Pregnancy timing - can I wait?

Factual Questions
1

This will be long, sorry. Moderators, feel free to move to IMHO if it better belongs there, I wasn’t sure. Disclaimer - I’m already planning on discussing some of this with my gyn at my yearly appointment next week.

Phlosphr’s recent threads have really resonated for me, as it’s something that I’ve been contemplating for awhile now (and I’m starting to panic myself I think).

I’m coming up on 31 this summer, and my proverbial “biological clock” has been ticking for a few years now. (I hit 28 and suddenly started thinking about children EVERY DAY. Please shut up now, brain.) The research I’ve done seems to say that female fertility drops a few percentage points a year after 30 (the numbers vary per website), has a large drop after 35, and becomes extremely difficult without donor eggs after 40. Charts like that of Down Syndrome risks increasing each year are increasing my nervousness. However, there are plenty of examples out there that say that it’s nothing like impossible to have a healthy baby after 35.

My husband (who is 31) wants to continue to wait, issue number one being outstanding debt that he wants to pay down first. Issue number two is our physical conditions.

Number one is the most clear cut problem and the hardest to argue with. We both have good jobs but are nowhere near one of us being able to be out of work for an extended number of months, so I’d have to go back to work pretty much immediately. One car loan and all college loans will be gone at the end of 2008. We’ve paid off a few credit cards in the last few years, but the rest of it won’t be able to be seriously tackled until after that 2008 date. Having a child now would extend the process for another few years, best case scenario.

Issue number two is what keeps this decision from being a clear cut budgeting vs. percentage risk game. To be frank, I’m in fairly poor condition. I’m roughly 350 pounds (at 6 foot and a little), and have high blood pressure. Diabetes, heart disease, and back problems run through both sides of my family, though I’ve dodged all of those bullets so far. I am actively trying to watch my diet and exercise more (mostly walking), but I have no reasonable expectation of getting to 300 pounds or less within the next couple of years. My husband is also out of shape, though not as badly as I am (he’s at about 320), and is also working to fix that a little.

[Possible TMI alert] My periods have been extremely irregular for the last few years (since I went off of the pill). I’ve gone as long as nine months without a period, and I’m currently averaging two to three months in between. [/TMI]

SO, my questions are:

  • What risks are there (health-wise, for my child and for myself) for having a child now versus waiting?

  • How long CAN I wait before pregnancy becomes impossible or impossibly risky? Am I already too late?

  • Does the financial side of the picture change your answer at all?

  • I didn’t mention it above, but both my mother and one of her sisters are schizophrenics, and both my mother and father are bipolar. Is the chance of mental illness increased at all by waiting? I couldn’t find anything on the topic.

2

I don’t think there is any reliable way to predict fertility. I know a woman of about your size who started at 36 and went on to have 3 children. They are all reasonably healthy, although the youngest is already obese at 4. She and her husband both came from families with 7 or 8 kids, though, so I don’t know if that was a factor.

I can’t imagine any doctor on earth, though, who wouldn’t want you to get your weight and blood pressure in hand first. Why don’t you think you can lose? I’ve been in Weight Watchers for a while now and seen some real successes. (I should note that Weight Watchers doesn’t allow pregnant women to participate in the weight loss program meetings and weigh-ins, although you are welcome while trying to conceive and as soon as the baby is born.)

The financial side is pretty much your call, though. I can tell you there will always be something.

3

It’s not that I don’t think that I can loose weight, it’s that I don’t think that I can loose 50 or 100 pounds in just a couple of years. You’re supposed to loose only a pound or so a week, right?

4

From what I’ve seen, people who start with more can lose faster for a while, even with a healthy diet. There’s one guy in our group who has lost over 100 pounds in less than a year and who claims he doesn’t even exercise much. It is easier for men, but women lose reliably too, if they are following one of the programs well. Also, every bit helps. I only had about 30 to lose, and I feel much better.

5

As for the money issue.
When my wife and I did the premarrige thing, they asked if we where planning on having kids, we said no and told them we didn’t have enough saved up right now. They chuckled and basically said don’t worry about that. Kids are cheap at the beginning, they don’t get expensive for a few years. And he was right, (assuming you have insurance), baby clothes are cheap, baby food is cheap (especially if you plan to breast feed), etc etc etc. (Oh, did I mention we have a baby now).
SO…Medical issues aside, assuming your doing okay, money wise, I wouldn’t let that be the deciding factor.

6

Childcare, however, is not cheap.

7

There seems to be an increased risk of schizophrenia in older fathers , but there isn’t a correlation with maternal age.

On preview, 1 - 2 a week is the general rule of thumb, but in your weight range, people have been known to lose up to 10 pounds a week at first. Are you working with someone, a doctor, dietitian, Weight Watchers, or doing this on your own? Your diet needs and requirements are much different from someone who is, say, 30 - 50 pounds overweight. Anecdotally, my friend emailed me recently that her husband has lost 139 pounds so far this year, under a doctor’s care, and from ~450. He has serious health issues, though, so getting the weight off is top priority.

8

While you’re right that fertility decreases after 30 (and I apologize for alarming you with that information) fertility also decreases and pregnancy and delivery complications drastically increase with obesity. While you should check with your doctor to be sure, my guess is that the two will sort of cancel each other out, and that waiting a few years and losing weight and getting into shape will find you MORE fertile than you are now.

One of the things stored in fat is estrogen, one of the female hormones. We overweight women have a lot more estrogen than our skinny sisters. This can really wreck havoc on our fertility - it can create an effective progesterone deficiency (that is, there’s not really a progesterone deficiency, but our body reacts to the ratio of estrogen:progesterone at certain points during the cycle. You may have so much estrogen because of your excess fat that your body isn’t really “reading” the progesterone. This can make your menstrual cycles really, really wonky, and make pregnancy very hard to achieve.

I’ll be honest - everything in me is whispering “wait”. I don’t know if the intuition of a stranger on the internet is worth a damn, but there it is.

9

I work with high risk pregnancy and I’d be out of work if it weren’t for advanced maternal age, hypertension, obesity, diabetes, and preterm labor! Most of our patients do well with proper management. Pregnancy can be a risky business for the young and healthy. Go for it!

10

Yes, you can wait. I became pregnant at 38 (totally out of the blue) with twins (who are also more likely when you’re older and overweight). High blood pressure is nothing to mess with. If you could lose 100 lbs in the next 2 years, plus make headway against that debt, it would be so much easier to handle motherhood. Motherhood is so big, it wipes you completely off your feet (most of the time). Make it easier on yourself.

11

I agree. If you have kids, one way or another you’re gonna figure out a way to pay for them. And if you wait, there will always be some sort of financial pressure on you. Also, fertility treatments are very expensive - the longer you wait, the more likely you will need them.

12

I second WhyNot’s advice, especially to consult a doctor. Weight problems, irregular periods and a family history of diabetes are all potential warning signs of PCOS, and even if it’s not that, the irregular periods alone are a cause for concern with regards to your fertility. It may take longer than you anticipate simply to fall pregnant. Of course, I’m a pessimist due to my own experience - we started trying for a baby at 26. Four years later when my husband left me, we still had not conceived. I have PCOS and he was infertile so we had a battle on two fronts. We didn’t pick up on his problems for two and a half years because mine were so obvious, so we wasted a lot of time treating the wrong condition. If I knew then what I know now, we’d have both gone to the doctor before we started trying for a baby and had a complete physical, a sperm analysis for him and a 2 hour glucose test for me. That would have detected his low count and my insulin resistance and saved us all a lot of time.

13

As a stranger on the internet I say, wait. Work on your health issues, and if you have two paychecks aim to deposit one whole paycheck into savings while living on the other. (You should probably pay down any credit-card balances along with the savings.) In other words, get in practice living on one income.

Right now you look at it as someone staying home for a few months, but child-care costs cut into your income even if you go back to work very quickly. Work-at-home sounds good but you still have to hire someone to look after the kid if you expect to get much work done. (You could probably swing about 4 hours a day without help, though.)

The risks of Downs Syndrome increases as you get older, but there are no guarantees of anything at any age. You’re not that old.

14

I also say go to the doctor and discuss this stuff. Your weight could be affecting your fertility and accounting for the irregular periods. Your age will soon be working against you and not for you, but is probably not as important as the health issues. Losing weight is a very, very good idea and will certainly help; OTOH, waiting too long for the exact right moment doesn’t always work. Work on your health and visit your doctor, and good wishes.

(Useless anecdote: my best friend is very overweight and has had a hard time conceiving–PCOS, Clomid, etc. She is the queen of getting pregnant unexpectedly and not while trying. Three kids so far, each in a new and creative way!)

15

Risha, the question is: are you both mentally ready? do you both want kids? If the answer is yes to both, then go for it. There will always be a reason or another to not have the kids. My wife and I live from one emergency to the next, and here we are with two kids (3 and 2) happily bouncing around, making our disaster zone a fun disaster zone.

If we had waited for the right time, we would still be waiting. You never have enough, you are never ready enough, you never feel like you can rise up to the task. All it takes is the desire to do it. Kids are born with a loaf of bread under their arm. Don’t sweat it.

16

But a year has 52 weeks. A pound a week would be 52 lbs in a year. Is there something I’m missing here (regarding your second sentence)? :confused:

17

Well, if you want to be literal about it… :smiley:

OK, I am really tired and need to go to bed, so I haven’t more than skimmed all of your responses (thank you, by the way! I will reread them in detail and respond tomorrow). But one clarification will help, I think.

I am not unhappy enough with myself to go for the sort of drastic measures that losing enough weight to no longer be obese would entail, unless my doctor says that its a medical necessity. Which she hasn’t yet. A general improvement to my health is all that I’m really aiming for. Let’s be realistic - I would have to lose an entire person to get down to a normal weight, even at my height. Dropping 50 pounds in the next year or two is probably possible if I’m diligent at exercise, and I’d be thrilled by that. But that would still leave me at 300 pounds. Losing a hundred pounds would require taking that to a level that would mean a kind of daily obsession about what I eat and do that I’m just not willing to put myself through without a good reason. And I’d still be obese, and would need to loose another hundred plus.

Would I put the effort into it if I couldn’t have a child otherwise? Yeah, almost certainly, but I’d be miserable the entire time. And my self esteem isn’t low enough to put myself through that for anything less.

So when contemplating these questions, assume that I’ll only be losing enough weight in the immediate future to make a minor difference, not to completely eliminate all weight-based risk. Unless that really is the answer to all of my questions.

(Wow, that turned really long winded anyway. Off to bed.)

18

I think that a “good reason” to start losing the weight now are the very real risks of heart disease, diabetes, and stroke that you are facing in the very near future. I hope that you aren’t in denial about the state of your health already. It doesn’t take low self-esteem to fight obesity, it takes having high self-esteem!
Do you, like some alcoholics and drug addicts, have to hit “rock bottom” in order to realize that you’re in trouble?

19

IANAD, but I thought the amount of weight you “should” lose on a diet is as much as 1% of your body weight. When my husband and I dieted together a few years ago (him to get from 220 to 175, me to get from 115 to 105) I lost 1 pound a week and he lost 2.

As practical rather than medical advice, I second waiting a few years and getting health and financial matters in order. Actually, I bet you’d find it safer, easier and more fun to be pregnant as a healthier, more financially secure 34-year old than as a 31-year old with some significant challenges on your plate.

Good luck!

20

I’m not trying to be snippy, but if you aren’t willing to take care of yourself why on earth do you think you’ll be willing to care for a child? 350 isn’t just a little overweight, even at 6 feet tall. You are dangerously, severely overweight. I’m certainly not your doctor or anything, but I can’t begin to fathom why they haven’t brought it up to you (although in previous threads on the subject, we’ve discussed how some doctors are afraid to bring it up, for fear that their patients will flip). Being only 50 lbs overweight is INCREDIBLY unhealthy, but your ideal weight couldn’t possibly be more than 190-- meaning you are in a danger zone that is incredibly bad.

How can you say it’s not reasonable that you’d lose more than 50 lbs in two years? Let’s be honest, the bigger you are, the faster you lose weight. A pound a week is normal, healthy weight loss. Assuming you lost one pound a week (which, if you’re 350 lbs, I imagine would involve a moderate caloric change, diet change, and adding in a bit more light exercise), you’d lose over 100 lbs in two years. Sure, 250 lbs isn’t exactly healthy, but that puts you within 50-60 lbs of your ideal weight.

How do you plan on carrying all that extra weight while you’re pregnant? Can your body handle pushing 400 lbs? What about gestational diabetes? Better yet, at 350 lbs, how do you plan on chasing after a toddler all day? If you can’t find the time to go to the gym for an hour a day (or you find that too much trouble or too exhausting), there’s no way you can handle caring for a child.

Take care of yourself, then worry about taking care of a kid. If you can’t get control of your own life until it’s too late, then perhaps it was for the best.