Patient #1 – “Lucy” is a new patient who recently got married and relocated to my city. She is coming to see me to discuss fertility. Her inability to conceive despite 3 months of trying has left her feeling frustrated. She breaks down into tears during the visit, “It’s not fair. ALL my friends are pregnant, when is it going to happen for me?”
Patient #2 – “Diane” is a long term patient, seeing me for her yearly well woman check. Reviewing the chart before walking into the room, I notice that for the last 4 years she had told me that she was considering trying to conceive. When I brought this up to the patient, she stated that she wanted to have children, but it never seemed like the perfect time. She wanted to wait one more year to get a few more things in order financially.
“Lucy” is 19 and “Diane” is 38. My examples might appear extreme, but I see these scenarios on a weekly basis.
Determining when to have your first child is a personal decision based on a multitude of factors. There is rarely a ‘perfect time’ to have a baby, but there are areas of your life that are helpful to have in order before you embark on the adventure of parenthood. Children are a beautiful gift, no matter when they come, but I am often asked what is the optimal time to have a baby. With half of all pregnancies being unplanned, some couples do not have the privilege of getting their ducks in order first, but for those who get a chance to plan accordingly, here are some issues to consider.
Tick. Tick. Tick. Many of us have heard the all too real alarm of our biological clock blaring. One of the biggest concerns of most women is age. While age is an important factor when considering fertility it should not be taken as the only indication to have a baby.
Women are most fertile between the ages of 20-24. Fertility then begins to decline at age 30 and then more sharply at 37. Miscarriage rates begin to increase after age 35, reaching upwards of 5o% after age 40. I don’t put those numbers out there to strike fear in your heart, but to give you a realistic picture of human fertility. Yes, in an ideal world it would be best to complete your family before the age of 30, but I have many patients with healthy pregnancies in their 30’s and 40’s. It is by all means possible to have babies in your 40’s, but statistically the chances of conception do decrease with age.
The risk of having a baby with Down’s syndrome and other genetic abnormalities increases with maternal age as well.
Here’s the numbers:
At the age of 20 your risk of having a baby with Down’s syndrome is 1 in 2000
At the age of 35 your risk of having a baby with Down’s syndrome is 1 in 250
At the age of 40 your risk of having a baby with Down’s syndrome is 1 in 69
At the age of 45 your risk of having a baby with Down’s syndrome is 1 in 19
Let’s look at the numbers another way. What’s your chances of having a baby that DOESN’T have Down’s syndrome?
At the age of 20 i’ts 99.995%.
At the age of 35 it’s 99.6%.
At the age of 40 it’s 98.6%.
At the age of 45 it’s 94.8%.
It’s is best to conceive when you are at a healthy weight. Ideally a BMI between 17-27 is associated with the best chance of conceiving and having a healthy pregnancy.
All chronic medical conditions should be stable for 6 months before getting pregnant. Talk to your doctor if you have diabetes, high blood pressure, lupus, hypothyroid or other chronic diseases to make sure you are stable on medication that is safe in pregnancy for 6 months before conceiving.
“Taking care of a colicky baby has really enriched our marriage!” said NO COUPLE EVER.
As I see women in my office for their annual checkups, I have noted several times over the years where a patient comes in to discuss getting pregnant in one visit, then sadly the next year she is divorced.
Having a baby is one of the most amazing experiences of your life. It is also very hard and stressful. A baby should never be looked at as a way to save or improve an already rocky relationship. It is going to test your relationship, so you want to make sure that you are starting in a solid place.
A lot of marriage experts recommend being married between 3-5 years before adding kids to the mix. Take the time to invest in each other and build a stable marriage before kids.
Ideally you want to limit the number of major life events that occur around the same year as having a baby such as moving, changing jobs or getting married. All of these add additional stress to your life and relationship.
I recently prescribed a medication to help a patient conceive. She called the office later stating it was too expensive and requested samples. The medication was $25.
If $25 is straining your budget, you probably can’t afford a baby right now.
You do not have to be rich to have a baby, but you do need to have financial stability. A steady income and health insurance are a must, while 3 -6 months of savings in the bank, a budget, and plan for childcare would be ideal.
You and your spouse should be in full agreement on your decision to start your family. As you prayerfully consider the timing, you should each feel a sense of peace about the journey. There are always moments in your parenting journey where you say to yourself, ‘What was I thinking?’ If you know from the start that you are following God’s timing for your life, then you will have an added level of reassurance on the long days of two year old tantrums.
In today’s society, there are not many couples who are going to be financially stable and married for 3 years by age 25 in order to be done with their families by age 30. These are all recommendations to help provide guidance, not rigid rules. There must be a balance between my examples of Lucy and Diane. You can’t wait until everything is perfect or it might not happen, and you can’t live in fear of getting too old and rush into kids before you are truly ready either.
Despite the best of our own planning, God has a way of putting our family together just the way it was meant to be, in His perfect timing.
What do you think is the most important factor in starting a family?