Questioning your ideal family size, birthing choices, and financial considerations? How many children is optimal? And is there even a right answer? Hopefully this guide can help!
By Lauren Butia
Spoiler alert: there is no one-size-fits-all answer when it comes to family size. But, we can go through all the pros and cons presented in various medical articles that will, with assurance, help you make your own informed decision.
How many children can women have biologically?
To begin, from a biological standpoint, one study shows that without fertility treatments, the average woman should try to conceive before 32 years old if aspiring to have one child, 27 for two children, and 23 for three. This is because as a woman ages, the number and quality of eggs make it increasingly more difficult. These recommendations were created from data using a computer simulation model of fertility; keep in mind that many women achieve their dream family size well after these ages.
Of course, there are other considerations beyond biology. With scientific advancement in fertility treatments, families are now able to conceive far past what’s possible “naturally.” According to data from the National Center for Health Statistics, birth rates among American women ages 40 to 44 have hit their highest point since 1967. Births have also become increasingly common among women in their late 30s.
How many children can women birth over her lifetime?
One study estimated a woman can have around 15 pregnancies in a lifetime, which is very uncommon today. There is no established threshold of pregnancies before it becomes unsafe; however, there are some loose guidelines around c-section births due to associated risks.
One study shows cesarean sections (c-sections) tend to have negative effects on maternal health. This study also reveals that higher cesarean section births lead to increased risk of morbidly adherent placenta (MAP) and scar pregnancy, making it difficult to have larger families without health risks. Specifically, risk of placenta previa after just one cesarean section birth increases by 1%, and after two, it becomes 3%. Thus, more cesarean section births make it harder to have more children. A higher number of c-section births lead to increased risk of morbidly adherent placenta (MAP) and scar pregnancy, making it difficult to have larger families without health risks.
Another study was done in a rural Indian community where women were evaluated on postpartum quality of life (QOL) after the two types of births. QOL included five categories: mobility, self-care, usual activities, pain or discomfort, and anxiety/depression, which the women could report using a scale from one-to-five (one being no or slight problems and five meaning extreme problems). The results indicated that from the day of giving birth to 30 days afterwards, the women that had a cesarean section experience moderate to extreme problems in four of the health dimensions: mobility, self-care, usual activities, and pain or discomfort. Anxiety and depression was the only health dimension left out; however, both groups reported zero in this particular category. A subgroup within the vaginal birthing women had episiotomy which lowered their QOL, but only to a smaller extent when compared to cesarean section birth.
Even though these evaluations of women show that cesarean section birth proves to be more difficult than vaginal birth, but levels out a month after birth, it is important to notate that there is conflicting research that says otherwise. Another study in California showed that a group of women including cesarean and vaginal birth had similar experiences in their fourth stage of labor. The department attributed this finding to the fact the group of women that had cesarean section births underwent an extensive informational process about the procedure weeks before giving birth.
So, to conclude, it is important to talk to a doctor and find out what works best for you. But, many studies do show that—unless there are health concerns that limits you from giving birth vaginally—it is all right to advocate against a cesarean section birth.
There are other ways to have children
Of course, having a biological child or birthing a child (biological or not) are just two ways to make a family. Other ways to grow a family include:
Children born through egg donation or sperm donation
Children born via gestational carriers (aka surrogates)
Children brought into a family via foster or adoption