In recent years, more people are sharing their decision not to have kids. You may have heard about people who are ‘childfree by choice’ in online articles and social media posts. You may have even decided that this is the right plan for you.
The term ‘childfree’ rather than ‘childless’ describes people who choose not to have kids. Childfree denotes the freedom to start a family, while childless suggests one is unable to have children.
According to the Pew Research Center, 44% of non-parents ages 18 to 49 say they’re not likely to have kids. This is up from 37% in 2018.
People choose to be childfree for many reasons. They may not feel having children is consistent with their desired lifestyle, or they may have medical history that makes pregnancy more complicated
Talking to Your Ob-gyn About Your Childfree Choice
If this is how you feel, you should consider sharing this with your ob-gyn. Your ob-gyn can help you consider the pros and cons of your birth control options.
You don’t need to share your reasons for your childfree choice if you don’t want to. Whatever the reason, your health providers should respect your decision. They should help you make informed decisions about your health with these factors in mind.
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Contraception Options for Those Who Want to be Childfree
Even if you are clear on your wish not to have kids, ob-gyns usually suggest reversible contraception. This is because these options work as well as sterilization — some are 99.9% effective — without surgery.
Plus, they won’t affect your ability to become pregnant if you change your mind in the future.
Many contraception forms today are long-lasting. You may only have to think about a refill or change once every few months or even once every decade.
Hormonal and long-acting forms of contraception include:
- The birth control pill taken daily.
- A shot you get every three months.
- An implant placed under the skin that slowly releases hormones and lasts for three years.
- A hormone-releasing patch on top of the skin that you replace each week.
- Intrauterine devices (IUDs) that release hormones and work for up to eight years.
- Non-hormonal or copper IUDs, which last up to 10 years.
- A ring you insert in the vagina that releases hormones. You change the ring each month.
Your ob-gyn can explain how each option works and how well they prevent pregnancy. They can go over the pros and cons as they apply to you.
For example, some women don’t like the side effects of hormone-based options and may prefer a copper IUD. But, copper IUDs may not be a good option for people with heavy bleeding or cramping.
There are also pregnancy-prevention options that you can use before sex. These include condoms, spermicides, sponges, diaphragms, and cervical caps.
With these options, you must remember to have them available and use them correctly. They may not prevent pregnancy as well as long-acting medicines and devices.
Talking to Your ob-gyn About Sterilization
Some people who choose to be child-free want a permanent option to prevent pregnancy. With tubal sterilization, the fallopian tubes get cut and stitched closed or closed with medical devices like clips. Some methods use an electrical current to seal the tubes.
People may choose sterilization because available birth control options didn’t work for them. They may find them inconvenient or don’t like the side effects. They may be unable to take certain types of birth control because of other health issues.
Some people don’t feel comfortable talking to their doctors about sterilization out of fear of being judged or not having their ability to make this choice respected. Your doctor wants to help you make the right choice for you, and will want to support your decisions. There is greater awareness about sterilization for younger people who don’t want kids.
This doesn’t mean your ob-gyn will refer you or perform the surgery right away. Your ob-gyn will want to explain any risks from the surgery. (While rare, they can include bleeding and infection).
The doctor will also want to make sure you appreciate the long-term impact. They’ll inform you about other birth control options you may not have been aware of or considered.
It’s important to carefully consider whether you want sterilization because a 2022 study found almost 13% of women who undergo sterilization before age 30 regret it. This compares to 7% for those who undergo the procedure after 30.
While doctors may be able to reverse tubal sterilization depending on how it was done, reversal may not work. In other words, people may still not be able to get pregnant, even if they get a reversal.
Still, the American College of Obstetricians and Gynecologists says sterilization in young people can be ethical. They instruct ob-gyns to “avoid paternalism.”
This means your ob-gyn can and should provide sterilization if you fully understand your options and request it. They’ll want to understand your reasons and make sure you are aware of alternative options and the possibility of regret. This process may take more than one visit to ensure informed consent.
Some insurance providers don’t cover sterilization before a certain age.
You Should See an Ob-gyn Each Year, Even If You Don’t Want Kids
Ob-gyns aren’t just for people who are pregnant or planning to have kids in the future. Even if you plan to stay childfree, you should still see your ob-gyn yearly. On top of helping you prevent pregnancy, your ob-gyn can:
- Provide screening for cervical and breast cancer.
- Discuss your risk of reproductive system cancers and ways of preventing them.
- Track your health by checking your weight, blood pressure, and more.
- Discuss diet and other lifestyle changes you can make to improve your health.
- Offer tests to check for sexually transmitted infections (STIs).
- Provide vaccines to prevent STIs and other infections.
- Diagnose and treat a range of symptoms. These include painful sex, pelvic pain, unusual bleeding, and much more.
- Help relieve heavy or painful periods.
- Address unwanted symptoms related to menopause.
- Support your mental health.
ACOG. Reasons to see your OB-GYN this year. Link
ACOG. Sterilization of women: Ethical issues and considerations. Link
ACOG. Sterilization by laparoscopy. Link
Dr. Antoinette Danvers. Risk of sterilization regret and age: An analysis of the National Survey of Family Growth, 2015-2019. Obstetrics and Gynecology. Link
Pew Research Center. Growing share of childless adults in U.S. don't expect to ever have children. Link
Planned Parenthood. Birth Control. Link
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Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.