Listen to a successful woman discuss her failure to bear a child, and the grief comes in layers of bitterness and regret. This was supposed to be the easy part, right? Not like getting into Harvard. Not like making partner. The baby was to be Mother Natur e's gift. Anyone can do it; high school dropouts stroll through the mall with their babies in a Snugli. What can be so hard, especially for a Mistress of the Universe, with modern medical science devoted to resetting the biological clock? "I remember sitt ing in the clinic waiting room," recalls a woman who ran the infertility marathon, "and a woman-she was in her mid-40s and had tried everything to get pregnant-told me that one of the doctors had glanced at her chart and said, 'What are you doing here? Yo u are wasting your time.' It was so cruel. She was holding out for that one last glimpse of hope. How horrible was it to shoot that hope down?"

The manner was cold, but the message was clear-and devastating. "Those women who are at the top of their game could have had it all, children and career, if they wanted it," suggests Pamela Madsen, executive director of the American Infertility Associatio n (A.I.A.). "The problem was, nobody told them the truth about their bodies." And the truth is that even the very best fertility experts have found that the hands of the clock will not be moved. Baby specialists can do a lot to help a 29-year-old whose tu bes are blocked or a 32-year-old whose husband has a low sperm count. But for all the headlines about 45-year-old actresses giving birth, the fact is that "there's no promising therapy for age-related infertility," says Dr. Michael Soules, a professor at the University of Washington School of Medicine and past president of the American Society for Reproductive Medicine (asrm). "There's certainly nothing on the horizon." This means, argues economist Sylvia Ann Hewlett in her new book, Creating a Life: Professional Women and the Quest for Children (Talk Miramax Books), that many ambitious young women who also hope to have kids are heading down a bad piece of road if they t hink they can spend a decade establishing their careers and wait until 35 or beyond to establish their families. Even as more couples than ever seek infertility treatment-the number of procedures performed jumped 27% between 1996 and 1998-doctors are lear ning that the most effective treatment may be prevention, which in this case means knowledge. "But the fact that the biological clock is real is unwelcome news to my 24-year-old daughter," Hewlett observes, "and she's pretty typical."

Women have been debating for a generation how best to balance work and home life, but somehow each new chapter starts a new fight, and Hewlett's book is no exception. Back in 1989, when Felice Schwartz discussed in the Harvard Business Review how to creat e more flexibility for career women with children (she never used the phrase Mommy Track herself), her proposals were called "dangerous" and "retrofeminist" because they could give corporations an excuse to derail women's careers. Slow down to start a fam ily, the skeptics warned, and you run the risk that you will never catch up.

And so, argues Hewlett, many women embraced a "male model" of single-minded career focus, and the result is "an epidemic of childlessness" among professional women. She conducted a national survey of 1,647 "high-achieving women," including 1,168 who earn in the top 10% of income of their age group or hold degrees in law or medicine, and another 479 who are highly educated but are no longer in the work force. What she learned shocked her: she found that 42% of high-achieving women in corporate America (def ined as companies with 5,000 or more employees) were still childless after age 40. That figure rose to 49% for women who earn $100,000 or more. Many other women were able to have only one child because they started their families too late. "They've been m aking a lot of money," says Dr. David Adamson, a leading fertility specialist at Stanford University, "but it won't buy back the time."

Recent Census data support Hewlett's research: childlessness has doubled in the past 20 years, so that 1 in 5 women between ages 40 and 44 is childless. For women that age and younger with graduate and professional degrees, the figure is 47%. This group c ertainly includes women for whom having children was never a priority: for them, the opening of the work force offered many new opportunities, including the chance to define success in realms other than motherhood. But Hewlett argues that many other women did not actually choose to be childless. When she asked women to recall their intentions at the time they were finishing college, Hewlett found that only 14% said that they definitely did not want to have children.

For most women Hewlett interviewed, childlessness was more like what one called a "creeping nonchoice." Time passes, work is relentless. The travel, the hours-relationships are hard to sustain. By the time a woman is married and settled enough in her care er to think of starting a family, it is all too often too late. "They go to a doctor, take a blood test and are told the game is over before it even begins," says A.I.A.'s Madsen. "They are shocked, devastated and angry." Women generally know their fertil ity declines with age; they just don't realize how much and how fast. According to the Centers for Disease Control, once a woman celebrates her 42nd birthday, the chances of her having a baby using her own eggs, even with advanced medical help, are less t han 10%. At age 40, half of her eggs are chromosomally abnormal; by 42, that figure is 90%. "I go through Kleenex in my office like it's going out of style," says reproductive endocrinologist Michael Slowey in Englewood, N.J.

1 | 2 | 3 | Next >>