Thursday, November 30, 2006


I had an interesting conversation with a patient this week. As you may or may not know, I'm the soccer doc for our boys high school soccer team. We got to talking about my experiences with the team when she said, "You know, I don't think I want to have children."

"Really," I said. "Now, doc, don't give me that look that everyone else gives me when I say something like that." We got to talking a little bit more. She's in her mid-30's, married, and she states that she's doing well in her career.

"Don't misunderstand, I like kids," she said. "I could be wrong, but I've never really believed that you could have it all - meaning both family and career - at least for women." She continued, "At least with the people that I know, when you try to go for both, then one suffers, and I never wanted that. I always knew I could be a good mom, but I didn't feel that I had the passion or drive to be a good mom."

Now, I know people out there in blog land are trying to figure out if I'm trying to make some kind of political statement with this post. I'm not. In talking with some of my female staff members at the office after this encounter, I guess this having children thing (or not having children) can be a divisive issue.

I did further research on this and found an article in today's Washington Post called Childless: Some by Chance, Some by Choice. The columnist begins the article by talking about how she had a stillborn baby. Soon after that, she and her husband divorced and the columnist chose to remain childless.

The next part of the article describes her work on a documentary about childless women. The reasons for remaining childless are similar to my patient's reasons.
Just as some women talk of a visceral urge that propels them to have children, others speak of an equally visceral urge that propels them not to. Laurie, a transplanted southerner who teaches history in New York, began to realize at an early age that she didn't want children, as she watched wealthy mothers in Richmond hire other women to care for their children. "These people compelled to have trophy babies in certain socioeconomic echelons don't want to face the realities of raising a child." She is now infuriated by what she calls "that Mother Right" -- the assumption that everyone will make way for a woman with a stroller or a child in tow. She goes on to challenge me: "If we believe that this is the hardest thing that anyone can do, then why should it be assumed we should all be doing it?"

This has been a more painful journey for my friend Lori from Tennessee, who, though quick to find humor in things, was devastated by a miscarriage. Her husband, who had two children from a previous marriage, was reluctant to try again. She's irritated by the signs in parking lots reserving spaces for parents with children: "I park in those spots sometimes just out of sheer defiance -- I'm a peri-menopausal woman under stress -- and I need a sign!" Lori argues that "if you don't have children you've . . . thrown a brick in your path that you're going to spend your entire life trying to crawl over. It would have been a lot easier having had children."
I realize that I'm putting a big target on myself and my blog for bringing an issue like this up. I have found that the "child people" Vs. "childless people" are very passionate about their respective points of view.

Me? I'm not passing judgement on this either way. I will be further exploring both sides of this issue, because I think it will help me better understand a patient's point of view.


Anonymous said...

Interesting post. There really are 3 catagories, aren't there? Actually, maybe 4 catagories: those that can and do have children, those that can and choose not to have children, those that have no choice in the matter, and those that can, did not want, but then had children. Now that I've totally confused you. I'll be interested to see where you take this.

Dr. A said...

Chrysalis Angel, Thanks for your comment. I guess there could be a lot of categories depending on how you classify it.

As far as where the post is going, I like to see where my readers take it. THAT is the interesting part.

I'm going to have to check out your blog as well....

Anonymous said...

Interesting points of view. I wrote an entry (Nov 8, 2005"Something's Gotta Give")about this issue after the Neil French debacle last year. My feeling is that having children is a very personal decision. In the local situation, monetary incentives are being used to try to encourage women to procreate as birthing rates are dropping alarmingly to less than replacement levels. IMHO, it takes more than just money to raise a child; it goes deeper than that.

Pieces of Mind said...

Being a parent requires people to make sacrifices. Not everyone is willing or able to do this.

In my field, a lot of young mothers opt to stop working altogether. The stress and the unpredictable hours are often incompatible with being present for your kids. It's not a problem for the dads though - hmmm.

We have a couple of young mothers right now and I have to say it's been a hassle at times. Even though I think everyone is understanding for the most part, there's some resentment when people end up with extra assignments or are stuck working undesirable hours for someone who has a sick child or wants to attend a school play on Friday night. If you object to it, you risk being labeled as a selfish child-hater.

I prefer to think of myself as child-free. ;)

I think human beings are hard-wired with a nurturing instinct but it doesn't have to be focused on a child. It can be pet or a garden or a niece or nephew or whatever. People can fulfill themselves in many ways, but somehow as a society we have bought into the idea that you are a lesser person if you don't reproduce.

Anonymous said...

You a brave man, Dr. A.

It is interesting in pediatrics when we complain about how parents are so uninvolved with their kids and wanting them all put on medication to perform better, yet we feel that it should be the right of people to hold a full-time job and be a mother at the same time. Now, I have no problems with "stay at home dads," and have a few in my practice, but parents do need to follow-through on their commitments, and having a child means you commit to taking care of it. Too many parents are both working so they can live in the nice suburban home, have the flat-screen TV, etc. Societal expectations of what everyone should have is much more expensive than it was in the past. What's wrong with a used car? What's wrong with using an antenna on your TV? What's wrong with eating at home rather than eating out?

No, people make choices when they say they have no choice. I don't judge them as being bad people, but I do think they need to not be surprised at the consequences of their decisions.

The Curmudgeon said...

I've been present for the birth of all five of mine and not one of them came with an instruction manual. That might have helped.

As for your patient: No, she can't have it all. Neither can I. Neither can my Long Suffering Spouse. If that was required to successfully reproduce and raise children, the human species would have died out long ago.

But why shouldn't I be happy for people who are childless by choice? Just don't move into a residential neighborhood and then complain about kids playing in their own yards... go live in a high rise or something... oh, wait, that's another story entirely.

XE said...

All I have ever wanted is to practice medicine, and I recognize the crazy schedule that comes with that. I love children but I don't think that I'm going to have any because it would not be fair to them. I would not have the time to give them the attention that they need.
And Curmudgeon,
Don't worry, children are what gives a neighbourhood life - I would never be one of those people. Just because I don't want to have children doesn't mean that I don't see the value of them in a community.

Anonymous said...

I can't speak for everyone but I really think that it is a personal choice. I have never had any interest in having children and this has been a strong drive (anti-drive?) since I was very young. I have a friend who also does not want children. I also have a friend who has a child and might wish to have more.

I could go on with women I know on both sides of the fence as it were.

The desires as to why the individual chooses to have children (or not) are just as individual and representative as/of each person, I would think.

Anonymous said...

I say good for her for realizing that she does not want kids. Nothing bothers me more than people that have them and then refuse to take care of them. I chose to have children and I also chose to not work outside of the home so that they would have a parent at home to care for them. With Evan's therapy appointments and various other doctor's appointments I doubt that I would have been able to hold down a job and see to his complex needs any way.

Anonymous said...

Very interesting post. I can actually see both sides of the issue. I really don't like other peoples kids all that much but I adore my own. On the other hand, I only have the one and never ever wanted more than that.

Fat Doctor said...

In reading this, I found myself wondering about Dr. A's personal life. Married? Divorced? Partnered? Kids? None of my business, but just thought you should know that I care.

As for the kids business, I'm afraid I see it both ways. I wanted this career when I thought I'd never find love and would be perpetually single. Then I found love and we had a child. Now, part of me wants nothing more than to be a SAHM. But a bigger part of me knows that I'd be a bad SAHM, which is probably worse for my kid than being a busy worker bee.

I do feel like I have it all. And I disagree with Rob and X.E.

I think Son will grow up to respect his working wife and be as awesome a fully- involved spouse as his father is.

Dr. A said...

Thanks for the great discussion on this sensitive topic. There is no right or wrong. It does come down to personal decisions and personal points of view. Here are mine....

I believe that society definitely gives an expectation to have children. Even though people don't talk about it, I believe there is a stigma on those who cannot or who do not choose to have children.

I also believe that society puts out an ideal that people can "have it all" (however you define it). But, the reality is that very few people can achieve that ideal - the ideal of a good personal and professional life.

When the ideal cannot be achieved for one reason or another, all of us can also think of those who have only a good home life OR a good work life where the other part suffers.

I guess what sparked the writing of this post in the first place was my own realization of unconscious societal norms which exist in a culture. And, defying perceived norms may not be a bad thing sometimes.

593 said...

Do you have children, Dr. A? It isn't easy . . . not at all. I could write a book, but my experiences are atypical.

Anonymous said...

Well, just because I feel like I being a big mouth and I haven't had any caffeine yet to reign in concentration, here are a few of my reasons for not wanting to have children (in no random order):

- I am too selfish and want my time to be my own in life (and my money!)

- It's too much of a sacrifice (sort of akin to above)

- I don't particularly like children for lengthy amounts of time (although I do find child development fascinating in a scientific sort of way)

- I find our world terribly disappointing at times and I wonder why you would ever want to bring another human being in to it

- My genes are tainted--why bother passing them on to another hapless soul?

There might be more but I guess that's enough for now haha. Are you depressed yet? I'm not a really misanthrope. I just play one on my blog haha.

And as far as Dr. A goes, my bet is he's young('s all relative mind you but he's not an old fogey!), single and no kids. Okay, he could be dating but who cares about that. No kids, though--except the soccer ones haha.

Anonymous said...

FD, I am not saying your choice was wrong. I do think you need to know yourself and what you can and should do based on your own make-up. I just have seen economic pressures push too many women into work when simple sacrifice of the "typical American lifestyle" would enable them to stay home with their kids. I absolutely think that you need to make your decisions based on what you know about yourself.

Anonymous said...

That is very true Rob. Many parents could stay at home if they were willing to make the sacrifice of a particular lifestyle. I know that my mother could have stayed at home and she did for a period of time but she did not like staying at home and when my dad lost his job she entered the work force and never left it.

We may not have a lot of fancy things but we really don't need the fancy things. Our basic needs and quite a few wants are covered by my husband's humble salary.

Anonymous said...

I agree that knowing yourself is the key. I know some great parents who work full time and I know some horrible parents where the mom is a SAHM.

My brother who is a physician is childless. not much chance now that will ever change. I think he would have been a wonderful father but he loves his work. His wife loves her work. They never wanted to have children. When they aren't working they want to travel together and see the world. He gives the best part of himself to other people each and every day, so what if he didn't chose to have children? he told me way back when he was in med school, that he had to hope for a wife that didn't want children, because if he was going to work 100 hours a week he didn't want to have any.

On the other hand, I had always worked full time and my husband always worked full time and part time. We had 2 kids. it was rough but ya know, they turned into good productive adults, and don't seem to have any problems from their parents working all the time. As a matter of fact, I think they grew up realizing how important working was to becoming successful. My grandkids are all from 1 son. The other and his wife have chosen not to have kids.

I think some people can have it all and for other's, it just doesn't work.

ipanema said...

I believe that some people chose to have and others not to. As one poster mentioned, it is a personal choice.

We may think that perhaps those childless couple are not happy with their lives, yet we see people blessed with children who are unhappy too. It's how one makes marriage work - with or without children.

There are many women who feel that having children impedes career advancement, even personal growth. They think they're going to be tied up with children. I think it's only about time that she'll come realise that once she has one, everything will fall into routine just as it used to be. It's a matter of adjustment for both husband and wife.

I know successful doctors with children.

But then again it's her personal choice.

Anonymous said...

This discussion is quite interesting to me. Indeed, to have children or not is a personal choice -- but what are the ramifications on the greater society?

For example, I've been reading a lot of the whole atheism vs religion debate flying around the blogosphere lately and one of the arguments that comes up now and again is that religion is a necessary driving force for society to continue and reproduce, since secular western culture -- like our own -- the birth rate is often below replacement levels, as someone pointed out above.

We've been addressing that problem by allowing immigration and assimilating the immigrants into our culture. But is a society where a significant number of people choose not to have children sustainable?

Anonymous said...

Years ago, my adolescent daughter asked me if I were making the decision now, would have children? She was appalled when I said, "No, I would not." One cannot know what it will require of you. I had not foreseen how much the responsibility for these kids weighed on me. And the costs. For twenty-some years you have to put the needs of someone else ahead of your own. That is wearing.

But now I have grandchildren, so it all worth it. Even without the grandchildren, I guess. Now that the worry and the work is over, I see how much it has enriched my life to have children. And the grandchildren...

So now what would I say to that question? Dunno.

XE said...

I'm sure that lots of people can do both - no doubt you do a great job of balancing parenting and your patients, it's just that I don't think that I am one of those people.

Anonymous said...

I knew I wanted to be childfree when I was 8 years old. My parents scoffed at my plan and told me I'd change my mind. Several boyfriends proposed marriage along the way, saying that I'd change my mind.

Guess what? Never changed my mind. I was the oldest of 5, my mom was SAHM and my dad worked 2-3 jobs to support us so my mom could be a SAHM. We had a good childhood and most of the memories are happy.

Except for having to dig thru the trash for food every now and then.

Except for having to have serious dental procedures in high school cause my parents could never afford to send us to a dentist.

Except for wearing ragged, threadbare clothing cause it was all we could afford.

Except for having to go without everything but the minimum basics cause it was all we could afford.

Except for being told college was not in my future cause all good Catholic girls got married right out of HS and had kids.

Except for having to pay every cent of my college education on my own cause my parents were too tapped out from raising 5 kids so close together.

So yeah, mostly happy memories but there were exceptions.

I've been steadfast on the childfree thing ever since. And (I feel) my life now is so much happier than my life as a kid.

Anonymous said...

People who decide not to have children do fine in terms of happiness with life, normal adult development, etc., despite society's 'ideal' of marrying and having children by one's 30s. It's the people who want to have children, but can't (e.g., because of infertility) who have difficulties. Or so say developmental psychologists.

Dream Mom said...

I guess there are two things going on here-the first is she doesn't want children. Some people don't and if you don't desire children, then maybe you shouldn't have them.

The part I am not understanding is when she says about not believing you can have it all-meaning both family and a career. I think some women get the message that they can have it all and yet, she seems to think it has to be a black and white issue. I have always believed that the reality is that you can have it all, just not all of it at the same time. At any one time, certain parts take center stage.

I do wonder though, what these childless couples will be doing when their spouse dies and they are 80 years old sitting home alone on Thanksgiving, Christmas and every other holiday. There is also a certain joy when your children grow up and have their children.

I also feel that if a person is serious about their career, that having children helps you look at the world in a different way that can be "beneficial" to your career. In short, I think it makes you more worldly and I guess a little self-centered. Just my opinion of course.

Anonymous said...

When I was young I wanted to grow up to be a mother, and that is exactly what I did. I'm very proud of my children, but this isn't the vocation for everyone. I wasn't at all suprised one morning at breakfast when one of my co-workers announced that she didn't think she wanted to have children. I put my hand on hers and looked her in the eye and told her that it isn't a requirement. She was relieved that someone finally validated her feelings. I think we all need to grow up and understand that what is right for me, may not be right for my sister or my friend. Then help them find what is right for them.

Anonymous said...

I agree with most people that this is a personal choice. However, most pro-childfree comments are made by young and middle-aged people. I'm wondering what when these people are older, will they regret?

I came across several people who are in the late 50s regret not having children. But I've never met anybody who regret having children. For people who regret not having children, most agree that children give parents hope when parents are old.

In my opinion, having children is highly rewarding mentally. It is not something that you can calculate payback by pennies, but something that makes the life complete. Reproduction is the most natural thing of creature, otherwise, the whole species dies out. The same rule applies to the humans, having children is the most natural and basic need of life. If nobody wants the responsibility of the children, the whole nation will disappear from the earth 100 years later.