Deciding whether or not to have a baby is a difficult decision even for people without ME/CFS and this illness certainly does not make matters any easier. Not only are there the normal issues to consider, such as money, age and room in your home but we also have to consider if we are well enough to be the parents we want to be, and how much pregnancy and a child will affect our health.

Are you ready?

The first step in deciding whether or not to have a baby is establishing that both partners want one. If one of you wants a baby and the other doesn't it can be a very hard situation where resentment and problems within the relationship can arise. If such a situation does arise you need to both sit down and try to understand each others feelings and reasons, pressure in either direction will not help. The more you understand the more willing you are likely to be put any plans on hold for the time being.

Financial concerns

Having a baby certainly isn't a cheap affair, the latest estimates are that a child will cost you many thousands from birth till adulthood (some estimates say £100,000!), but remember that it is paid out gradually over many years so it certainly won't feel like that much!

Even just pregnancy can be expensive, with pregnancy tests costing around £8 each! There are always ways of cost cutting of course, you can get pregnancy tests from your GP for free, pregnancy clothes can be bought second hand, and as can baby equipment (though car seats should always be bought new). You can also choose cheaper brands, such as Tesco's rather than Gap for baby wear.

If you have a low income or know your income will reduce from one of you stopping work you need to look closely at your outgoings each month to try and establish where you can cut back.

If you haven't already investigated which benefits you are entitled to now is probably a good time.

Age

As many of you probably know fertility declines with age, especially for women. By your mid to late 30's chances of conceiving after a year of trying fall to 50% (from 80% at age 20) and by forty chances are even lower at 36%. There is also an increased risk of infertility and abnormalities. (Source: http://www.babycentre.co.uk/refcap/6155.html)

Many people with ME/CFS put off having children in the hope that the condition will improve, but they need to consider the effects that age will have on their ability to conceive later. Other people decide to have a child anyway as they get older despite their illness still being disabling.

How will pregnancy affect the ME/CFS?

Unfortunately there have been very few studies of pregnant women with ME/CFS, and the studies that have been carried out use a very small number of subjects, making the results less reliable.

Some doctors may advise you to become pregnant as a "cure" for ME/CFS but this is not advisable, as although some people have remissions during their pregnancy looking after the baby afterwards can be very tiring and may result in a relapse. In fact some people even find that their ME/CFS becomes worse during pregnancy. In general most people find their symptoms stay the same, some people report an improvement and a minority find their symptoms worsen during pregnancy.

Will ME/CFS be passed on to my baby?

As I said above there are very few scientific studies into this, but all evidence suggests that ME/CFS is not something which is passed onto your baby. The majority of people with ME/CFS go on to have healthy babies.

However there are some suggestions that there may be a genetic factor to ME/CFS, it runs in some families. I do not believe it is a genetic illness though (where children will have the illness or become carriers), but it is possible that there is an inherited weakness to the immune system which makes family members more susceptible to illnesses like ME/CFS.

Can my having ME/CFS affect the baby or threaten the pregnancy?

There have been no studies which suggest that a baby is affected by the mothers ME/CFS nor that abnormality rates are any higher. However it is possible that miscarriage rates are slightly higher in ME/CFS sufferers, although this is disputed by some doctors.

How well should I be ME/CFS wise before considering pregnancy?

This is a question I myself asked before becoming pregnant, and there are no easy answers I'm afraid. It is a very personal decision, and other factors like age may take a higher precedence if you are certain you will be able to have the support you will need after the baby is born.

Obviously if you are bedridden you will need a lot more additional help with the baby than someone who was able to work part-time before conceiving. Ideally you should aim to start trying for the baby when you are at a fairly good level of health, and when your illness has been stable for about a year.

What about medications I am on?

Many people with ME/CFS are on some form of medication such as pain relief. Your doctor is likely to advise that you stop taking these drugs when you start trying to conceive and while pregnant (possibly while breastfeeding too), so you will need to decide how well you will cope without the relief from symptoms that these medications give you.

How does ME/CFS affect the birth?

Obviously the nature of ME/CFS being that muscles fatigue quickly will affect childbirth. Generally the first stage of labour will occur as normal, but the second stage of labour (pushing the baby out) may see the mother fatiguing quicker than normal and needing an assisted deliver. Some people may prefer to opt for a c-section especially if their illness is very severe, but remember that this is a major operation and takes a long time to recover from.

How will I cope afterwards?

Looking after your baby is bound to be very demanding on you, especially when you are still recovering from the birth. But if you know to expect this you can make plans to make life easier in the weeks following birth. Having your partner home for the first two weeks to help with the housework and caring for your child will be very useful, and you can stock up easy to cook food.

After this you may need to have considered some outside help, whether it be someone helping with household chores, or someone to take your baby for an hour or so to enable you to rest.

What if this isn't my first?

Deciding on whether to have a sibbling for your current child/children can be a difficult decision. You may be concerned that you won't have much energy to devote to your older child/children when a new baby comes along. Try to think about the stage your current child/children will be when you have the baby, school age children might be away from the house a lot of the day, but they also need walking too and from school.