A few years ago, at the ripe old age of 26, I confided to a friend that I was convinced I would have a hard time getting pregnant. To be clear, I wasn’t trying to get pregnant. I wasn’t even considering trying to get pregnant anytime in the near future. I simply had a dreaded feeling that it would be a struggle whenever the day arrived.
I expected my friend to be surprised, to ask why, to tell me not to worry because it would work out. Instead, she rolled her eyes and said, “Elli, everyone thinks she can’t get pregnant.”
I was floored. Don’t women spend most of their adulthood worrying about the opposite? But as it turns out, my friend was on to something. Over the next year or so, as conversations about babies became more prevalent within my age group, I talked to more and more women who felt the same way. We were all younger than 30, and though we'd never tried, we shared the same worry we'd never be able to conceive.
While the discourse about infertility is beyond needed, it can also have an unintended side effect: In some cases, women are changing their life plans based on the fear that they too will have trouble conceiving.
A post on a babyandbump.com discussion board sums it up best: “I thought I was the only one! I don’t know why I would think this, but I have a deep fear of not being able to conceive.”
With increased openness about infertility and IVF treatments and ongoing and discussions about America’s “infertility crisis,” women are thinking about — and fearing — infertility more than ever. While the discourse about infertility is beyond needed, it can also have an unintended side effect: In some cases, women are changing their life plans based on the fear that they too will have trouble conceiving.
Courtney Unger, a nurse and mother of two living in Minneapolis, was fairly certain she would have trouble getting pregnant when she was married at 25. “For whatever reason, I assumed it would take a while,” she tells Bustle. “My mom had a hard time conceiving, so I think I was just under the assumption that the majority of people had a hard time getting pregnant.”Instead, Courtney got pregnant on her honeymoon, just over a month after going off the birth control pill. “Hell yeah, we were surprised!” she says. “I realized that I was due to get my period, which was always very regular when on the pill, so I thought maybe my body was just adjusting to new hormones.”
94 percent of women are fertile, and 89 percent will not have any trouble getting pregnant.
Although the chances of getting pregnant in one try like Courtney are fairly low (20–40 percent), 85 percent of all couples trying to conceive will get pregnant within 12 months. According to the Centers for Disease Control and Prevention, 94 percent of American women are fertile and 89 percent will not have any trouble getting pregnant. The numbers are similar in Great Britain, where according to the British Pregnancy Advisory Service, 90 percent of women age 19–39 will conceive after two years of actively trying to have a baby.
Yet panic remains, and it’s not hard to see why. Infertility is real. The stigma attached to childless women is real. Watching others suffer from infertility is gut wrenching, and imagining going through that painful experience contributes to women’s fears and doctors’ warnings.
Julianne Zweifel, a clinical psychologist and clinical adjunct professor in the Department of Obstetrics and Gynecology at the University of Wisconsin School of Medicine and Public Health, regularly witnesses the heartbreak of infertility in her profession. '[If you're young], the odds [of getting pregnant] are still dramatically in your favor," she says. “But if you’re the person on the negative end of that percentage, it’s bad. When you are 30 years old and you have fertility problems, you are even angrier than when you’re 36.”
“You have a backdrop in society of women having kids later and later,” Zweifel says. “You think, ‘Maybe this is more possible’ and you’re lulled into a false sense of security. [But] we weren’t just created in 2014 with bodies that were created in 2014. It really might work out, but the older you get, the less likely that is.”
The other side of this story — unplanned pregnancies or rushed timelines — has consequences of its own: financial stress, sacrificing an education or a career, relationship/marriage struggles, resentment and low self-esteem, just to name a few.
Half of pregnancies in this country are unplanned, and 40 percent of those end in abortion.
Colleen Krajewski, M.D. MPH, a gynecologist affiliated with The National Campaign to Prevent Teen and Unplanned Pregnancy, feels strongly about drawing equal attention to the consequences of perceived infertility, especially because they are more likely to occur than infertility itself. Half of pregnancies in this country are unplanned, and 40 percent of those end in abortion.
“This seems much less talked about than infertility," Krajewski says. "My perspective is that I see women on an almost daily basis who have an unintended pregnancy based on incorrectly perceived infertility, and my patients can also feel ashamed, guilty, or stigmatized.”
With a barrage of statistics and an endless supply of messages on infertility floating around, Zweifel and Krajewski agree that women must educate themselves and visit their doctors to gain a thorough understanding of what all this information means. Basing a decision on one article, a targeted campaign, or what a friend heard may not be the best approach.
For example, women hear all the time that age affects fertility. Although this is true and should not be taken lightly, it’s important to understand how and to what extent it plays a role. The chances of becoming pregnant quickly (within a year) decrease significantly as women age, particularly after age 35.
According to a study in Helen A. Cacio's Management of the Infertile Woman , women ages 20–24 have an 86 percent chance of conceiving within a year. Women ages 30–34 have a 63 percent chance. The chances of women of all those ages becoming pregnant after trying for two years, however, leaps up to 90–94 percent.
“I think it’s good to talk to your doctor about any risk factors you may actually have, as opposed to perceive, with regard to infertility, and also the actual incidence of infertility with age,” Krajewski says.
"I encourage women and couples to parent when they are ready. Don't push up your timetable based on fear."
She also suggests setting aside a specific visit for “preconception counseling,” rather than asking a quick question at the end of an annual exam, to ensure a thorough review of medical history and enough time to create a plan for optimizing pregnancy chances.
“Each woman can make a decision about what risk of infertility she’s OK with,” Krajewski says. “I encourage women and couples to parent when they are ready. Don’t push up your timetable based on fear. On the other hand, have a realistic expectation that conception may not be as easy at age 40 as at age 20.”
At age 29, I now feel a sense of peace having a better understanding of fertility. I also visited my gynecologist specifically to ask questions and better understand my fertility.
I want children badly, but I also know that now is not the right time. Although I’ll never truly know if I can get pregnant until I try, it’s immensely liberating to allow logic to lead the way. Deciding when and why to have children is a personal decision for every woman, and knowledge, not fear, will breed the best choices.