Tuesday, June 25, 2013

Family Planning after Infertility and Pregnancy

At my 6 week postpartum check-up, my doctor asked about birth control. She prefaced her question with, "I know birth control can be hard to stomach after all of the trouble you went through to get pregnant..." After a little chat about my endometriosis, my concerns about hormonal birth control (which I have never used), condoms (which we have also never used), and Natural Family Planning (NFP), she suggested condoms until we are open to expanding our family. I continued the discussion with The Bee later that evening and we decided to stick with NFP as we have all along. Unfortunately with breastfeeding, signs have been very hard to read so there hasn't been much romance around here (that, and the fact that my husband is rarely home).  The chance of my fertility (which is subpar to begin with) returning this early is slim to none, given that I am currently ecological breastfeeding and co-sleeping, and of course I have endometriosis, a disease that is the cause of my infertility.

In the days of our infertility before our daughter came along, I thought I would be open to as many babies as close together as they happened to come. I have always wanted 3-4 kids and we got a later start than we planned to. I mean, if we had a baby when we originally thought we would, we'd be trying for #2 right about now. After a couple of years of infertility and currently having a five-month-old babe, I am faced with a reality that I never really considered before. I have lots of questions and concerns swimming in my head almost constantly:
  • How would F handle having a sibling at various ages (specifically before age 2.5 or so)?
  • How would my body handle another pregnancy so soon after F?
  • Does it even make sense to "worry" about getting pregnant again with all of the trouble we had the first time around?
  • What would it mean for my career? I don't have any leave saved anymore and I don't make enough for it to be worth working as many hours as I do while paying for 2 young children to be in daycare. Our plan (as if we have any control/choice in things, we know planning is really a joke in the world of infertility) is for F to be enrolled in the preschool at my school before we'd have another babe to find care for. 
  • If we avoid pregnancy using NFP or other means, is it wasting the only time we may potentially have to become pregnant again?
  • Would a second child, if conceived sooner than expected, have poorer health than our first born because my nutrient stores haven't been replenished yet? I read an article about this and it said that 2-3 years between pregnancies is ideal for maximum baby health, lower risk of allergies, higher IQ, etc.
  • Will I forgive myself if we wait 1.5-2 years before trying again and it never happens? We already know we will likely have trouble given my endometriosis. 
  • How long will we try before giving up the dream of a sibling or 2 for F? 
  • Will adoption be a feasible option? We have talked about it and have been open to it, but we know it is a time consuming, expensive endeavor that may not work out even if we do everything 'right'. (Does it make any of your blood boil when people say, "Why don't you just adopt?" as if it is as easy as going to the pet store for a goldfish? It makes me crazy!)
I know for those of you still waiting for your baby these may seem like ridiculous or even shallow concerns. Let me tell you, I wasn't worried about these things until about 6 months ago! How do you feel now about how close you would like children?

For those of you who have a child/children after struggling with infertility, what are your family planning ideas/concerns? 

6 comments:

  1. I really appreciate hearing your thoughts about this. It's something I think about, too. I used to think we would never bother with any sort of BC or NFP at all, even if/when we actually HAVE a kid. I mean...duh...the odds are not great that we'd have a SUPRISE baby at an inconvenient time! And even if we did, I imagine I'd be so thrilled by it, I wouldn't care! But now I tend to think that if I WANT to have a second (let's just pretend I have a first) kid, my best chance at getting pregnant again is going to be to slow the growth of endo as much as possible until we're really ready to hit the ground running. Going on BCPs can help that (not to mention save me from a lot of pain in the meantime)...so although I wouldn't really be wanting to go on BCPs for the 'birth control' aspect of it, I would for the 'endo control' aspect. Ugh. But I just don't know. Tough choices no matter what!

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  2. Isn't it crazy to be thinking about this already?! But I think that's normal. We have already been asked a million times if we want to have anymore and are in your same boat with a lot of these questions. Of course, having 4 frozen embryos complicates things even further :o/ Just taking it day by day for now and making sure to use some form of birth control just in case, as I have heard many stories about people who struggled for years to get pregnant the first time and then had surprisingly no trouble at all for the next one!

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  3. Before giving birth, I read/heard from various reliable sources that your generally more 'fertile' in the first 12 months or so after giving birth. That was enough to scare me into going on a low-dose BCP after my 6 week check-up. The decision wasn't terribly difficult for me - I'd been on BCPs before so it wasn't anything new. And unlike the horror stories I heard/read from some lactation consultants, I saw no change in my supply when I started the pills. I used to think we'd just go with the flow and not worry about it, but I'm just now getting into a rhythm with my 5 month old and being back at work and whatnot. As much as I would love to conceive the next hypothetical child the old-fashioned way, I also feel that we worked so hard to get to where we are at and I really want to just enjoy this time with Nathan. I do want to try again eventually, but I don't want to be pregnant now. I always envisioned 2-4 kids, but I'm allowing myself to get used to the idea of only 1 (if future attempts don't work out).

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  4. For us we had thought about throwing caution to the wind, not really trying but not preventing either. However, that changed after Reagan got here and having to have the c section. I knew my body couldn't take another surgery for awhile so we decided that I would go back on the pill. Another big reason for going on the pill was to have a normal cycle with a normal AF. Not knowing when she would show up and how horrible she would be was something I was not cool with.

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  5. Ugh I have been thinking about this a lot right now. We have twins and even though I want three kids a part of me says, well, maybe it would be okay if we didn't have another kid. And another part of me says, I don't want to wait too long and, have it take another 2 years - or more! - to get pregnant, and have another kid a lot later... I know that twins can be exclusionary and it would be hard if the current kids were 5 years old and had a baby sibling to potentially boss around and exclude from their twinny languages and games. (I know someone with twin brothers 7 years older than him and he wasn't very close to them at all) And I just had a crazy period and my OB wants to talk about putting me on birth control because it probably isn't good for me to have too many periods like that. AND another part of me is still struggling with PPD and anxiety, and I don't know if I WANT another kid, but that part of me is usually silenced by the other parts of me that say I WANT A HERD OF CHILDREN, I WANT TO BE A MOTHER DUCK WITH A TRAIL OF DUCKLINGS.

    There are no answers. :(

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  6. It took my husband and I a year and a half to get pregnant with our daughter. She is almost five months old, and I have some of the same concerns. Our current plan is to start trying again sometime after her second birthday, but I'm afraid it will take a long time to get pregnant again.

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