England and Wales fertility rate falls to lowest on record. Is that by choice, asks expert?

Striking new figures from the Office for National Statistics (ONS) reveals millennials (people born between around 1981-1996) and Gen Zs (people born between around 1997-2010) now have a statistical average of just 1.44 children, the lowest level on record. The average age of first-time mums also reached an all-time high in 2023, while the average age of fathers increased to 33.8 years.

The report – ‘How is the fertility rate changing in England and Wales’ – reveals only 1 in 5 millennial women has had a child before the age of 25, the lowest of any earlier generation.

Dr Avinash Hari Narayanan (MBChB), Clinical Lead at London Medical Laboratory, says: ‘Women born since the mid-1990s are seeing lower age-specific fertility rates in their 20s than any other generation since 1920. Yet, while the number of births has fallen to a record low, this new report reveals that the number of women of childbearing age is at its highest.

‘There were almost 11.9m women aged between 15 and 44 years in England and Wales in 2023. Yet, there were only 591,072 live births, the lowest number for almost 50 years. That means the total fertility rate (TFR) in England and Wales has dropped to 1.44 children per woman, its lowest value since records began in 1938. Wales and the Northwest of England saw the largest declines in TFR last year, compared with 2022.

‘The reasons why women are opting to have children at a later age seem to be both positive and, sometimes, negative. On the positive side, by the time a Gen Z born in 1997 turned 18, more than half of young women were attending university and, by the time they reached 25, more than 7 in 10 women were working.

‘However, there are also more negative issues that sometimes influence the age a woman chooses to have children. Fascinating new research from the UCL Centre for Longitudinal Studies has revealed that only a quarter of millennials who want children are actively trying for them. That’s because many don’t feel ready, are experiencing financial pressures or have not yet found the right partner. Those financial pressures include the cost of housing and, particularly, childcare.

‘There’s no doubt having a child later in life can be very positive for both mother and baby. Women who have children later tend to have a longer life span, while their children tend to perform better in education, achieving higher test scores and graduation rates.

‘There are, however, a number of potential increased risks to keep in mind, including:

• High blood pressure — this may increase the risk of the pregnancy complication preeclampsia
• Gestational diabetes

‘These can be picked up in blood tests and routine antenatal checks.

‘It also gets harder to conceive, which is why fertility hormone blood tests are vital for informing women about their overall health and fertility. A hormone and fertility blood test will measure levels of key hormones such as:

• Oestradiol — Oestradiol tests are used for the evaluation of ovarian functions
• Follicle Stimulating Hormone (FSH) — stimulates the growth and development of unfertilised eggs during the menstrual cycle
• Luteinizing Hormone (LH) — regulates the menstrual cycle and ovulation by stimulating the ovaries to produce other reproductive hormones
• Prolactin — promotes lactation (breast milk production) during pregnancy and after childbirth

‘Amid conflicting pressures, women need to know that, when they do feel that the time is right, they have a strong chance of conceiving successfully. Today’s revolutionary new blood tests can help empower women to postpone having children until the time is right for them.

‘For example, London Medical Laboratory’s next-generation Fertility Hormones Profile test is specifically tailored to analyse hormones related to fertility, menopause and period problems. It measures key hormones including oestrogen, luteinising hormone, follicle stimulating hormone, testosterone and prolactin.

‘The test can be taken at home through the post, or at one of the many drop-in clinics that offer these tests across London and nationwide in over 120 selected pharmacies and health stores. For full details, see: https://www.londonmedicallaboratory.com/product/fertility-hormones-profile