Author: Poh Lin Tan, NUS
In early 2023, Singaporean women aged 21–35 will be given the option to freeze their eggs under the Healthcare Services Act. These frozen eggs can be later used for in-vitro fertilisation (IVF) for married women, but questions remain as to whether this new policy will solve Singapore’s demographic problems.
According to local media, the legislation was greeted with enthusiasm by eligible women, who feel that they have been gifted a reprieve from an ever-ticking biological clock. Those who previously wanted to freeze their eggs for non-medical reasons could do so overseas, with Malaysia and South Korea being popular destinations. But the option to do so in Singapore means the procedure will become more feasible due to greater convenience, affordability and lower safety concerns because of the high standards of domestic health services.
The announcement of the lifted ban was released in a policy white paper on women’s development. It is perceived as a concession of the government’s longstanding concerns about social egg freezing, in view of Singapore’s stubbornly low fertility rate.
Despite the array of pro-natalist incentives on offer — financial transfers, paid leave and childcare subsidies — the fertility rate stands at around 1.1, below the replacement rate of 2.1 and the Prime Minister Lee Hsien Loong’s target of 1.3–1.4. One distinguishing feature of the city-state’s fertility transition is that even as women in their 20s eschew childbearing, the uptick in births among women in their 30s has been weak, resulting in a dearth of ‘catch-up’ babies.
Elective egg freezing performed at younger ages has a higher chance of inducing a successful live birth through IVF. It also seems like a promising instrument for boosting birth rates among older women. Live births resulting from assisted reproductive technologies (ART) currently comprise only 2–5 per cent of all births in developed countries, but this figure is projected to double. As Singapore rapidly ages, the contributions of women aged 35–44 will become increasingly important to the national birth rate, making the success rates of ART procedures a vital biodemographic determinant.
Singaporean women and demographic observers may have cause for celebration. Yet medical technology does not present the ideal solution to what is, at heart, a social problem. The drawbacks of the technologies are too often discounted or ignored. Studies show that individuals overestimate the success rates of IVF and have a low awareness of the serious health risks it poses to both the mother and child. Lifting the ban on elective egg freezing may widen these informational gaps due to the misperception that ART treatments have received official endorsement.
Due to marriage and motherhood penalties, women everywhere face a trade-off between investing in their education and career or pursuing marriage and parenthood. In Singapore, this trade-off is especially salient due to the cultural emphasis on hard work and individual success. This has propelled Singapore to the top of international education and human capital rankings. Societal incentives have created a very clear universal message for both men and women — invest in yourselves.
By contrast, the value of marriage and childbearing is regarded as highly subjective — at times derided as outdated, unnecessary, or even oppressive and detrimental to personal freedom and growth. Parenthood is widely regarded as expensive, tiring and stressful due to the high academic standards children are expected to meet. The burden of children’s education and household care are disproportionately placed on women. This makes the transition to motherhood an especially daunting prospect without adequate conditions and resources.
The legislation of elective egg freezing for younger women reinforces the message that women should focus on their education and careers first and children later. Having children at younger, more medically optimal ages has now lost some of its urgency. The choice to have children earlier is more difficult to justify to mentors in graduate programs or supervisors at work.
Moreover, the reduced visibility of the risks of late childbearing may disproportionately affect women from lower-income backgrounds for whom egg freezing may not be economically viable, potentially leading to a divergence in fertility options and outcomes.
Even as the new law may help to expand women’s reproductive health choices and boost birth rates, informational gaps must be identified and addressed to improve medical outcomes and to allow women to make fully informed decisions. There also remains a public health imperative to make childbearing a more viable aspiration for fertile couples in their late 20s.
Policies should acknowledge that younger couples often need more government subsidies and financial assistance to start a family. Mentorship programs and career networking opportunities are needed to offset the scrutiny and stigma that younger mothers face and push back against the norms and expectations that come with ever-later motherhood.
Poh Lin Tan is Assistant Professor at the Lee Kuan Yew School of Public Policy, National University of Singapore.
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