The Non-Existent Clock of Pregnancy

When I worked as the front desk medical assistant a few years ago at a primary care physicians office, I was able to observe many different questions, concerns, and discussions between the physician (Dr. F) and her patients. One afternoon Dr. F came out of an exam room looking amused and let all of the staff know that there would be an office meeting at lunch. During this meeting Dr. F applauded everyone for taking every patient concern seriously and scheduling appointments for every patient.  However, we were scheduling one type of appointment far too often. This type of meeting concerned infertility in couples trying to get pregnant. We were taught that patients should be comforted and advised to not be concerned if they were not pregnant after one or two months of trying to conceive. In fact, we were told that an appointment should only be necessary after a couple had been trying to conceive consistently for six months to even a year! We were asked to continue to be respectful of patients’ concerns, but to advise couples to not request an appointment for infertility until they had been trying to conceive for longer than six months.

So why do so many couples get so nervous if they cannot get pregnant after a few months of trying to conceive? The answer is simple: culture. Dr. F said it best when she said, “when we teach our kids about sex during high school we push this idea that women will get pregnant if they even look in the general direction of a mans genitalia!” And while she was hyperbolizing, the statement has a point. Sex education in America is pretty hit-and-miss depending on what state you reside, with one study stating that sexual education programs often lose in competitions for school funding. But even when someone has received a satisfactory sexual education, there are several cultural factors that often affect couples’ thinking.

Have you ever heard that a woman has to have her babies before she turns thirty-five or her chances of having a baby will drop drastically? How about that once she is forty, her chances of having birth defects are doubled? I would be surprised if someone in their twenties hadn’t heard these statements. We hear comments such as these all the time from concerned friends, mothers, and other close individuals. Every year during the holidays, many young couples are accosted by inquisitive family members about when they are planning on starting because, their “biological clocks are ticking!” Commonly held beliefs such as these come from caring individuals but are simply not true. First off, the “thirty-five year cut off” came from a French census record from the 1600’s. More modern studies from populations of modern women see a drastic increase in the child bearing years of women. In fact, in one study it was shown that women at near forty still had an 87% of getting pregnant within a year. And the doubling of birth defects? That is a quote from a study that completely missed the point of the study itself. While it is true that women over forty have a doubled chance of experiencing birth defects, the study from which these statics originate found that the percentage of women experiencing birth defects after the age of 35  only “climbed” from .5 to 1%. So, while it is technically true that the rate of birth defects doubled, this “doubling” was in an extremely small number! When we separate out the cultural boogey-man stories of infertility and the ever ticking clock of a woman’s body, we realize that couples have way more time than they thought to start their families.

But what about “right now” for all of those couples that I saw at the front desk, and all of the other couples that are trying to get pregnant in their twenties? It is fine that they have more time than commonly believed, but they still aren’t pregnant after three months of trying? Multiple failed attempts at pregnancy can in fact be very stressful, but everyone—young couples and their friends and family alike—need to understand that getting pregnant is hard. In a study done by the journal of human reproduction, when couples timed intercourse with ovulation there still was only a 37% of getting pregnant in one month. Creating a human body is incredibly intricate, there is a reason that many call it the miracle of birth.  More often than not, something goes wrong during the first couple weeks of pregnancy, resulting in a failure to truly conceive a child. When someone is trying to get pregnant, it more common to experience failure rather than success in the first month. However, if they keep trying throughout the year, it is probable that they will conceive before the year is up!

So what is the take away? Women have way more time than they often think to conceive a child, it can be hard to conceive the very first time that a couple tries.  Finally, if a couple keep trying, success is right around the corner. When it comes to starting a family, there are a lot of things to get stressed out about, but whether or not a couple will be able to conceive should not be one of them. Take a deep breath and enjoy the process.