Women's

Since 1973, the RCOG has regularly convened Study Groups to address important topics in our specialty. Ageing and reproductive ageing affect us all as individuals and as society. Obstetricians and gynaecologists are witnesses to the impact of reproductive ageing and to some of the fears, misinformation and misapprehensions that the general public have.

One purpose of the Study Group was to raise awareness of the societal trends and implications. Practitioners, academics and informed lay contributors from around the world were brought together to look at the current situation and available evidence.

This volume gathers together a diverse but timely set of contributions in order to inform Members and Fellows of the RCOG, interested healthcare and research workers and the general public.

Table of contents:
SECTION 1 BACKGROUND TO AGEING AND DEMOGRAPHICS

1 Ageing: what is it and why?

2 Culture and reproductive ageing

3 Background to ageing

4 What has happened to reproduction in the 20th century?

5 Trends in fertility: what does the 20th century tell us about the 21st?

6 Demographics

SECTION 2 BASIC SCIENCE OF REPRODUCTIVE AGEING

7 Is ovarian ageing inexorable?

8 The science of ovarian ageing: how might knowledge be translated into practice?

9 Basic science: eggs and ovaries

10 Male reproductive ageing

11 The science of the ageing uterus and placenta

12 Basic science: sperm and placenta

SECTION 3 PREGNANCY: THE AGEING MOTHER AND MEDICAL NEEDS

13 The effect of age on obstetric (maternal and fetal) outcomes

14 The older mother and medical disorders of pregnancy

15 The ageing mother and medical needs

SECTION 4 THE OUTCOMES: CHILDREN AND MOTHERS

16 What is known about children born to older parents?

17 Consequences of changes in reproductive patterns on later health in women: a life course approach

18 The outcomes: children and mothers

SECTION 5 FUTURE FERTILITY INSURANCE: SCREENING, CRYOPRESERVATION OR EGG DONORS?

19 Screening for early ovarian ageing

20 Egg freezing: the reality and practicality

21 Assisted conception: uses and abuses

22 Future fertility insurance: screening, cryopreservation and egg donors

SECTION 6 SEX BEYOND, AND AFTER, FERTILITY

23 Contraception for older couples

24 Ageing, infertility and gynaecological conditions: how do they affect sexual function?

25 Sex beyond, and after, fertility

SECTION 7 REPRODUCTIVE AGEING AND THE RCOG: AN INTERNATIONAL COLLEGE

26 What should be the RCOG’s relationship with older women?

27 Reproductive ageing and the RCOG

SECTION 8 FERTILITY TREATMENT: SCIENCE AND REALITY – THE NHS AND THE MARKET

28 Evidence-based and cost-effective investigation and treatment of women aged over 35 or 40 years: moving beyond NICE

29 Bang for the buck: what purchasers and commissioners think and do?

30 Fertility treatment: science and reality – the NHS and the market

SECTION 9 THE FUTURE: DREAMS AND WAKING UP

31 In our wildest dreams: making gametes

32 The future: dreams

33 Managing expectations and achieving realism: the individual journey from hope to closure

34 Managing expectations and achieving realism: the realpolitik of reproductive ageing and its consequences

35 The future: waking up

SECTION 10 CONSENSUS VIEWS

36 Consensus views arising from the 56th Study Group: Reproductive Ageing in Older Mothers Index

A qualitative study examining women's perceptions and experiences of routine enquiry for domestic violence in a maternity service. Purposive sampling was used to select a sub-sample from a larger group of women who participated in a domestic violence in pregnancy screening study undertaken at Guy's and St Thomas' Hospitals in London. Interviews were conducted in women's homes and general practitioner's surgeries. Ten women who experienced domestic violence in the last 12 months (including pregnancy), six women who experienced domestic violence in the last 12 months, but not in pregnancy, and 16 women with no history of domestic violence. Semi-structured interviews conducted during the postpartum period (up to 14 months). Women's views on the acceptability and relevance of routine enquiry for domestic violence. Routine enquiry for domestic violence in maternity settings is acceptable to women if conducted in a safe, confidential environment by a trained health professional who is empathic and non-judgemental. The effectiveness of routine enquiry to elicit a history of domestic violence is influenced by factors such as lack of time, confidential consulting time, continuity of care, training and availability of resources. Further research is needed to determine whether the use of on-site specialist domestic violence workers will increase midwives' ability to routinely enquire about domestic violence.