Some folks have asked if my doctors are putting pressure on me not to have more children. I usually respond with a sound like hoooooo-ho-ho-hooooo (which is not supposed to be a sound like what Santa says, but rather a hearty laugh to indicate, YOU HAVE NO IDEA).
The doctors have said this before, when I was diagnosed with the clotting disorder after getting a deep vein thrombosis during my second pregnancy, but, luckily for my third, fourth, fifth, and sixth children, I knew that they weren’t that serious when they said, “You seriously can’t have any more children.”
But now they’re saying it with extra drama, and there’s nothing like lungs full of blood clots (for me) and lungs full of holes (for the baby) to make me think that they might actually mean it this time.
So what does that mean for me? When I converted to Catholicism, to my great surprise I came to agree whole-heartedly with what the Church teaches about contraception. I do Natural Family Planning (badly), and probably have about eight years of fertility left. Am I still going to stick with it? Am I resentful of these rules? Do I even want to have more kids? If the subject lines of my email inbox are any indication, a lot of folks are curious about this; hey, I would be too if I followed someone’s blog who found herself in this situation.
So let’s go ahead and crack open that can of worms, and I’ll give you my long answer to the question: Your doctors said you can’t have any more kids. What now?
Let’s talk about risk
First of all, let’s remember that when we speak about the dangers of pregnancy or any other undertaking, we’re talking about risk. This is not certainty. Nobody has a crystal ball. It’s all just educated guesses.
This sounds obvious, but it’s surprisingly easy to forget.
You hear a doctor say, “You shouldn’t do XYZ because it would put your health at risk,” and it’s tempting to immediately declare, “‘Risk,’ you say? I SHALL NEVER DO XYZ AGAIN THEN!” But it’s critical to do the best we can to identify what level of risk we’re talking about.
In my own case, for example, I have a responsibility to my existing children not to take unnecessary risks with my life. The word to hone in on here is “unnecessary,” though, because the reality is that we take risks with our lives all the time. I’m thinking about taking a road trip this summer that would involve driving for hours down two-lane roads with 70-mile-per-hour speed limits and no barriers separating oncoming traffic. I would be driving on a weekend, when plenty of people are on the road after having beers at nearby lakes. There is no question that my life would be in danger if I went on that trip; in fact, the danger to my health in that situation is probably not even drastically lower than it would be with another pregnancy. Yet we perceive the pregnancy as being so much more fraught than the fun road trip.
For a variety of reasons, we’re always tempted to freak out and get all fearful when it comes to new life, much more so than in other areas of life. A mother setting out to climb a famous mountain as a personal self-fulfillment project would be congratulated and encouraged, whereas another mother being open to pregnancy despite concerning health conditions would be chided and discouraged, even if the risk to both women’s health from their respective activities were the same.
So, especially when it comes to the question of more children, we need to look very carefully at the question, “How big is the risk?” There are times when we’ll take a closer look and find that the risk is real and huge and deeply concerning; but other times we might just find that the risk isn’t all that much greater than it would be with plenty of other “normal” activities, and that the doom and gloom predictions about future pregnancy were fueled as much by our culture’s fear of life than as by a reasonable analysis of risk.
The hope factor
Every risk has a flipside, and this is another area that is too often forgotten about when we’re talking about pregnancy: the benefits of undertaking the risk.
We have this problem in our society of seeing new human lives as burdens. Instead of celebrating new people, too often we chalk them up to carbon footprints and mouths to feed. We deem others (always others, not people we know) to be “overpopulation.” And I’m not using “we” rhetorically: Seriously, I’m not immune to the mentality either.
The soundtrack to all of my pregnancies is the noise of my whining voice. I always forget about the life of the new son or daughter that I’m carrying, and talk about the huge burden that “the pregnancy” is placing on me. Maybe it’s all those years I spent immersed in secular culture, but I am naturally sympathetic to the frame of mind that wants to immediately shut down the pregnancy train as soon as the doctor says the word “risk.” Especially in the case of those of us who already have a lot of children, why not? After all, how many kids does one person need?
But children are more than a number in the family birth order, and each human life is infinitely valuable. Think of someone you love: When you consider the worth of his or her life, it makes you view the pregnancy that brought him or her into existence differently. It makes you willing to accept higher levels of risk to add a person like that to the world.
Imagine that you were diagnosed with a rare and fatal illness, and you discovered that there was a doctor who had developed a brand new way to treat it. Imagine that this doctor cured you. Imagine the waves of joy and relief that would sweep over you when you found out that he had defeated the disease that threatened to cut your life short. Now imagine that you found out that he was his mother’s seventh child, and that her pregnancy with him went against warnings from her doctors not to have any more children. Would his mother seem crazy for becoming pregnant anyway? Would she seem irresponsible for deciding that adding another soul to her family was worth the risk?
Unfortunately, sometimes we need to remind ourselves what other people can do for us in order to remember the value of their lives.
I’m not suggesting that there’s never a good reason to avoid pregnancy; even aside from health risks, there are plenty of other reasons couples might decide that it’s not a good time for another kid. I only suggest that when we make those decisions, it’s critical that we make them in light of the hope that every new baby brings. When you think of making sacrifices for a nameless, faceless “pregnancy,” it doesn’t seem worth much effort. But the cost/benefit ratio changes drastically when you really think about the worth of one boy or girl’s life.
NFP is worth it
All that said, I do think there’s enough risk in my own situation that I should chill on the pregnancy front for now, maybe forever. In that case, then, wouldn’t contraception or sterilization make everything easier? To put it concisely:
First of all, Natural Family Planning can be an effective way to space children. (I’ll give you a moment to stop laughing and clean up the drink you just spilled on your keyboard.) No, seriously, if you’re willing to invest a little time to learn the ropes, it can work just as well as contraception. I’ll be the first to admit that it’s not always easy, and that the challenges that come with NFP are very real. However, it’s not like the alternatives offer problem-free solutions either. As the great Simcha Fisher once said, “When it comes to facing fertility, all God’s children got angst.”
I know a lot of other couples who have given up contraception to use NFP, and not a single one of them has ever returned to contraception use. I’m not saying it never happens, but, at least in my experience, it’s rare. That’s totally counter-intuitive since NFP is a sacrifice-based system, but I think what most couples find when they give up artificial birth control to space children naturally (especially when they involve God in the process), is that the high level of personal sacrifice involved is a feature, not a bug. NFP is not just another form of birth control; it’s an entirely new lifestyle. It makes you see yourself and your spouse and your children entirely differently. It makes you see the meaning of life differently. It even makes you see your relationship with God differently. And once you’ve spent a while living that kind of life, you don’t want to go back.
Intellectually, I don’t think that contraception is a good thing. I’ve come to believe that it takes away women’s reproductive freedom, and, on a societal level, fuels abortion culture. But, when I think of my own situation, I never even get that far in the analysis. Like so many other people who have made the switch to NFP, I simply couldn’t be okay with any form of sterilization anymore, whether temporary or permanent. I don’t know how to articulate it other than to say I just couldn’t do it. On a purely visceral level, in that place deep in the heart where the most important truths about our humanity reside, I know as surely as I know anything else that those Catholic teachings about human sexuality are true and good.
So what now?
As you can imagine, I’ve gotten some flack about all of this lately, especially in light of this disastrous pregnancy. Sometimes I catch myself reacting by saying:
“I didn’t know!”
I mean, yeah, I knew that I had a blood clotting disorder that’s exacerbated by pregnancy, and, okay, there was that one just slightly life-threatening DVT in my second pregnancy. BUT! I thought that it would be fine once I took preventative Lovenox. I didn’t know that it was possible to end up with bilateral pulmonary embolisms when you were on blood thinners — I thought that I was stabbing myself with needles every day to prevent that kind of thing! I didn’t know that a one-month supply of said blood thinners would set me back FOUR THOUSAND dollars. I didn’t know that I’d end up having to undergo medical procedures that were like something out of a bad episode of Fear Factor. I didn’t know that one of my veins would turn black from having over 10 blood draws in the same arm over a few hours. I certainly didn’t know that my baby would have his own, unrelated life-threatening lung issues that would put him in intensive care for two weeks. Sheesh, people, I didn’t know!
The implication there is that I would have done something differently if I had known that I was signing up for a pregnancy that was like something out of a homeric epic.
But would I?
I look down at my sweet baby boy, who is sleeping in my lap as I type, and I am overwhelmed with love and joy at his existence. I am filled with certainty that his life was meant to be. I can barely even remember all the pain I went through to bring him into the world, because that finite amount of suffering seems so utterly insignificant in comparison to the infinite value of his life.
Yet I am also sitting here saying that it would probably be best if I didn’t have more children. It leaves me in a place of strange tension: If this baby was so worth it, wouldn’t that be the case for another one? As a mother, I certainly have a duty to my precious children not to take risks with my health; but if I’d followed that train of thought more closely before, most of said precious children would not even exist.
It is when I ponder these truths that I realize: It’s so freaking complicated.
There are no more difficult, complicated, messy decisions in the human experience than the decisions we make about having kids. In no area of life is there more at stake, more opportunities for suffering and loss, and more opportunities for joy and love and connection that will last through eternity.
I don’t have all the answers; many days, I don’t feel like I have any. I have no idea if I’ll ever have another biological child. Today I’m thinking that I probably won’t…but will I feel that way tomorrow? If I’ve learned anything so far this year, it’s that your whole world can be turned upside down in a matter of hours, leaving you with an entirely different perspective on life than you had the day before. Luckily, with NFP, you make these kinds of decisions on a month-to-month, rather than a long-term basis. I’ll have regular opportunities to re-evaluate my choices.
And so when people ask about whether I think I’ll have more children, I usually respond with a responsible-sounding answer about how I am aware of the risks and currently plan to take the prudent course and avoid pregnancy for the rest of my fertile years. But then I’ll glance over at my little blond-haired son, and sometimes his tiny, ink-blue eyes will catch mine, and I can barely suppress a smile as I think: Never say never.
When Joe first saw me in the hospital, he said I reminded him of this scene from Office Space:
I had tubes in my nose, a 16-gauge IV in my hand that was causing me constant pain, had just received a daunting diagnosis that left me with a ton of questions about both my immediate and long-term circumstances, and yet I seemed…happy.
Undoubtedly, a large part of that can be attributed to being lifted up by so many wonderful prayers. But there was something else, too, that was responsible for my surprisingly peaceful state of mind:
December was a hard month. I couldn’t seem to stay on top of anything, and my inability to deal with life seemed to get worse by the week. Three days before Christmas I cleared off an entire evening to wrap presents, and quickly became so angry and overwhelmed that I went to bed in disgust instead. I felt like I barely survived the chaos of Christmas day, and in the week before New Year’s Eve I hardly lifted a finger around the house. I was unmotivated to do anything. I began backing out of social events, and felt exhausted by even the simplest tasks around the house.
I was aware of my abysmal state, and knew what the problem was: I’m lazy. And kind of a whiner. Not to mention not being fully dedicated to my vocation, and unwilling to carry my (small) crosses. Christ asks a few simple things of me, and even gives me this lavish, first-world life surrounded by luxuries, and I let a little pregnancy fatigue keep me from getting the job done! If only I were more open to God’s grace, I’d be able to unload the dishwasher without feeling like it was such a big deal.
These are the thoughts that were going through my head for the better part of a month. And so when the doctor at the Emergency Room sat me down and told me that my lungs were full of blood clots, some of them large, and that he was astounded that I’d been able to function at all, I almost cried with relief. To be completely honest, I was more relieved than I was scared. I know the facts about pulmonary embolisms and know how dangerous they are. Later, I did experience worry and fear. But first, relief.
There is truth to the accusations that I’m ungrateful, spoiled, and lazy. No false humility here — I really do posses all those attributes to some degree or another. But it was simply not true to say that those faults alone were the cause of my suffering. I was struggling against a terribly difficult physical condition, and my body was running in the red zone for all of my waking hours. In those weeks when I was unaware of the reality of my situation, I worked under the incorrect assumption that my circumstances were normal, and that therefore the problems must come down to spiritual and mental character defects on my part. Not surprisingly, this caused me to be in a state of constant inner turmoil. In fact, it was reminiscent of the hidden angst that simmered silently within me when I was an atheist: whenever you live under false assumptions about reality, you will live in anguish. It may be buried and only pop up occasionally, or it may burst to the surface in explosions of acute despair, but whenever you try to jam a square peg of your perception of reality into the round hole of actual reality, there will always be friction.
And you know why I bring this up? Because I think I’m not the only one who could benefit from an outlook-shattering diagnosis.
Once I felt like I had permission to admit that one area of my life was legitimately hard, I began to look at other areas as well. And in the process I’ve been reminded of something I’d known for a while, but had slowly forgotten: that 21st-century motherhood is really hard, whether or not you have clots in your lungs.
Yes, motherhood has always been hard, and our ancestors faced more grueling physical challenges in a month than many of us do in our entire lives. I wouldn’t trade my life for that of my great-great grandmother. However, I think that being a mother today comes with exponentially more psychological challenges than moms have ever faced before. A few examples that come to mind:
We live in isolation. From time immemorial mothers have raised their children in close-knit communities, surrounded by their own mothers and aunts and cousins and nieces and lifelong friends. In traditional human villages, women would gather to wash and cook together, their kids running around freely with friends and relatives. Even the more-isolated farm wives and suburban moms of our grandparents’ generation had refuge to the classic sanity-saving phrase, “Go outside!” (My grandfather reports that he and his siblings often only saw their mother at mealtimes and after sunset, since they spent so much time hunting and exploring each day). Mothers were never meant to be the sole people in charge of their children’s wellbeing all day, every day. It is utterly unnatural to go for 12 hours without having a face-to-face conversation with another adult.
And here’s a big one that’s rarely acknowledged: it feels like what we do isn’t important. It is important, of course…but the reality is that, thanks to all those wonderful modern conveniences, what most of us do on a daily or even weekly basis doesn’t necessarily contribute directly to anyone’s survival. Pouring effort into my vocation can bless my family tremendously, and makes all the difference between thriving and just getting by. But the reality is that if I were to totally slack off and not do much of anything for a few days, everything would be fine. Nobody would starve. We’d still have shelter and food and clothes and clean water.
Not so for the women of history. I doubt that my great-great-great grandmother and her friends had to remind themselves that motherhood is the most important job in the world: if they didn’t cook, their children would literally have nothing to eat. If they didn’t fetch the water from the well, there would be nothing to drink. If they didn’t launder and mend the clothes, there would be nothing to wear. The daily work that the housewife of 1813 did was of life-and-death importance; the daily work that the housewife of 2013 does doesn’t have anywhere near that level of urgency. And that’s a good thing — I don’t think any of us would want to go back to a time when basic survival was so difficult — but it’s also worth admitting that it’s a little demoralizing to know that most of your day to day work falls under the category of “nice to have” rather than “have to have.”
I could go on: the fact that our isolation means that no one outside of our immediate family ever sees the fruits of our labor; that our kids are constantly lured to become peer-oriented; that the norms of our culture push us to pile way more onto our plates than we can realistically handle…but you get the idea.
What we modern moms do is hard, and not just hard in the way that motherhood has always been hard. We’re laboring under unique conditions that few people in human history have ever experienced, trying to thrive in utterly unnatural circumstances. It may not be hard physically, but it’s a great challenge psychologically.
My point here isn’t to wallow in self-pity, or encourage anyone else to do so. In fact, as odd as it may sound, my hope is to inspire fellow moms to deeper peace and gratitude.
We’re hesitant to admit that our lives are difficult in any way. We feel the pain, but then we look around at our washers and dryers and smartphones and televisions and all the other trappings of our first-world lives, and we feel embarrassed to complain about anything. It feels easier, and certainly more noble, to blame ourselves, to assume that the problem must simply be moral failings and character defects on our parts.
But what I found with my undiagnosed medical issues is that when we refuse to accept real suffering as legitimate, it actually makes it harder to be grateful. We spend so much mental energy fighting the wrong battles and beating ourselves up over phantom failings that we don’t have much energy left to take stock of all the wonderful things in our lives. Living in a false reality is exhausting and demoralizing. It’s much easier to be happy, peaceful, and close to God when we acknowledge the truth, even if that involves acknowledging that some things are hard.
I’ll never forget the powerful, soul-cleansing relief that poured over me when I learned that there really had been something wrong with me for all those weeks. Even though I had not begun to receive treatment and felt no better than before, I was suddenly inspired to do my best despite my circumstances. Almost immediately, I began to approach my situation with joy. Once I stopped lamenting sins I wasn’t really committing, I could take a clear look at the sins I was committing, and made a better confession than I had in months. Even sitting there in a hospital room, I felt closer to God and happier with my life than I had in a long, long time.
I feel like I’ve been given a divine permission slip to stop defaulting to self-blame for all of my little daily difficulties (not just as it related to my lungs, but in every area of life) and I want to share it with you. If you’re a mom and you’re struggling, let me just tell you that the problem is not you. Well, I suppose I can’t know that for sure; if you find that you’re regularly too drunk to put the Cheez Whiz on your kids’ cookies for dinner, then maybe the problem is you. But, short of that, my guess is that your suffering is due to your difficult circumstances far more than it is due to laziness or lack of holiness or ungratefulness on your part. What you’re doing is hard, harder in certain ways than what your grandmothers experienced, and don’t let the voices in your head tell you otherwise.
Just like the medical professionals in the ER did for me, Dr. Jen is here to give you a diagnosis: you have condition called “life as a 21st century mom,” and it’s known to cause fatigue, drowsiness, nausea, vomiting, confusion and conditions mimicking insanity. Your suffering is legitimate, and it’s not your fault.
I wish for you that same moment I had, when I was hooked up to wires and IVs, dried blood splattered down my arm, tubes all up in my nose, and yet was so profoundly relieved to know the reality of my situation that I gave my husband a big grin and a thumbs-up sign as if to say, “Life is awesome.”