¿Por qué las mujeres españolas retrasamos nuestra maternidad?
- Autores: Beatriz Mercedes Moya Esteban
- Directores de la Tesis: Álvaro Zapico Goñi (dir. tes.), Aldina Couso González (codir. tes.)
- Lectura: En la Universidad de Alcalá ( España ) en 2023
- Idioma: español
- Tribunal Calificador de la Tesis: María Jesús Cancelo Hidalgo (presid.), Isidoro Bruna Catalán (secret.), Onica Armijo Suárez (voc.)
- Programa de doctorado: Programa de Doctorado en Ciencias de la Salud por la Universidad de Alcalá
- Materias:
- Enlaces
- Resumen
- español
En las últimas décadas, las sociedades occidentales sufren un retraso paulatino en la edad a la que las mujeres son madres por primera vez. De continuar esta tendencia, las pirámides poblaciones de las sociedades modernas terminarán por invertirse. Esta situación pondría en jaque la sostenibilidad de las sociedades occidentales y supondría un grave detrimento sobre el actual estado de bienestar. España, se sitúa entre los tres países europeos con mayor edad materna al nacimiento del primer hijo, situándose actualmente por encima de los 32 años, y con tendencia a continuar subiendo en los próximos años.
Las técnicas de reproducción asistida (TRA) continúan su auge y desarrollo para intentar contrarrestar esta postergación de la maternidad. Sin embargo, ningún factor se ha relacionado con mayor tasa de éxito en las técnicas de reproducción como la edad de la mujer. Ningún tratamiento ha conseguido paliar los efectos del paso del tiempo sobre la reserva ovárica o la calidad de los ovocitos.
Esta tesis muestra el resultado de un estudio cuantitativo descriptivo para intentar esclarecer los principales motivos de retraso de la maternidad en las mujeres españolas. La obtención de datos se realiza a través de entrevista on-line con cuestionario estructurado en castellano. La recopilación de datos se realizó durante el plazo de 1 mes (del 27 de enero de 2020 al 27 de febrero de 2020). Este periodo fue previo al estado de alarma en España debido a la pandemia por COVID-19. El cuestionario incluye 24 preguntas, todas con opciones cerradas de respuesta.
El público objetivo son mujeres españolas de 18 a 40 años (ambos inclusive) sin hijos. La acotación de la edad responde a que, en dicha franja, se concentra el periodo de máxima fertilidad. Además, la población diana a la que podría enfocarse las estrategias de promoción de la maternidad a edades tempranas, también queda incluida en dicho intervalo.
EL objetivo principal es conocer la principal razón por la que las mujeres retrasamos la maternidad en España. Otros objetivos secundarios son: - Percepción sobre tasas de éxitos de las TRA.
- Valorar los conocimientos asociados a la reproducción que tienen las mujeres (por ejemplo: concepto de reserva ovárica).
- Conocimiento e intención de preservación de la fertilidad.
- Principales fuentes de información consultadas por las usuarias sobre aspectos de reproducción.
- Papel de los ginecólogos/as como fuente de información.
- Posibles medidas de promoción de la maternidad en España.
La muestra final asciende a 2.600 mujeres encuestadas.
Las principales conclusiones tras el análisis realizado con error muestral máximo para un nivel de confianza del 95% del ± 1,96% son:
1.La principal razón por la que las mujeres españolas retrasan su maternidad es no querer cambiar su estilo de vida (viajes, planes con amigos).
2.La percepción de las tasas de éxito de las TRA que tienen las mujeres es mayor que la tasa de éxito real. Esto puede suponer una falsa sensación de seguridad a la hora de posponer la maternidad.
3.El concepto de reserva ovárica es ampliamente conocido por las mujeres, así como que el inicio de su declive se sitúa en torno a los 30-35 años.
4.La vitrificación de ovocitos como método de preservación de la fertilidad está menos extendido entre las mujeres. Es importante insistir en que la preservación de la fertilidad no es un seguro reproductivo.
5.Las principales fuentes de información sobre temas de fertilidad para las usuarias son internet y las amigas. El papel del ginecólogo como fuente de información supone un porcentaje casi irrelevante.
6.La confluencia de múltiples factores sociales, laborales y económicos hace que las mujeres soliciten por parte de los gobiernos medidas encaminadas a la promoción de la maternidad. Las medidas más solicitadas son aquellas encaminadas a la estabilidad laboral y la facilitación de la conciliación.
- English
Introduction: Never before parents in most Western societies have had their first children as late as the most recent decades. If this trend continues, modern societies will experienced the inversion of their population pyramids. This would jeopardise the sustainability of Western societies and seriously impact on the current welfare state. Spain is among the three European countries with the highest maternal age at the first child birth, currently above 32 years of age, and with a tendency to continue rising in the coming years.
Assisted reproductive technologies (ART) continue their boom and development in an attempt to counteract this postponement of childbearing. However, no factor has been associated with a higher success rate in reproductive techniques than woman's age. No treatment has been able to mitigate the effects of ageing on the ovarian reserve or the quality of the oocytes.
Material and methods: A descriptive quantitative study was carried out to try to clarify the main reasons that justified delaying childbearing for Spanish women. Data collection was made through an on-line interview with a structured questionnaire in Spanish. Data collection was completed during a one month period (January 27th 2020 until February 27th 2020). This occured inmediately prior to Spain’s state of alarm due to the COVID-19 pandemic. The questionnaire includes 24 questions, all with closed answer options (Annex 1). The target audience is childless Spanish women aged 18 to 40 (both inclusive). The age range is narrowed down because this included women who are at the peak of their fertility. In addition, the target population on which early childbearing promotion strategies could be focused on is also included in this range.
Participation in the survey is not encouraged with any incentives.
Identification with an e-mail address is required to access the survey. The same e-mail address could not be used to access the survey more than once The questionnaire answers were collected through the Google Forms® platform and downloaded into a Microsoft Excel® template. Subsequently, they were analysed and tabulated with the Gandia Barbwin® data processor Barbwin version 7.5.1924.4.
Objetives:
Principal objetive: Find out the main reason why women delay childbearing in Spain.
Secundary objetives:
a. Knowledge of success rates related to ART.
b. Value women's reproductive self-knowledge (for example the meaning of ovarian reserve).
c. Awareness and intention of fertility preservation.
d. Main information sources consulted by users on reproductive issues.
e. Gynaecologists role as an information source.
f. Potential measures to promote motherhood in Spain.
Results: The final sample amounts to 2,600 women. The maximum sampling error for a 95% level of confidence was ± 1.96%. Significant differences were calculated using Student's t test at a 95% confidence interval. It should be noted that the sample allows to obtained results with an acceptable precision for all the women surveyed. The mean age of the sample is 28.6 years and the mode is 29 years. 41% were in the 26-30 age group. 82% of the women have a university degree or higher (postgraduate). In addition, 80% of the women were in the labour force at the time of the survey. A 42% earned enough to be able to save. Three out of four women had a partner at the time of the survey, the most common being a male partner.
87% of the women have no intention of becoming mothers in the 12 months following the time of the questionnaire and the reason given for not becoming a mother is "not wanting to change my current way of life" (being given by 29% of the women as the main reason and by 46% of the women as one of the two main reasons for not becoming a mother in the year after answering the questionnaire). Only in the group of women between 36 and 40 years of age do "economic reasons" overtake "not wanting to change my current way of life" as the main reason for delaying childbearing by a small percentage.
75% of the women said they were familiar with the concept of ovarian reserve. Seventy-one percent of the women who know about the concept of ovarian reserve have learned about it from friends or the Internet. Only 12% said they had been informed by their gynaecologist.
65% of the women would resort to ART if they had difficulty in getting pregnant. Among the women who declare their intention to resort to ART, there is a higher percentage of those who believe that the success rate of these techniques reaches 70% - 80%. This percentage is much higher than those actually obtained by these techniques.
Just under half of the women (48%) have heard of fertility preservation (oocyte vitrification technology). The idea that oocyte vitrification is a guarantee for the reproductive future is the most frequently mentioned reason in favour of fertility preservation. On the other hand, not wanting to undergo hormone treatment is the main reason for not intending to preserve oocytes. In second place come economic reasons.
Greater job stability and easier work-life balance are the main demands of women in order to avoid delaying motherhood.
Conclusions:
1. The main reason why Spanish women delay motherhood is not wanting to change their lifestyle (travelling, meeting up with friends...).
2. Women's perception of the success rates of ART is higher than the actual one. This may lead to a false sense of security in postponing childbearing.
3. The concept of ovarian reserve is widely known among women as well as that the onset of its decline is around the age of 30-35 years.
4. Oocyte vitrification technology as a fertility preservation method is less widespread among women. It is important to insist that fertility preservation is not reproductive insurance.
5. The internet and friends are the main information sources on fertility issues for users. The role of the gynaecologist as an information source is almost irrelevant.
6. The combination of multiple social, work and economic factors make women to request the governments for measures that aim and promote motherhood. The most requested measures are those directed towards job stability and the facilitation of work-life balance.
- español
