Discuss Childbearing with your Fiancé

            A friend told me a story that revealed a blind spot in some relationships. He was speaking about his son and new daughter-in-law.

            My friend (who is also concerned about population) and the newlyweds had just seen the film An Inconvenient Truth. The groom, concerned about the future, asked his dad what was the most important thing that the newlyweds could do to slow climate change. My friend told me that his response was: “Have a small family”.
            The son responded that he never wanted to father a child. The new daughter-in-law replied “Of course we’ll have kids!
            My friend could understand his son’s reluctance to father children. This young man was born with a serious congenital problem that took multiple surgeries to correct. He was worried that any child he might father would have the same problem, even though the risk was only about 1 in 20.
            When practicing obstetrics and gynecology, I was amazed and concerned by the number of couples I encountered who disagreed about childbearing. Sometimes the woman wanted a child (or more kids) but the man didn’t, and sometimes it was vice versa. Often this was mentioned to me in passing as a minor concern. However, to parent or not was a major sticking point for some couples.
            There are a growing number of young people who plan to be childfree; most of them are women. Their reason for rejecting parenthood is fear of the future condition of the world that the movie describes.
            Fortunately, Gail and I both wanted two kids, and we even had the name for one chosen before we got together. I had always wanted to name a son, if I had one, David, and Gail the same.
            A few years ago, I mentioned Jane in one of my essays. She wrote me that she had resulted from an unplanned pregnancy. Her parents had different ideas about childbearing. When her mother found out that she was pregnant with the third child (Jane), she demanded that the father (a physician) abort the pregnancy. Jane’s mother and father went together to his office more than once, but he refused to perform the abortion. Jane wrote that being born from an unwanted pregnancy severely affected her life adversely. She never wanted, nor had, children. Jane reported that she was happily married, and that, fortunately, her husband was pleased to be childfree.
            Another couple was just the opposite. They were active in outdoor sports and had never planned on parenting. Accidents happen; they were delighted to relive their son’s birth and update me on his progress when we met at City Market. Fortunately, this sort of good outcome is much more common than lifelong regrets about parenting.
            How can this sort of discrepancy about parenting be approached? Many couples go through religiously-based premarital counseling, which makes sense to me, although Gail and I didn’t 50+ years ago. She went to a doctor and had her first Pap smear in order to get a prescription for birth control pills. We agreed to wait 5 years before deciding to have our first child, David.
            My understanding of most premarital counseling is that it is most common in religions that encourage large families, so I doubt that family size or contraception is likely to be discussed. My own faith, the Religious Society of Friends (Quakerism), does not have a prescribed curriculum for premarital counseling. Quakers recommend that the couple select a clearness committee of Friends to help them decide if marriage is right for them. The goal is for the two to determine for themselves if they are truly prepared to spend the rest of their lives together. Suggested topics for a clearness committee for marriage include “background”, “religious beliefs” and “growth and fulfillment.
            Under the heading “relationships with others” is a relevant question for a clearness committee to consider: “Have they considered whether they desire children, the problems as well as the joys children would bring, and the responsibilities for nurturing and guiding them?” There is no mention of birth control, but certainly no prohibition against using it.
            Fortunately, there is a happy ending to my friend’s story. Although the newlyweds started off their relationship with a serious discrepancy in their desire for childbearing, they eventually resolved their difference. My friend is the grandfather of a beautiful and playful young girl. The proud parents were reassured by the ultrasound pictures taken routinely during pregnancy that there was no sign of the same congenital defect that the father dealt with.
© Richard Grossman MD, 2020

By Richard

I am a retired obstetrician-gynecologist who has been fortunate to live and work in the wonderful community of Durango, Colorado for 40 years.