👩⚕️When Women Delay Motherhood – A Warning Bell for the Future of Reproductive Health and Society in Thailand
Author: Dr. Nalinee Chansiri
Obstetrician and Gynecologist, Samitivej Sukhumvit Hospital | Graduated from Mahidol University, Thailand
Recently, I have noticed that in my clinic, the number of patients who are women over 35 who are coming for their first prenatal check-up or expecting a baby is increasing. Some are financial experts, some work in the creative field, and some are even university lecturers. They all have one thing in common: they are successful – independent – and… have passed their prime for reproduction without even realizing it.
I am not writing this article to urge women to get married or have children early. I am writing out of genuine concern – from the perspective of an obstetrician who has seen hundreds of cases of late pregnancies, high risks, or inability to conceive simply because it is too late to turn back.
Thailand's record low birth rate - A sign of an alarming future
According to data from the Thai Ministry of Public Health in 2024, the birth rate in Thailand has dropped to just 1.08 children per woman - lower than both Japan (1.26) and Singapore (1.05). Notably, over 30% of women who have their first pregnancy are 35 years old or older, double the rate from 10 years ago.
Pregnancy after 35 means:
The risk of fetal malformations is 2-3 times higher
The risk of preeclampsia and gestational diabetes is significantly increased
The rate of spontaneous abortion is higher than in women under 30
But the most dangerous thing, in my opinion, is the subjective mentality: "Modern medicine will help me". Yes, medicine has advanced. But science has not yet been able to completely reverse the reproductive aging process of the female body.
When hormones change – not only affect fertility but also overall health
Women who delay having children often spend years living in a state of hidden endocrine disorders without realizing it. Polycystic ovary syndrome (PCOS), ovulation disorders, or progesterone deficiency can silently cause:
Menstrual cycle disorders
Difficulty getting pregnant
Mental and sleep imbalances
Risk of early cardiovascular disease, high blood pressure, and dyslipidemia in middle age
A study published in the Thai Journal of Obstetrics and Gynaecology in 2023 showed that women with untreated endocrine disorders in their 30s are 2.4 times more likely to develop cardiovascular disease after menopause than normal people.
The importance of early obstetrics and gynecology examinations at reputable facilities
As a doctor trained at Mahidol University and having studied in Singapore, I understand that delaying obstetrics examinations just because “there is no plan to have children” is an unfortunate mistake. At specialized centers, such as Samitivej Sukhumvit Hospital, we use:
4D ultrasound to screen eggs - uterus - ovaries
Endocrine hormone quantification (AMH, LH, FSH, progesterone) to assess ovarian reserve
Consultation on egg freezing if you are not ready to get pregnant but want to preserve your chance of becoming a mother in the future
In particular, for patients with cardiovascular disorders accompanied by endocrine disorders, I often coordinate with a cardiologist for a comprehensive assessment. Early detection of high blood pressure, abnormal heart rate or increased cholesterol is completely possible with proper obstetrics and gynecology examinations.
Some real-life cases that made me feel uneasy
I once received a 39-year-old woman who came to the clinic because she could not get pregnant even though she had been married for 2 years. After testing, we discovered that she had premature ovarian failure. “If only I had gone to the clinic sooner…” – is what she told me, but we cannot turn back time.
On the contrary, I also helped a 33-year-old girl who did not want to start a family, get an endocrine screening and decided to freeze her eggs. Now, she continues her career and knows that she can still become a mother when she is ready – safely and proactively.
Sincere advice from an Obstetrician - Gynecologist
❝ If you are between 25-35 years old and do not plan to have children – go for regular reproductive health check-ups. Not to get pregnant right away, but to understand your body, to best prepare for the future. ❞
Being proactive today can save you from regrets in the future. Don’t let your “silent” biological clock lead you on a bumpy and worrying journey. Let modern medicine and well-trained doctors accompany you early.
Reproductive health is not just a personal matter – it is the future of a nation
Low birth rates are not simply a family issue. They are a warning bell for the unsustainability of Thailand’s population structure, workforce, and social security system. And it starts with silence and procrastination on the part of individuals.
I am Dr. Nalinee Chansiri – and I am ready to listen to you, at any stage of your journey to motherhood.
