For some people, there is an instinct, a gut feeling, a primal desire, a knowing, that they want to have children. Others are unable to simply look inwards and just know if this is something they want. And there are also those of us who were brought up believing that there was an order to living life and that having children was part of it (even whilst simultaneously being told ‘don’t do it’, ‘it’s too much hassle’).

For those of you that are on the fence, have no idea on what path to take, and even for those that are adamant that you do or don’t want children, it’s worth doing a little soul searching.  After all, women have a biological limitation on the options of having children and it’s something you want to be sure of – and confident of your decision in- before this clock runs out. So how do you even begin to dive into such an enormous life-forming decision?

Fertility testing

This may seem like a strange place to start when you’re only just beginning to consider if this something you want. However, there are two reasons to start with fertility testing:

1. Fertility testing may help you to understand more about your primal desire on whether becoming a mother is something you want, and the journey of discovering if you can have children, can often trigger lots of uncovered thoughts and feelings while waiting for and receiving your results.

2. You may discover that there are complications to conceiving naturally, if at all, that could have you question if the other routes to motherhood are what you want to experience and ultimately if motherhood is something you want.

Additionally, fertility testing can help you to understand your current fertility state and estimates as to how long this window may be open to you- though of course, this isn’t set in stone. Ultimately, it can be helpful to start with fertility testing because you may go through the painstaking process of trying to really understand how you feel mentally about becoming a parent, weighing all of the options and having your heart set on motherhood and a particular route to parenthood, but then discover it isn’t something that’s possible for you.

Although the doctors can perform fertility testing- they may perform a blood test which can indicate hormone levels and therefore possible viability of natural conception, you would only be referred for extensive screening and testing under the NHS if you were already experiencing gynaecological issues or having trouble with conception, usually 1-2 years after initially trying to get pregnant. If you want to get a better picture of your fertility health, it would entail a private assessment. Thankfully, private options are more widely available and more affordable.

The HCA Assessment’s Fit for Fertility test for example, can help to assess individuals or couples, and their chances of natural conception. During a screening, the consultants review your medical history, your body mass index and the effects this can have on fertility, conduct an AMH blood test and antral follicle count scan to determine ovarian reserve, a transvaginal scan to observe womb health and whether any cysts, fibroids and endometriosis may be present and cause complications, analyse thyroid function, and conduct an assessment of your current lifestyle. This is a comprehensive assessment that will provide you with a good indication of fertility health and potential for natural conception. Your report will outline the results, their meanings and further recommendations, which could mean further investigations, or suggestions on ways to conceive. It’s also a good opportunity to discuss any concerns around conception with your consultant.

Counselling

Deciding whether to have children is an immensely complicated subject that can often mean delving into your past, childhood experiences and your upbringing, as well as your perceived expectations of adulthood to see if subconsciously these are weighing on and affecting your decision. Independently, these factors can be overwhelming to probe into and can be complicated to make objective decisions, often because there is a lot of emotion at play too. Meeting with a registered BACP psychodynamic or psychotherapeutic psychiatrist can help you to uncover these experiences and how they’ve shaped you today, as well as how they’re influencing and impacting this particular decision. Through counselling, whether you choose to have children or not, it becomes a conscious and thoughtful decision.

Couples counselling

Ultimately, it’s important to understand your own particular desires and expectations on childbearing and rearing, but if you’re having to make this decision alongside another, or you’re experiencing some friction on this particular issue, couples counselling can be extremely beneficial. Sarah Wheatley, registered BACP counsellor, from Birth + Beyond says:

“Having young children can be one of the toughest times for a couple, with an estimated one fifth of couples separating before their child is one (according to research done by Channel Mum).

So one of the best things a couple can do before having kids is to access couples’ therapy. This can help you both identify what your vision of family life and parenthood might be, and to start to think about how those ideas might be combined.

You might discover that you have different ideas about who is in ‘charge’ of the baby or have the roles of the mother and the partner.

You might also discover that you have different expectations of how parental leave is managed, whether caring for the baby also involves housework, and whose career, if any, might be prioritised if the baby gets sick.

It can also help you think about your sex life and how you might cope if the baby doesn’t allow you much time for intimacy.

Talking about these things in a less pressurised environment before conception can help new parents navigate all the adjustments to their relationship after a baby.”

Understanding how we make decisions

Counselling delves into the psychology of an individual, helping you to understand how your own experiences, upbringing and the influences on your life have made you the person you are today. Philosophy too plays a part in helping you to decide if you want children. The TED Talk below, by philosopher Ruth Chang looks at how we, as humans, make hard choices, particularly when it’s one choice over another. In this instance, whether to have children, or not.

If you find you’ve been agonising, or even putting off really thinking about this decision, or you’re a person who doesn’t like to commit, or generally struggles with decision making, this talk can help you to position yourself in a particular decision. The key takeaway is although we may give different weights to different choices (and therefore the perception of one over another being easier or harder, better or worse), even those seemingly small choices, the example given, “what to have for breakfast”, could actually be perceived as a hard decision, particularly for those decisions where there is no clear distinction of one being better than the other – the options are on par with each other, and as such is seemingly more complicated to determine a result. When faced with such a challenge, Ruth advocates making reasons for yourself in the scenario you’re faced with. In putting “yourself behind the option…this is where I stand, here’s who I am”, the decisions are supported by reasons given by us, not dictated to us. It’s really quite fascinating and could help you envision one event over the other.

Note: I had to watch it twice to fully grasp the concept but at just under 15 minutes, it’s easy to come back to if it doesn’t sink in the first time and I advocate you do. 

Taking the motherhood clarity course

If you need a structed and supported approach to taking a good look at those questions around parenthood- the effects of the climate, financial stability and the cost-of-living; your concerns around mental health, child birth, societal pressures, all the things that can have you deciding whether you want or should bring a child into the world, you could take the Motherhood Clarity Course to really dive into those concerns. The Motherhood Clarity Course, delivered by Parenthood Clarity Mentor, Licensed Marriage and Family Therapist, Ann Davidman, is a 4-month virtual programme that, through a variety of exercises, helps you explore and come to an understanding on the various feelings and emotions you may have with these different complexities, questions and concerns to deliver clarity on the right choice for you.

If you need something more flexible or cost effective, but provides plenty of guidance and an opportunity to really work though these questions, the self-help book ‘Motherhood, Is It For Me?’ by Denise L Carlini and Ann Davidman, follows a 12- week guided programme which could provide this.

If you need more time…

As women we can often feel burdened by the chiming of the biological clock which can make us feel pressured into making such an important decision quickly. If you’re struggling to make this decision and feel you need the time to explore it in depth, or if you’ve made the decision you do want to have a family but, in the future, freezing your eggs could be a good option for you to help preserve your fertility. It’s important to note that as natural conception rate is around 20% at the age of 30 and around 5% by the time we’re 40 and egg quality begins to decrease significantly from 35, freezing your eggs gives you the opportunity to have children when the time is right for you.

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