the U.S. hovering at 50%, not one more marriage will succumb to the marital stress caused by these trends. But as long as parents are either too shy or too worried to put in their two cents, these emotionally devastating and costly trends may continue to surge.
Remember how it took courage to sit down with your pre-teen and explain the birds and the bees? Summon that courage again and tell your adult children your opinions on the importance of marriage and the timing of children.

Remember when your child was in grade school? You soccer moms and side-line dads, who ran yourselves ragged in your minivans because violin, astronomy, chess, swimming and painting weren’t enough—you also insisted that your child go to Math camp. Didn’t you believe that all the hyper-parenting was in your child’s best interest so that she would have the best chance to succeed in life? Do you want to see your adult child go through the frustration, pain and sometimes grief from the trends described above? And the possible negative consequences for your grandchild?

Final Thoughts
It is vital to remember the "context" that a parent would have this discussion with an adult child. You cannot just spring this topic on your grown child out of nowhere. You need to communicate and demonstrate the values of marriage and parenthood to tweens and teens, long before they are ready to be independent. Second, you have to convey to your grown children that you are willing to help them raise their children, to the extent that you are able. You cannot simply give lip service to the trends and consequences described here; you need to step up to the plate and offer your services and resources. Be willing to put your time, energy, and money where your mouth is, not only for the personal joy of bouncing a grandchild on your lap, but so your grandchildren can reap the benefits of significant contact hours with YOU....their grandparents. Don't you want to help your adult child start a family while you are young and have the energy and health to be helpful in addition to joyful? So please don't be cheap. Your offer to help your children financially in the early years of marriage can make all the difference in the world to a young couple who is determined to be self-sufficient. I’d like to change the rejoinder to open your mouth and open your wallet too.

When your newlyweds tell you they are in no hurry to start a family, will you be prepared to respond? Children do respect the opinions of their parents, and truly need to hear them.

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Supersized Family Big on Parental Love, Sibling Support by Dr. Alan Singer

When you see a family with a huge number of children, is your first can they possibly manage? In this column, I discuss several large family stereotypes, but more importantly the conluence of sibling support. The Home News Tribune published this on May 28, 2008

In order to give you a complete picture of life in a large family, I first asked Rabbi Norman Weitzner and wife Naomi how many children they have. His response: More than 10. Her response: Not enough.

When asked why they won't give me the exact count, Norman responded, "It hurts childless couples to describe the size of a big family so I don't want to." Naomi's approach: "When you quantify the size of a group of children, you don't differentiate individuals and you should, because each one is a separate person."

Back in the 1970s, when they lived in Boulder, Colo., where Norman directed the University of Colorado Hillel, a reporter with an anti-large family bias asked their 7-year-old son, "Don't you feel bad you have so little time with Mom and Dad because there are so many kids at home?" Their son responded, "Oh no, just the opposite. When one parent is busy, there's always someone else to play with." As a large family in the heyday of the Zero Population Growth movement, they used to get plenty of dirty looks. Naomi recalled overhearing a woman say to her friend, "What can we do, they are using up all our oxygen."

Even though I have no anti-large family bias, I still felt the need (not sure why) to question them on large family stereotypes. One by one, they shot each down. When I asked about safety, Naomi described the "buddy system" rule for bicycle riding. "They could never ride without a sibling, and once it really paid off because my son fell off his bicycle and was badly hurt. His brother flagged down a car and sent them to our home urgently." Naomi insisted, "Our children know that we are not out for No. 1 all the time; we're also out for No. 2, or No. 3, which is how we raised them." The rabbi added, "Kids in a large family know that they have to share with other people; they are not as self-centered."

When I asked how they survived what had to be a three-ring circus at times, they explained the importance of being well organized. Each child had a job to do, and jobs were rotated monthly.
Was there time for recreation? "Sure," Naomi responded, "if they wanted a day trip on Sunday, I'd point out their unfinished household chores and give them a time deadline. Things happened — zoom!"

I inquired about the amount of time they gave each child, based on dividing up the parental hours per day. Naomi took umbrage at my question: "Tell me, Dr. Singer, today's latchkey kids, who come home to an empty house or to the maid, are they all from large families? The amount of time a parent has is not related to the number of children. I don't subscribe to the thinking that if you have six kids, each child gets one-sixth of your love. You can read a story to three children and you can take three kids on an adventure hike. A child does not feel less loved because his siblings come along on a trip."

The last stereotype we discussed was the resentment of older siblings who are placed in a caretaker role. The rabbi explained, "Someone asked if our firstborn daughter, who was followed by many sons, resented being the oldest. I suggested to him that we wait and see what my daughter decides for her own family size when she gets married. Well, she has many children of her own, so the proof is in the pudding."

Enough about stereotypes; let me describe some fascinating sibling insights. The Weitzners are quite proud of how well their children look after each other. Four of their married sons and their families live within one block of each other in Brooklyn, N.Y. "It is not to be believed how much they help each other," Naomi says. "When one of them moves to a new house, they all get together, pack the furniture, and load the moving van, even if it means lowering a couch from a second-floor balcony." "My son, who is in home construction, will go to his siblings and retile their kitchen floor at no charge," says Norman. "My son the lawyer did all their house closings for free." "One of our sons often says to his siblings, "If you ever need money, just let me know." Naomi adds. "Can you imagine?"

Certainly, credit for the success of this large family belongs squarely in the hands of Norman and Naomi. Dr. Richard Weinberg, professor of psychology at the University of Minnesota, stated in Child Magazine (September 2000), "Indeed, parents — not family size — have the ultimate power to shape their children's lives. If parents are patient and caring and want to invest in their kids, they can have lots of well-adjusted children." "And," add the Weitzners, "plenty of prayers and tears directed toward the Creator, who is the third partner of every set of parents."

"Be Counted" columnist Dr. Alan Singer is a marriage therapist in Highland Park. Respond to this column at Dr. Singer's blog or e-mail "Be Counted" columnists are members of the public.