Dena Spence Hyatt | Supporting women beyond career versus motherhood debate

As a society, we repeatedly stress the importance of women bearing children, often warning that “time is running out”. At the same time, recent demographic data show declining fertility rates, prompting concerns about the long-term social and economic implications. Yet, women are simultaneously expected to be ambitious, career-oriented, and economically independent.

What is often missing from this discussion is a critical reality: many women are not choosing careers over children out of defiance or selfishness, but are navigating serious medical, economic, and institutional barriers that remain insufficiently acknowledged.

Given the ongoing nature of these discussions, it is concerning how casually we discuss women’s reproductive choices while ignoring the realities that shape many of them. For instance, many young women live with medical conditions that affect fertility and reproductive health; for example, endometriosis, polycystic ovary syndrome (PCOS), fibroids, and other severe menstrual and reproductive disorders that the medical professionals are more proficient in identifying. These conditions are neither rare nor trivial.

There is much global medical research which shows that many conditions related to a woman’s reproductive health reveal themselves in menstrual-related disorders which affect a significant share of women and are often associated with chronic pain, fatigue, and reduced daily functioning. Managing these conditions requires ongoing medical care, medication, specialist visits, and sometimes surgery - costs that many women must absorb personally. This brings me to another salient point.

In Jamaica, health insurance coverage is uneven and public health resources, as well as services are stretched. Therefore, these financial and emotional burdens fall excessively on women, particularly young professionals and those early in their careers. However they choose to finance it is another conversation with quite a number of variables. Yet, there are some public discourses that continue to frame delayed childbearing as a seemingly personal failure rather than a structural one.

TROUBLING

Even more troubling is how many workplaces respond - or fail to respond - to women’s biological realities. Menstrual health is still widely treated as a private inconvenience rather than a legitimate workplace concern. Most institutions offer no formal menstrual leave or clear accommodations for women experiencing severe menstrual pain, migraines, excessive bleeding, or hormonal complications.

While sick leave exists, it is limited, and its structure does not reflect recurring health challenges that some women face. As a result, many employees are expected to maintain full productivity, regardless of physical distress. Can you imagine if every woman had to use their sick leave for this purpose? What would the weekly numbers in the workplaces look like?

However, that, too, is another conversation for another time. The fact of the matter is, many women are often expected to “push through”, remain fully productive, and perform at optimal levels, regardless of physical and even emotional distress. Now this does not mean all women are “suffering”.

The World Health Organization (WHO) has long emphasised in the past that women’s reproductive and menstrual health is a key determinant of overall well-being and economic participation of women. It has called for menstruation to be recognized as a human rights and health issue, not a hygiene issue – a health issue with physical, psychological, and social dimensions, and one that needs to be addressed across the life course and integrated into policy planning and budgeting. These recommendations reflect not advocacy, but sound public health and economic reasoning.

Ignoring these realities does not eliminate their effects; it simply forces many women to suffer in silence. From an economic perspective, this silence is costly. The International Labour Organization has warned that, when workplaces fail to accommodate biological and care-related needs, absenteeism increases, productivity declines, and burnout becomes more likely. These outcomes are not individual failures; they are institutional inefficiencies that ultimately affect national output. When women are forced to choose between their health and their employment, the economy loses skilled, capable workers.

CONTRADICTORY

It is contradictory to emphasise labour productivity, human capital development, and gender equality while overlooking the conditions that constrain participation in the workforce, in this case, women’s participation. The World Bank’s Women, Business and the Law report has repeatedly demonstrated that legal and institutional frameworks - particularly those related to health and workplace protections - play a significant role in shaping economic outcomes

What is equally troubling is the lack of empathy in some public conversations. Women’s bodies are often politicised, judged, and policed, yet rarely protected. We demand resilience without offering relief. We praise strength without providing support. This is not a call for special treatment. It is a call for practical, evidence-based adjustments. Menstrual health policies, flexible work arrangements, and more comprehensive health coverage, and open dialogue are not luxuries.

They are reasonable responses in a society that relies heavily on women’s labour, intellect and skills. There are obvious and persistent gaps in access and support that directly affect women’s quality of life and economic security, and these are important matters to recognise.

If national development is the objective, then discussions about fertility, labour supply, and productivity must move beyond simplistic narratives of “career versus motherhood”. Addressing medical, economic, and institutional constraints is not ideological - it is pragmatic.

Our declining birth rate cannot be accurately captured by a simple linear model. It reflects complex social, economic, and health dynamics and we must confront the economic, medical, and institutional failures that make some aspects of womanhood unnecessarily difficult.

Until then, urging women to “have children before it’s too late” and/or implanting a sense of guilt for the declining birth rate (whether implicitly or explicitly) while offering little protection, understanding or support, is not just unfair; it is irresponsible. Overlooking women’s health is more than a social failing; it reflects weak policy design and poor economic judgement.

Dena Spence Hyatt is an economist and mathematician, she is a lecturer at the University of Technology, Jamaica. Send feedback to columns@gleanerjm.com