Peter Moore: A generation game played for high stakes

In the early 1970s, I sat in on a family planning clinic as a part of my training. Before prescribing the contraceptive pill, the doctor ensured that every woman was married or planning to get married. This is not an approach I continued when I was in practice, but it might help a major problem we are facing today.

We need more babies, and refusing contraception to unmarried women would certainly increase the pregnancy rate. According to the United Nations, every country needs a birth rate of at least 2.08 per woman to simply maintain the current population. In the UK, the rate has fallen to 1.44. Does this matter? With fewer people, doesn’t it mean that housing will get easier and there will be less pressure on the NHS and on schools? 

Unfortunately, it is bad news for all of us. The country needs people of working age to ensure the economy is strong enough to support everyone and pay enough taxes. We can’t build more houses or staff the NHS without younger people. If there are too many old fogies like me on a pension and not enough people paying taxes, we have a problem. We also need younger carers to look after us. A country with more pensioners than working people is not viable. 

Whisper it quietly, but unless we increase the birth rate, we have to allow more immigration. It is the only way to ensure we have enough young people to work and pay taxes, although we must ensure that they are the people the country needs. 

We are not alone. Greece, the UAE, and Bhutan have a birth rate of 1.4 per woman, and Japan, Thailand, and Italy, 1.3. There is no clear pattern except that the 30 countries that are having the most babies per woman are all in Africa, apart from Afghanistan, which has a rate of 4.3. 

Why has this eclectic mixture of counties stopped having enough babies? I am not an expert on Bhutan or the UAE, but I can guess that there are some possible explanations for the UK. 

Housing is expensive, but living with Mum and Dad is not the ideal place to bring up your own family. 

Childcare is also expensive, but this cannot be the whole answer. In Hungary, the baby grant is equivalent to five years on the minimum wage, and maternity leave is available on full pay for up to three years. Families with three or more children get tax breaks and subsidised mortgages and yet their birth rate remains at 1.5. 

Another factor must be the ease of contraception and abortion. Never has avoiding pregnancy been such an easy choice for women. 

Society has changed. The old idea of the man going out to work while the “little wife” stays at home with the children is for the history books. Women often have a career and see pregnancy and a young family as a handicap. 

Childbirth and family life get bad publicity. Women talk about the pain and risk of childbirth, although the risks are lower than at any time in human history. As a man I cannot talk about the pain except to point out that most women with children have more than one. 

Young couples see new parents desperate to stay awake after a night with a crying baby. They hear about the difficulty of ferrying children around from school, after school clubs, ballet, football and all the other activities children enjoy. 

The difficulty is that the incredible enjoyment of family life is hard to explain to anyone who has not had children. Seeing the kids grow up, following their successes and failures, emotional ups and down is an amazing experience. Very few people with a grown-up family wish they had never had children, although there may be moments in the teenage years. 

If you wait long enough it is also fantastic to have grandchildren. For any couple who feel that having children is too expensive and hard graft I recommend missing out on the children and going straight to having grandchildren.