{"id":87967,"date":"2026-06-21T09:06:41","date_gmt":"2026-06-21T15:06:41","guid":{"rendered":"https:\/\/www.opinionpublica.tv\/portada\/?p=87967"},"modified":"2026-06-21T09:06:43","modified_gmt":"2026-06-21T15:06:43","slug":"how-mental-health-can-complicate-the-decision-to-have-children","status":"publish","type":"post","link":"https:\/\/www.opinionpublica.tv\/portada\/how-mental-health-can-complicate-the-decision-to-have-children\/","title":{"rendered":"How mental health can complicate the decision to have children"},"content":{"rendered":"\n
\"How<\/figure>\n\n\n\n

Deciding whether to have a child is one of the most consequential choices that someone will make. In many ways, it\u2019s a leap of faith: Nobody can know ahead of time exactly what parenthood will look or feel like.<\/p>\n\n\n\n

Prospective parents often worry about problems like economic uncertainty, global crises or the difficulty of balancing parenting responsibilities with career. And for those with mental illness, there are additional considerations that can make the choice feel especially fraught.<\/p>\n\n\n\n

The New York Times asked readers in April how mental health had influenced their feelings about opting for parenthood, and we received nearly 700 responses. Many readers said they were worried about the possibility of passing along mental illness to a child or maintaining their own well-being under the stresses of raising a family.<\/p>\n\n\n\n

\u201cI feel utterly ill equipped to raise and provide for a child as I am often unable to care for myself,\u201d one reader wrote.<\/p>\n\n\n\n

Many were certain that they did not want to take the risks. Others were wavering, undecided. And some explained why, in the end, parenthood felt like the right decision.<\/p>\n\n\n\n

Some researchers are beginning to study how adults with challenging health conditions weigh parenthood. Their work suggests that physical and mental health concerns are crucial in shaping fertility plans: In one 2025 study, participants who rated their mental health as poor were more likely to report a lower likelihood of becoming parents one day.<\/p>\n\n\n\n

We spoke with four couples, and a woman who is considering becoming a single mother, about what it\u2019s like to have mental illness while navigating one of life\u2019s biggest decisions: whether to become a parent.<\/p>\n\n\n\n

Still Trying to Decide<\/strong><\/p>\n\n\n\n

Courtney Kramer and Charlie Enders of St. Paul, Minn., are weighing their desire for children against the challenges posed by anxiety and depression.<\/p>\n\n\n\n

Courtney Kramer, 34, and her husband, Charlie Enders, 34, both enjoy spending time with their niece and nephews. When the kids are being especially sweet, Ms. Kramer said, she gets a \u201cwarm, fuzzy feeling.\u201d<\/p>\n\n\n\n

It happens when they\u2019re having quiet time, reading books together or snuggling up to watch their favorite movies, like the \u201cGodzilla\u201d franchise from the \u201950s and \u201960s.<\/p>\n\n\n\n

In those moments, Ms. Kramer can imagine having children of her own. But then she thinks about her anxiety and depression, and the decision to have kids seems less appealing.<\/p>\n\n\n\n

It\u2019s a similarly difficult decision for Mr. Enders, who has been in treatment for depression since he was 18.<\/p>\n\n\n\n

Although they both benefit from medication, they said, they still have rough days.<\/p>\n\n\n\n

\u201cIt\u2019s hard to take care of yourself,\u201d Mr. Enders said. \u201cAdding another person that\u2019s entirely dependent on you can be scary.\u201d<\/p>\n\n\n\n

For Ms. Kramer, depressive episodes can happen out of the blue. And during one, doing the bare minimum feels like a chore. If she\u2019s suddenly \u201csitting on the couch catatonic,\u201d she added, how would she care for a child?<\/p>\n\n\n\n

Studies suggest that both anxiety and depression run in families. Other members of Ms. Kramer\u2019s family are also on antidepressants \u2014 and the couple worry a future child might develop their disorders.<\/p>\n\n\n\n

So, for now, they remain undecided.<\/p>\n\n\n\n

Mr. Enders said he would let his wife take the lead. If she decides she wants to try, they\u2019ll go for it. He believes he would be a good dad. But if she decides against it, he\u2019ll be OK with that, too.<\/p>\n\n\n\n

\u201cI\u2019m happy with just me and her,\u201d he said.<\/p>\n\n\n\n

A Difficult Transition to Parenthood<\/strong><\/p>\n\n\n\n

Aimee Bui and Tommy Bui of Los Angeles decided to have children. Her anxiety and depression flared in the first year.<\/p>\n\n\n\n

For Aimee Bui, 39, the decision to have children didn\u2019t come easily. Ms. Bui, who was diagnosed with anxiety and depression in childhood, feared that her future children would experience the same suffering she did, and that she would blame herself.<\/p>\n\n\n\n

But her husband, Tommy Bui, 40, was more optimistic. With the right supports in place, he was sure they could manage.<\/p>\n\n\n\n

So they decided to try, and quickly became pregnant.<\/p>\n\n\n\n

The pair were at the gynecologist\u2019s office last year for a routine early pregnancy checkup when the doctor paused, looked at the screen and grew quiet.<\/p>\n\n\n\n

They weren\u2019t having one baby, the doctor explained. They were having two. It was shocking news, but also exciting.<\/p>\n\n\n\n

\u201cWe took every precaution we could and tried to get in front of the travails of the pregnancy,\u201d Mr. Bui said. \u201cWe arranged perinatal counseling and prepared ourselves for the emotional slings and arrows.\u201d<\/p>\n\n\n\n

During pregnancy Ms. Bui continued taking her antidepressants, but in the second trimester, she began feeling increasingly depressed. By the third trimester she was experiencing debilitating sciatica, high blood pressure and pre-eclampsia.<\/p>\n\n\n\n

Then, in the weeks after the twins\u2019 arrival, Ms. Bui found herself racked with fear. She barely slept. Sometimes she found it difficult to breathe.<\/p>\n\n\n\n

\u201cIt was like a sense of doom. Like it was the end of the world,\u201d she said, adding that it felt like \u201cchronic panic.\u201d<\/p>\n\n\n\n

Her parents offered to help pay for a nanny, and she joined a support group for new mothers. Her psychiatrist also increased her antidepressant dosage.<\/p>\n\n\n\n

Today, the twins are 11 months old, and Ms. Bui said she was starting to feel like her old self again. Her husband said he had seen the change, too.<\/p>\n\n\n\n

It had been an \u201cemotional roller coaster,\u201d Mr. Bui said. \u201cBut we\u2019re getting by and we\u2019re together and that\u2019s the most important thing.\u201d<\/p>\n\n\n\n

Feeling as if Time Is Running Out<\/strong><\/p>\n\n\n\n

Liz Robinson of Seattle has always wanted children \u2014 but it feels difficult to choose that path while also managing her mental health.<\/p>\n\n\n\n

Liz Robinson, 42, likes to joke that she runs her life on a different clock called \u201cLiz time.\u201d<\/p>\n\n\n\n

Ms. Robinson, who has both attention deficit hyperactivity disorder and a history of severe depression and anxiety, is often late to appointments and gatherings. And there are rites of passage that she assumed she would experience earlier, but hasn\u2019t yet.<\/p>\n\n\n\n

One of those is having children.<\/p>\n\n\n\n

\u201cThe thing that I wanted more than anything was to be a mom,\u201d she said. \u201cI could not even begin to conceive of a future in which I didn\u2019t have kids.\u201d<\/p>\n\n\n\n

But the right partner never materialized. As time passed, she decided at age 39 to freeze her eggs. Now at 42, she is still single and feeling as though time is running out.<\/p>\n\n\n\n

She considered the possibility of getting pregnant with the help of a sperm donor but isn\u2019t sure that she should choose to raise a child by herself. For Ms. Robinson, the decision to move forward isn\u2019t a simple one.<\/p>\n\n\n\n

\u201cThere\u2019s this divide between my heart and my brain,\u201d she said.<\/p>\n\n\n\n

She wonders how her mental health will change during the pregnancy. And if she\u2019s more anxious or depressed, could it affect the development of the baby?<\/p>\n\n\n\n

She worries about whether it\u2019s safe to take her medications while pregnant and whether she will develop postpartum depression.<\/p>\n\n\n\n

She also ruminates on the possibility of passing on her mental health struggles.<\/p>\n\n\n\n

\u201cDo I want to force this on someone else?\u201d she said. \u201cI didn\u2019t ask for all of these things that I inherited.\u201d<\/p>\n\n\n\n

And she questions whether she could handle the fierce love and vulnerability that accompanies parenting.<\/p>\n\n\n\n

\u201cI am such a sensitive, emotional person that I can\u2019t even imagine having that,\u201d she said.<\/p>\n\n\n\n

An Unexpected Path to Parenthood<\/strong><\/p>\n\n\n\n

Mental health concerns helped Jess and Courtney Faust of Macungie, Pa., decide which of them would be their child\u2019s biological mother.<\/p>\n\n\n\n

Mental illness has been a constant for Jess Faust, 35, ever since she started having panic attacks at 6 years old.<\/p>\n\n\n\n

Her brain felt chaotic. As a child she would peel the skin on the bottom of her feet, pull out her hair and pinch her stomach to distract herself from her psychological pain.<\/p>\n\n\n\n

At 21, after she voluntarily admitted herself to an inpatient mental health clinic, her psychiatrist diagnosed her with bipolar disorder as well as generalized anxiety disorder, which she had also been diagnosed with in her youth. None of this stopped her from wanting a child, however.<\/p>\n\n\n\n

\u201cI assumed I would marry a man,\u201d she said. \u201cI assumed I would have a biological child. And I absolutely assumed that as a result, that child would develop some kind of mental illness.\u201d<\/p>\n\n\n\n

Then she met Courtney.<\/p>\n\n\n\n

Jess was 24 when they started dating. \u201cShe was the best person I\u2019d ever met,\u201d she said. \u201cIt was a no-brainer.\u201d<\/p>\n\n\n\n

They married and started talking about the possibility of having children. While Courtney, 37, has experienced anxiety, too, her symptoms were less severe.<\/p>\n\n\n\n

In the end, given Jess\u2019s mental health issues and some of her physical health problems \u2014 she has lupus and the BRCA2 mutation, which raises breast cancer risk \u2014 they decided it made more sense for Courtney to be the biological mother of their child, and to carry the pregnancy.<\/p>\n\n\n\n

At times Jess felt jealous, \u201cwatching Courtney go through this beautiful life experience,\u201d she said.<\/p>\n\n\n\n

But those feelings didn\u2019t linger. Once their child was born, Jess said, \u201cI felt nothing but pride, exhilaration and liberation at the fact that my daughter was now officially mine, and free of my genetics.\u201d<\/p>\n\n\n\n

Deciding Parenthood Wasn\u2019t Right<\/strong><\/p>\n\n\n\n

For Jim and Patricia Gatewood of Walnut Creek, Calif., mental health was the top concern.<\/p>\n\n\n\n

Jim Gatewood and his wife, Patricia, married in midlife: He was 41, and she was 39.<\/p>\n\n\n\n

Ms. Gatewood sometimes felt pressured by other people\u2019s expectations. Friends and co-workers would ask whether she and her husband wanted children. Mr. Gatewood\u2019s mother, unprompted, knitted a baby blanket.<\/p>\n\n\n\n

They considered trying to conceive. But their top concern, Ms. Gatewood said, was her husband\u2019s history of obsessive-compulsive disorder, or O.C.D., a diagnosis shared by his mother and another family member.<\/p>\n\n\n\n

While his family had found relief with medication, Mr. Gatewood, now 53, struggled with his condition. He couldn\u2019t seem to escape his obsessive thoughts. He often catastrophized. When he had stomach pain, a frequent problem, he wondered whether it was pancreatic cancer.<\/p>\n\n\n\n

\u201cI\u2019ve thought so much about my own death,\u201d he said.<\/p>\n\n\n\n

Even with therapy, a support group and medication, it could be hard to stop ruminating.<\/p>\n\n\n\n

A month ago he had a flare-up. Mr. Gatewood, a nurse practitioner, was juggling final exams \u2014 he is training to become a psychiatric nurse practitioner \u2014 and teaching graduate students.<\/p>\n\n\n\n

Ms. Gatewood, now 52, could quickly tell something was wrong.<\/p>\n\n\n\n

\u201cHe was physically here, but mentally in a separate space that I couldn\u2019t reach,\u201d she said.<\/p>\n\n\n\n

Ultimately, having a child didn\u2019t feel right for the couple. Instead, they each decided to invest in their careers. Ms. Gatewood transitioned into nursing from the tech industry.<\/p>\n\n\n\n

They have no regrets.<\/p>\n\n\n\n

O.C.D. is difficult to live with, Mr. Gatewood said, and he didn\u2019t want to pass down such a painful disorder to a child.<\/p>\n\n\n\n

And while children can be a blessing, he said, they already feel that they live a full, rich life.<\/p>\n\n\n\n