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Monica Cruz-Lemini, a 46-year-old obstetrician living in Spain, had her first child at 44.
While pregnancies after 35 are considered "advanced maternal age," Cruz-Lemini's experience is far from unusual in Spain, where more than 10% of all births involve mothers 40 or older.
"I think there's a growing pool of women in recent years — and I've seen it both professionally and personally — who are a bit like me," Cruz-Lemini told Business Insider.
According to Eurostat's latest data, Spain had the second-highest average age of women at childbirth in Europe in 2022, at 32.6 years, as well as the second-oldest average age for first-time mothers, at 31.6 years.
Spain also ranked second for the share of births to women aged 40 or older; 11% of live births in the country were to mothers in their fifth decade or beyond.
In comparison, only about 4% of live births in the US were to women over 40, according to data from the US National Center for Health Statistics, compiled by nonprofit group March of Dimes.
(Comprehensive global data isn't readily available, but Ireland came top in the most recent European stats.)
Delaying motherhood is a growing trend across Europe and beyond, not just in Spain.
However, Juan García-Velasco, chief scientific officer for IVIRMA Global, which operates a network of fertility clinics, highlights "a combination of factors" that help explain Spain's particularly high ranking.
One key factor, he said, is financial insecurity.
Spain has the highest unemployment and youth unemployment rates in the EU, and García-Velasco said that this, combined with low wages and financial instability, leads many women to wait until they are more financially secure.
Sarah Richards, a Barcelona-born mother of two who had her second child at 40, said that people want to be financially secure and own their own house before starting a family, "so that's going to happen a lot later here than it would in the UK, where salaries certainly are higher."
Property prices in cities and coastal areas also make it harder for many to afford a home, with Spain having one of the highest average ages in Europe for young people leaving the family home — at just over 30.
"You can't buy there, and the rents are just out of control," Richards said. "You either have a very good job, or you have a rich family that can help you and help with childcare."
Waiting longer often leads to a growing reliance on treatments like IVF, and Spain is a leader in Europe in IVF success rates, according to the global fertility agency International Fertility Group.
While a like-for-like comparison between Spain and the US isn't available — as different countries and clinics measure success rates differently — Spain remains a popular destination for Americans exploring international fertility treatment options.
García-Velasco said this may be why it may feel less risky for some women in Spain to leave trying for kids until later in life. "As the outcome is good, this reduces the pressure and the fears," he said
IVF is also widely accessible in Spain and is free for women 40 and under, including those who are single or in same-sex relationships.
In comparison, the estimated average cost per IVF cycle in the US is about $12,000, according to the American Society for Reproductive Medicine.
Spain also has more IVF clinics than any other country in the EU, per the European IVF Monitoring Consortium.
"The more facilities that are offered to become a mother later in life, the easier it's going to be," said Pauline Bronkurst, who had her second child this year at the age of 43.
"In our case," Bronkurst added, "both of our babies were conceived through IVF, so that definitely played a role."
Having kids later in life does increase the risk of genetic conditions.
But Bronkhurst emphasized the importance of Spain's public healthcare system, which was particularly beneficial after her second child was born with a genetic condition.
While getting pregnant at an older age can increase the likelihood of complications, Bronkhurst said that in countries with universal healthcare and a high standard of medical care, the perceived risk of advanced-age pregnancy is significantly lower.
"I think that plays into the whole thing of waiting longer," she told BI.
Another major factor contributing to delayed motherhood in Spain is that people are simply settling down later in life.
The average age of first marriage among men in Spain is 36.8, the highest in Europe, while for women it's 34.7, also the highest, according to the latest Eurostat data.
Stephanie Galavodas, who had her son three years ago aged 41, told BI she waited until her 40s to have a child because she was "saying yes to things in life when I didn't have the partner to build a family."
After years of pursuing degrees, traveling, and establishing her career, she eventually met her partner, with whom she had her child.
"I always knew that I would have kids someday," she said, "and so it felt fine to me to kind of go out in the world and experience things instead of rushing to have a child first."
A growing number of Spanish women are also going it alone.
García-Velasco said the fastest-growing group seeking fertility treatment at his clinics in Spain are single mothers who have decided to raise a child on their own.
This trend is not unique to Spain. A 2020 study published in Fertility and Sterility found a significant rise in the number of single women undergoing IVF in the US over the preceding 12 years.
In Spain, García-Velasco said that many single mothers pursuing fertility treatment cite a "lack of adequate partner" as their primary motivation for going solo.
For Cruz-Lemini, the doctor who had her child at 44, this was the reality. "I'm a single mom by choice," she told BI.
Cruz-Lemini was occupied with studies, training, and then work as a doctor, but, she said, "You get to be around 40 years old and then suddenly you realize that it might be your last chance or chances to have a child."
She found a sperm donor and pursued IVF. A little over two years ago, she gave birth to her daughter.
Sometimes, she said, "you have to do it by yourself because you don't have time to get into a relationship."
