|
|
|
|
Lacamas Life Magazine
|
|
|
Having your Cake and Eating it Too – Possible?!
Family AND Career
Perhaps this conversation is one that sounds familiar.
“Honey, do you want to have kids?”
“Absolutely. No doubt….eventually.”
“Hmm. What do you mean?”
“Well, I’m still in school, and I’d like to concentrate on that for the future, you know?”
“I understand. When were you thinking?”
“Well, I have four years of training after that then I have to get established in my job. I can’t risk getting passed by at the beginning by the others.” Not only have I heard this from my own wife, I’ve also heard this from patients dozens of times over the years. Today’s family dynamic is significantly different from that of years past. More and more women are choosing to delay childbirth until such time as it fits into their busy lives. In fact, more and more often, women are the primary bread winners for their families. Career for these women, obviously, becomes a necessity. How does one balance these two issues? When IS the right time?
The easy answer is that there is never a “right” time. There will always be the next hurdle to leap, the next mountain to climb. During an upwardly mobile career, there is rarely, if ever, a comfortable time to take a break. For a woman to whom her career is more than “just a job”, it is difficult to pinpoint a time when one can afford 2 months away from work after the birth of a child. Who knows what or who will have passed us by during that time. Of course, one can choose to return to work immediately, but after knowing and caring for many of these women, not to mention my own wife, I can say with some certainty that it is not that easy to leave a baby that you have just given birth to! The love that a mother feels for her child is an amazing thing that defies explanation. The most driven of women melt under the liquid eyes and brand new coos of their newborn child. I certainly do not want to sell us fathers short, but the maternal infant bond is truly a magical thing. I cannot imagine loving my children more, but watching my wife with them always humbles and inspires me.
When it came time to return to work after maternity leave, I think my wife cried everyday for the first week. The question, then, becomes whether to go back to work at all or even if you do, how much to work. While most professions will forgive two months off, many fewer would forgive 5 years off. Very, very few would forgive 18 years off to completely watch a kid grow up. If you have more than one, well, you can do the math!
The other issue is the pregnancy itself. Many jobs would be amenable to work during pregnancy. There are obvious ones, however, that would not be. In addition, there are several pregnancy complications that require restricted duty or even strict bed rest. What to do about that? I have also been told by patients that some employers even frown upon their female employees working while they are pregnant because of the way a pregnant woman looks leading them to hide it after conception! As women begin to hold more executive positions, pressure mounts to not have children at all. With all of these issues, a woman can get discouraged very easily. Even once the decision has been made to have children in spite of all of this, there arises something else…..
“I’m in my thirties. Does that matter?”
In a word, yes. The first issue is the number of children that you want. As most people know, a pregnancy usually lasts nine months. How many nine month pieces of time do you have left? The so-called biological clock is indeed ticking! I have been asked often about the 65 year old woman in Brazil who had twins about 6 months ago. I want to assure all of you that while this is very occasionally biologically possible, it is extremely ill-advised for many reasons. I will touch on a few of them here.
As you get older, it becomes progressively more difficult to get pregnant. The age of 35 seems to be a watershed age where fertility takes a bit of a downturn. Ovulations become fewer and farther between. While for most, this does not occur until their 40’s, it can certainly begin in the middle to late 30’s. As a result, the nine month periods of time become nine months plus whatever the time period it takes to achieve the pregnancy in the first place. This can be months to years! In my case, the period was almost two years. As you can see, if you want three or more children, the ticking of the clock suddenly gets much, much louder.
The next issue is the pregnancy itself. As is the case with anything, the newer something is, the better it works. Miscarriage percentages go up as you age. The longer you wait, not only is it harder to achieve pregnancy, it is harder to hold on to it. The risk of miscarriage doubles as you approach 40 years of age. It is estimated by the American Society of Reproductive Medicine that pregnancy loss rates approach 75% past the age of 40! Risks for complications like gestational diabetes and gestational hypertension also increase as age increases. While most complications of pregnancy can be treated and risks to the mother and fetus minimized, risks are by their very nature statistics and can never be eliminated completely. There are some complications, though, that cannot be treated. These are the genetic defects and syndromes that come with abnormal formation of the chromosomes sometimes contained in the ovulations of those over 35. Risks for Down Syndrome increase from 1 in 800 at the age of 20 to 1 in 60 at 40 to 1 in 20 at 45. If the most common chromosomal abnormalities including Down Syndrome are combined, the risk becomes 1 in 40 at age 40 and 1 in 11 at age 45. That is almost a ten percent chance of having a genetic defect that is clinically significant! That may not sound high but that is almost 100 times more likely than a woman in her 20’s.
“Wow. I need to get going then!”
The above statement may be going through your head right now. Do not fret. There are many things we as obstetricians can do to help speed this process along a bit. Everything from simple advice to oral or injectable medicine to even more advanced, albeit invasive, techniques are available to the woman who for whatever reason cannot wait for nature. There are many things that can be done before pregnancy to minimize the risks that I mentioned before. Most of these things are very simple. Anyone with motivation and some discipline can accomplish most of the treatments and advice we can offer. Call your obstetrician and make an appointment to discuss any of these issues. Often a little preparation before trying to conceive can actually make the conception and the pregnancy go much more smoothly.
And the answer is…
The answer to the title of this article is, of course, yes. What’s my advice? Don’t wait. The right time is now. Work is work; a child’s love is forever. A bit of foresight, a bit of preparation, and if necessary, a wee bit of help from us doctors can give you everything you ever wanted. My wife and I decided to have a baby toward the end of her training as an internal medicine doctor. She stopped taking her pill, and we tried. We tried some more, then we tried some more. A year later, we were still unsuccessful. We went to see a specialist and tried some treatments- still no success. We tried yet more treatments, and after months of worrying and many bouts of crying from both of us, we were finally successful. We were going to have twins! Seven months later (which included 10 WEEKS in the hospital), we had two beautiful baby girls. They are now almost nine months old, and they are the most incredible, beautiful, amazing little people in the whole world. (I am, of course, completely objective!) We went through the putting off of the trying, then the delay in the actual conception. We also went through the complications. (Ours was preterm labor beginning at five and a half months of pregnancy.) My wife now works as an internal medicine doctor that specializes in taking care of sick people in the hospital part time and spends the rest at home with our daughters. At work, she is Doctor Chang and commands the respect that her years of hard work and determination have rightfully earned her. At home, she is mom and wife - two “jobs” that she does better than anyone could ever hope for. We three love and cherish her more than we can adequately describe. Well, my kids do not talk yet, but if their smiles are any indication, they could not love her more. She is surely a success by any measure in either the professional or familial arenas. It is absolutely possible to have it all. My wife obviously has her cake and is enjoying every bite. Go get yours.
|
|
|
|
|
