Transcriber: Ale Heredia Allegretti Reviewer: Pari A
What happens when you try to become pregnant?
This is a question that could easily be mistaken for how do I get pregnant?
And I bet if I were to ask all of you this question, you would tell me,
you know exactly how this works.
The steps that I hear recounted the most when
I ask this question Are Number 1: go off the pill? Number 2: to have sex?
Number 3, there’s not supposed to be a number three.
It's supposed to work like this. Except this is not true.
There is a large blind spot,
and that is the result of the well meant sex education we receive as teenagers.
When we are teenagers, we are taught that pregnancy happens in
the split second where we don't have contraception under control.
We are told to be careful when we become sexually active
because that's before we know it.
We will be stuck with an unwanted pregnancy or
a sexually transmitted disease.
And to be fair, these risks are real and therefore this approach is valid
for sex, education and teenagers.
Now, let's look at teenage pregnancy for a moment.
A pregnancy during teenage years,
Be it wanted or unwanted is something really difficult to handle.
Most of the times the relationship doesn't last and
the young moms are left with the burden of being a single parent
and still having to complete their education.
The TV show 16 and Pregnant has been airing on MTV since 2009,
and it portrays the reality of soon to be teenage moms in the U.S. .
It's really not an easy thing to do.
The problem is that this is really
the only sex education we get until some of us find themselves trying to conceive,
and it doesn't happen.
Many of us think that pregnancy happens instantly once contraception is
discontinued. And let's think this through together,
if the probability to become pregnant is well under one percent while we are
on the contraceptive pill,
how high do you think the probability to become pregnant is, when we go off
the pill? Our human brain is built in
a way where most of us would intuitively say: if it’s well under one percent in
the one scenario with the pill, it's got to be above 99 in the other one.
Unfortunately, this is not true.
If 100 women have sex continuously for one year unprotected at the end of
the year, 85 of them will be pregnant and 15 still will not be pregnant.
This statistic is also known as the pearl index,
and it is supposed to tell us about
the reliability of different contraceptive methods.
The problem is it doesn't tell us anything about what happens when we get
older. Hence, we assume that nothing changes.
When we are younger in our 20s,
most of us find themselves well underway to collecting our education certificates,
wanting to be a mother or father is something that almost every student
imagines for later. By the standards of the sex education, we received
as teenagers, we are on the perfect trajectory.
Everything is under control and plans.
In the meantime, however, the looming threat of instant pregnancy silently
makes a U-turn and becomes not being able to become pregnant at all.
Fertility and the ability to become pregnant,
it's not a stable characteristic. They have a variance.
They vary over time and they vary between people.
Many people need years of timed intercourse to achieve pregnancy,
and one in seven couples actually ends up requiring medical help to have
a chance of pregnancy. And there's never a guarantee.
Now, if you think back to what I first told you,
the magnified scenario of instant pregnancy and the looming threat,
somehow this knowledge never changes in us.
It lies dormant, but with age, it should get an update.
I mean, how many updates have you given your computer since you were a teenager
and received that knowledge?
Many people keep thinking that becoming pregnant involves two steps;
one and two that I told you about in the beginning.
This is further fueled by the media reporting stories of late parenthood left
and right. It makes us think it's possible for everyone.
But the problem is we only really find out ourselves.
At what end of the spectrum of easiness to achieve pregnancy we are when we
actually start trying? Let's look at the spectrum a little bit.
In Germany, the mean age for
a woman to give birth to her first child has continuously risen since 1970,
and is now at a little over 30 years of age at 30 in women.
On average, fertility starts to decline at first slowly and from the age of 35,
significantly until at the age of 43. The chances to have a baby are almost zero.
Now, you may tell me: “but Sally,
I know people personally who have had kids at that age.” Yes, you are right.
These people are real and their stories are true. But, let me ask you one thing.
How many people do you know who tried to have a baby later in life were unlucky
and are now involuntarily childless?
Let me guess, probably none,
because this is still a major taboo topic of our time.
Sex is everywhere, but the knowledge about fertility is shockingly little
and extremely flawed. I once even talked to
a medical doctor who kinda sorta wasn't really sure where the fertile days in
the menstrual cycle are and how they are calculated in relation to ovulation
and sperm lifespan.
By now, you may be wondering how I am personally affected by all of this.
If I'm a teen mom or if I've been trying to conceive over the age of 30,
fortunately, I have not been affected this way. But who knows? I'm 34.
I have not frozen eggs and I've never tried to become pregnant so far.
I've been affected in a different way.
However, I've been deeply touched by
the courage that women develop to get through infertility treatment one or
the other way. I'm a mental and reproductive health specialist.
There are about 150 of my trade in Germany,
people who are licensed to provide fertility counseling.
You probably didn't even know this existed.
It is our job to help women and couples to continue fertility treatments,
or to discontinue treatment and start out on the surreal journey of creating
a fulfilled life without children.
I have talked to many women about their shocking realization of what
I explained to you earlier as fertility having a variance;
or to put it differently. Everyone thinks they will get pregnant instantly until
it doesn't happen.
Now, don't get me wrong, I'm not promoting early parenthood per say,
nor am I against contraception.
I'm just saying we need to update our knowledge about sex
and how to become pregnant during our 20s
and 30s in order to make self-determine choices.
When the miracle of instant pregnancy that was previously
the looming threat doesn't happen,
it turns the world upside down for the people who are affected.
Many tell me that they feel deceived by the sex education of their teenage lives,
that they feel like the years in which they would have been able to have kids
have slipped through their fingers while they were taking contraceptives
and making life choices based on
the knowledge from sex education in school.
This is why I am speaking to you about updating your knowledge.
And let's start with this update now.
Shockingly, people who have been trying to conceive
and open up about it, are mostly given false information.
They will most likely be told that they haven't become pregnant yet
because they have too much stress and this is something
I want to stress here; that is false.
To date, there has been no scientific evidence that has identified
the type of stress that is supposed to make pregnancy unprobable.
It is medical conditions and the normal effects of aging that prevent
a pregnancy from happening.
This is described extensively in medical guidelines, but the myth prevails.
The problem is that this myth keeps people who have
a good chance of getting pregnant with some medical help;
The myth keeps them from seeking help.
And people who have actually been through
the treatment also prefer not to talk about it.
And I mean, who can blame them. if you had gone on a vacation
and received some medical infertility treatment to become pregnant?
Which story would you prefer to tell?
Now, let me get back to my initial question once more again:
what happens when you try to become pregnant?
Well, you're either in the group of
the lucky ones, where it happens in six to 12 months, or you involuntarily become
a member of the trying to conceive community.
This is accompanied by a distortion of time.
Suddenly, you can't wait for your next menstrual cycle,
your next ovulation or the next pregnancy test.
And at the same time, time seems to be slipping through your fingers.
Many people tell me that they had never thought that this could suck them in
so much and that the wish to have a baby could be
the only thing they can think about from morning till night.
And here again, they are mostly given false information when they open up about
it. Many of them will be told: “If you stop thinking about it so much,
it’s going to happen.”
And when I hear this well, meant advice,
I try to think it through with my professional education as
a psychotherapist. Are there supposed to be harmful thought molecules that travel
to the ovaries or the endometrium
and push some sort of pregnancy off button?
And all of this is supposed to not be detectable by contemporary research
methods? No such associations between thoughts and
the probability to become pregnant have been observed to date.
So please, if someone opens up to you,
encourage them to seek medical treatment and don't tell them it's the stress
or the thoughts. That is as if you were putting up a sign in
the desert that points away from the oasis.
Now, imagine hearing these things as a counselor every day.
At first, I thought this should be different. Someone needs to do something.
And when my best friend Louisa was affected, I decided to do something.
I accompanied Louisa and her husband through two years of infertility
treatment as a counselor and friend.
And now brace yourselves; because this is not one of the stories with
the happy ending that, you know,
from all the internet ads where they try to sell you
the next magic potion to make you pregnant.
Louisa and her husband, after two years of fertility treatment,
arrived at the conclusion that the chances for them to have
a baby are almost zero. Recently,
they embarked on the journey of creating their fulfilled life without children,
and this in the midst of both their siblings welcoming little ones.
Luisa cannot speak up here because for her,
the implications of sharing her unwanted childlessness are still too great.
But I can and I can make her experience useful for all of us.
So this is why I'm encouraging everyone to update your knowledge on sex
and how to become pregnant.
Let’s base our decisions on when to have kids and life on solid statistics
and not the sex education of our teenage years are
the stories of individual people.
It is a numbers game to a large extent,
and we need to know what we can count on.
Let's talk to our friends,
family and doctors about this to get on top of things.
Let's give ourselves the update we have given our computers 100 times since we
were teenagers. Thank you.