Health & Pregnancy

Planning a Family

Waiting Too Long? continued...

So how long is too long to wait? "Unfortunately, there's no test doctors can conduct that will tell you, 'You have two years,' or 'You have four years,'" says Goldstein.

According to Fretts, women who delay childbearing often have "more education, good jobs, and perhaps more money -- so they're socially advantaged but biologically disadvantaged. The optimal time to have children is really in the 20s."

Gayle Peterson, PhD, MSSW, a family therapist in Berkeley, Calif., says that the challenge of balancing work with the desire for parenthood is becoming very intense for many women. On the one hand, as their biological clock ticks, they understand the need to start their family, she says. "But lately the work environment has moved toward demanding more overtime, especially in certain professions, and it's almost impossible for these women to find balance."

New Birth Control Alternatives

Ironically, when it comes to contraception, couples have more options today, and thus greater control over at least one component of family planning. In about the last year, the pharmaceutical industry has spawned a wave of new alternatives for women, which include:

• A new type of intrauterine device (IUD), called Mirena, which can be left in place for up to five years. It contains the hormone levonorgestrel, which is gradually released over the life of the T-shaped device.
• Lunelle is a once-a-month injection of synthetic estrogen/progesterone hormones. Despite the convenience of not taking a birth control pill each day, Lunelle does require a visit to the doctor every 28 to 30 days for a new shot.
• The first contraceptive patch, called Ortho Evra, delivers a steady stream of estrogen and progestin through the skin, and is replaced every seven days. Worn under the clothes on the buttocks, upper torso, or abdomen, it will become available sometime in 2002.
• A vaginal ring, called NuvaRing, is a small, flexible ring that will soon come on the market, and provides a low dose of estrogen and progestin over a 21-day period.

Does Size and Spacing Matter?

The trend toward women starting families later (or not at all) -- along with the availability of more birth control methods -- does not seem to have made much of a statistical impact on family size in the U.S. According to a recent CDC report, analyzing data from 2000, the average number of offspring born to women over a lifetime was 2.1, compared with fewer than two children per woman during most of the 1970s and 1980s.

With the help of contraceptives, some parents continue to try to space out their children in what they consider the most appropriate intervals, although Mother Nature doesn't always cooperate with their family planning. Many child psychologists advise that three to three-and-a-half years between children is optimal.