'Maybe-Baby' Mindset Can Put Mom and Baby in Harms Way

Oct. 9, 2011— -- After five years of marriage, 31-year-old Erin Riggio and her husband jetted off to Italy on a second honeymoon of sorts--and they left their birth control behind. Yet their two-week coastal tour wasn't quite a baby-making trip. Sure, she popped a folic-acid vitamin every day--you know, just in case--but she also indulged in plenty of pinot grigio.

"We weren't exactly trying to get pregnant," says the book editor from Chesapeake, Virginia. But they weren't exactly trying not to get pregnant either.

Erin, like about a quarter of women ages 25 to 45, had adopted a passive attitude toward family planning--she wasn't gunning for a child, but she also wasn't carefully avoiding having one. In fact, women with this "maybe baby" mentality have come to outnumber those actively trying to get pregnant by a whopping four to one, according to a study in Maternal and Child Health Journal. "I now see patients all the time who are ambivalent about pregnancy," says Pennsylvania-based clinical psychologist Elizabeth Lombardo, Ph.D., author of A Happy You: Your Ultimate Prescription for Happiness.

How Much Should You Compromise For Him?

Pregnancy Re-conception

Thanks to a host of seemingly viable backup plans--egg freezing, new and improved in vitro fertilization (IVF), genetic embryo testing--many women no longer feel the urgency to conceive during their younger years. Indeed, IVF rates alone have more than doubled in the past decade, says Margareta Pisarska, M.D., director of the Center for Fertility and Reproductive Medicine at Cedars-Sinai Medical Center in Los Angeles.

But it's not all about medical helping hands: Social pressures surrounding pregnancy have changed dramatically in the past few decades, says clinical psychologist Michelle P. Maidenberg, Ph.D., of Harrison, New York. "Women used to feel pressure to become pregnant within a year of getting married--two years, maximum," she says. But a troubled economy and shifting breadwinner roles have stamped out old stigmas about delayed family plans. For some, the resulting relief has helped usher in a blase attitude about having a baby.

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Maybe Baby: Risky Attitude?

For others, however, the lack of a socially imposed timetable has left them even more anxious than before. Minus the fear of being judged for not hopping on the mommy express, young women have ample time to overanalyze the pros and cons of pregnancy and the trade-offs they'll make for parenthood. "A lot of women are now scared to take an active step in that direction," says Maidenberg. "Pregnancy that happens without really trying, on the other hand, feels like it was meant to be."

If that sounds like a cop-out, it just might be: The maybe-baby approach often boils down to avoiding stress by adopting a Zenlike outlook, says Mary L. Rosser, M.D., Ph.D., an obstetrician and gynecologist with Montefiore Medical Center in New York City. In other words, choosing not to choose allows some women to skirt the nerve-racking "Am I ready for kids?" question and the often stressful and emotional process of trying to conceive.

Nikki Brush, 31, has adopted such a mindset.

"The planning part of getting pregnant isn't something we're ready for," says the Portland, Oregon, resident, who's been married for nine years. "But we're at a point in our lives where a pregnancy would be OK. If it happens, it happens."

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A Healthy Gamble?

Because the maybe-baby mentality flies in the face of a traditional approach to family planning, it has some healthcare providers grappling for context. Most doctors have typically given advice based on the long-held assumption that if a woman wasn't trying to get pregnant, she was trying to avoid it, says Rosser. And physicians believed that if a woman had a casual attitude about pregnancy, she might be putting herself--and her potential kid--at risk.

To wit, studies show that women with unplanned pregnancies are less likely to get early prenatal care and their babies have increased chances for preterm birth. Of course, a maybe-baby pregnancy isn't totally unplanned, but doctors worry that skipping out on early counseling could leave women in the dark about pregnancy-related health conditions, complications, or medication conflicts (normally harmless retinoid skin creams, for example, are hardly fetus-friendly). Plus, women who don't quickly realize they're expecting are more likely to engage in no-nos like boozy happy hours or social smoking, says Rosser.

Just ask Erin Riggio. Her low-stress maybe-baby approach ended up giving her more anxiety than anticipated when she discovered she was pregnant. Yep, she got preggers on her Italian getaway, and she spent the next few months worrying about whether she had inadvertently harmed her unborn child with too many sips of wine. "Of course, I immediately thought about all the things I shouldn't have done," she says. (Her baby, Calvin, is now a healthy 3-year-old boy.)

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Could Being Laid Back Help?

Despite its downsides, a laid-back attitude toward conception can be a positive thing, says Rosser. A new study in the journal Fertility and Sterility suggests that relaxing may actually help you get pregnant faster. And in a way, skipping over the stress of planning a pregnancy is ideal--as long as the mom-to-be is healthy, says Lombardo.

Therein lies the key to maintaining a responsible maybe-baby attitude: Even though you're choosing not to choose, you still have to stay in baby-making shape (see "Baby Steps," at right). You also need to be sure to keep realistic expectations. Fallback options such as IVF can be very expensive and are never foolproof, and women with diabetes, high blood pressure, and sexually transmitted diseases must consult their doctors before throwing caution (and condoms) to the wind.

Maybe-Babies By the Numbers

23 percent of women ages 25 to 45, including those who already have kids, fall into the maybe-baby camp

6 percent of women in the same age-group, including those who have kids, are actively trying to get pregnant

75 percent of 30-year-old women will get pregnant within a year of starting to have unprotected sex

66 percent of 35-year-old women will get pregnant within a year of starting to have unprotected sex

Baby Steps

Health advice every woman should follow--whether she's thinking about pregnancy or not--from Mary L. Rosser, M.D.

Step 1

Yes, you've heard this before, but folate not only protects against neural tube defects, it also wards off anemia and prevents DNA mutations that can lead to cancer. Get at least 400 micrograms of the B vitamin a day.

Step 2

They're controversial, but some immunizations are a must and can't be administered if you already have a baby on board. Make sure your tetanus, measles-mumps-rubella, and chicken pox vaccines are up to date.

Step 3

Cigarette smoking--even just a social puff--riddles your bloodstream with chemicals and heightens the risk for infertility, miscarriage, and sudden infant death syndrome. Need we say more? Ditch the cancer sticks.

Step 4

Rocking a fit bod benefits everyone: A normal weight and body mass index (BMI) means lower chances of diabetes and heart disease for you, and a reduced risk for preterm birth, birth defects, and obesity for your potential mini-me.

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