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:

No.

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.

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