Fertility treatment caters only to married couples | Older mothers becoming increasingly common

Getting married later in life has become increasingly common in Macau society, where more people are tying the knot after the age of 30 compared to the past.
According to data provided this week by the Health Bureau to the Times, in 2013 the percentage of Chinese women aged 40 or above giving birth in Macau was 3.44 percent, whereas for non-Chinese women, the figure was 0.53 percent. In 2014, the respective figures were 3.13 percent and 0.37 percent, whereas in 2015, the percentages were 3.20 percent and 0.44 percent respectively.
Local sociologist Larry So attributes the growth in older mothers  to the growing number of individuals who are more “professional and educated.”
Although the recognized cut-
off line for advanced maternal age is 35, So claimed that women tend to seek help using advanced medical technology such as In Vitro Fertilization (IVF).
Dr Fong Kuan Io, an obstetrics and gynecology doctor at the Macau University of Science and Technology (MUST) Hospital told the Times that even though many women resort to IVF, the quality and quantity of women’s ova start to decline after the age of 40. It is therefore not an easy process for them to undertake treatment, as success rates are not high.
Fong also stated that “delayed pregnancies” increase the risks of spontaneous abortion and premature delivery, chromosomal abnormality and fetus congenital malformation, pregnancy-induced hypertension and pre-eclampsia, and stillbirths.

“Late mothers can try vaginal delivery, but it has a high chance of labor dystocia that can eventually lead to a C-section or [the requirement for] midwifery [assistance],” stated the physician.
Noting that late pregnancy generally refers to women who give birth or become pregnant at the age of 35 or older, the Health Bureau listed the possible health risks of late pregnancy. Those include, according to the bureau,  “miscarriage, pregnancy-induced hypertension, gestational diabetes mellitus, pre-
eclampsia, pre-term delivery, intrauterine growth retardation, fetal chromosomal abnormalities (trisomies 21, 18 and 13 are most common), fetal genetic mutations,” among others.
An older mother who did not want to be identified stressed to the Times that giving birth at her age was “a lot harder” compared to when she gave birth over a decade ago.
“I could really feel the difference. My body felt really weak, especially during my third trimester [of pregnancy],” she said. “It was very complicated because I was still aiming for a normal delivery but due to complications, we had to resort to a C-section.”
Since fertility treatment in the MSAR only caters to married couples, cohabiting couples are forced to seek such treatment in Hong Kong and China, said So.
“Because you don’t assume that an intimate relationship is kind of like a family,” he argued. “In Macau, the definition of family is marriage.”
Although So added that blue-card holders are not entitled to the same privileges and treatment opportunities as local residents, he denied allegations that non-residents are not given pre-natal care at local hospitals.
The Health Bureau didn’t reply to the Times questions on fertility treatment for single mothers, non-residents and unmarried couples. However, hospital doctors confirmed that fertility treatments exclude the referred groups.
In Hong Kong, the number of women giving birth at and after the age of 40 has increased by nearly 90 percent over the past decade.
Hong Kong’s Census and Statistics Department data revealed that 3,391 babies were born to mothers aged 40 or above in 2014, an 86 percent rise from 1,819 in 2005. The number of babies born to mothers aged 45 or above increased from 87 to 174.
The South China Morning Post indicated that the Hong Kong statistics reflect “a trend towards late-in-life motherhood,” with the median age increasing from 30.8 to 32.4. Staff reporter