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Mothers and Other Strangers : There are plenty of statistics about the costs of too many children. Have we thought about the cost of too few?

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Motherhood just isn’t in vogue any more. What was once an honorable profession with a sought-after product (a productive human being) is quickly going the way of blacksmithing and aerospace engineering. Some people--those who teeter on the apogee of political correctness--consider mothers downright subversive, a threat to the environment. Even moderates look on children as expendable frills, to be acquired in small numbers by those affluent enough to indulge themselves.

Having a baby sometimes seems like a hobby. A woman is socially permitted to conceive a token infant to complete her “experience of life” sometime after her career is tactically safe and before the curtain of menopause descends. The actual parenting of the child will then be done through surrogates. This type of motherhood is applauded as neither interfering too much with the female person’s life nor clogging up the environment with excess humanity.

The mother who discovers she actually loves the sculpting of a little human--and who then goes on to have a couple more--will receive scant affirmation from those around her. And if for some reason she actually has the time to sit down and read, she will find her vocation lambasted daily in the media. Imagine being up all night with a fussy baby who has his days and nights inverted only to find yourself staring at the morning paper with headlines that proclaim a top Stanford professor has declared you are bringing misery to the world through your fecundity. Or being stopped by a little old lady as you push a stroller and aggressively grilled about your reproductive plans. No wonder the American woman isn’t producing enough offspring to replace herself and her husband in the next generation. Who wants to live with all that?

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In the last several months, doctors practicing in several different areas of Los Angeles have noticed an interesting phenomenon. It may just be a fluke, but many of us are talking about the decrease in the number of prenatal patients in our practices. We can’t even test the validity of our observations; the drop is so recent that the babies would not even have been born yet. But it did get some of us to thinking, and the issues that have arisen are so complex that, in the words of the Grinch who stole Christmas, we “puzzled three hours till (our) puzzler was sore.” Some of us think our hitherto porous border has finally become more impermeable to pregnant women, while others point to plentiful and socially encouraged abortions.

My opinion is that the drop is due to many factors: a bad economy, relatively small numbers of women at peak childbearing age, delayed marriages and the socially accepted conundrum that children are damaging to the environment and to personal happiness. (The corollary to the latter is that if one does choose to parent, the product’s quality will be inversely related to the number produced.)

Our society has pushed for limitations in family size. It looks as if we are now to see that. What are the implications of a child-poor society? Have our intellectuals really thought this thing through?

As a family physician, I’m saddened. I love obstetrics and pediatrics, but I can switch to geriatrics. Other doctors whose practices are exclusively obstetrical or pediatric may not be so fortunate. But we are a small number. Let’s look at other segments of the economy. Kids go through a lot of clothes, vast quantities of food, need to be taught, read to, housed. Lots of people make their livings providing goods and services to kids. What about their jobs?

And I’ll take this a bit further. Seniors are the most rapidly growing segment of our population. Though they have more money on average than younger people, their money will be valueless if they can’t purchase the goods and services that they no longer can provide for themselves. This could well reach a crisis sometime in the 21st Century, when all of us Baby Boomers can no longer mow our own lawns or even feed ourselves.

Perhaps the observations of those of us on the front lines in prenatal care are in error. Perhaps motherhood will still be considered of value by a sufficient number of young women. For me, it will always be, as the bumper sticker I just purchased says, “an honorable profession.” Meanwhile, if you see a mom struggling with a bunch of fussy kids in the supermarket, give her a verbal pat on the back. Her kids may just be the ones taking care of you some day.

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