When you can't afford a baby

For some couples, the decision whether to have children is largely a financial one

HER HUSBAND GETS home close to 4 p.m., the first day in 20 he has been back on the job as an electrician. He walks through the house, past the outlets with safety covers, the gated basement stairs, a bookcase bracketed to the wall — baby-proofing measures they took a few years ago in still-simmering anticipation. The house is quiet. Just Rick Myrick and his wife. He kisses her hello. Then he checks to see how many hours he has worked this year: 130 in four months. Not nearly enough. Not if they hope to start a family.

Melissa Myrick, 33, thought for sure she'd be a mother by now. She could picture it: one boy, one girl, both with her blue eyes. That was the plan when she and Rick married in 2008: Get pregnant right away. But first he lost his job, then she lost hers. They decided to wait. A year later, barely back on their feet, a doctor's visit revealed that they would struggle to conceive. The best chance for Melissa and Rick to have a baby would cost at least $15,000 — money they didn't have, a financial risk they still feel unable to take.

Their quandary echoes that of millions of American families in this recovery, people who have watched the economy grow and the unemployment rate fall but who are still waiting for their outlooks to brighten. Choices large and small hang in the balance — whether to buy a house, go to college, get married. Have a baby.

"I want to get ourselves in a better situation before we start trying," Melissa says, sitting at the kitchen table. And the already difficult economics of the decision were made even harder by the need for expensive treatment to conceive.

They've hashed this out hundreds of times. Pledged to find a way. Mapped the options, tracked his hours. They know they can't wait much longer. But is this the right time?

"We don't want to bring children into this world if we can't provide for them," Rick says, hitting upon his fear.

For Melissa, the fear is different. It's that they will never get a chance.

The decision to have a child is not coolly rational, yet clinical calculations often play a role. Kids are expensive. Diapers. Food. Clothes. Doctor's visits. Day care. Maybe college down the road. Assuming that kind of responsibility is an act of optimism, the belief that tomorrow will be better than today.

SO WHEN THE economy plunged into recession in 2008, shedding jobs and expectations, the U.S. birthrate followed, reversing an upward trend seen when times were good. And the birthrate has continued to fall, a sign of just how many Americans continue to struggle, five years after the recession officially ended.

Last year, the nation's fertility rate hit a historic low — 62.9 births per 1,000 mothers ages 15 to 44, according to the Centers for Disease Control and Prevention. Some of that decline came from a long-term shift toward smaller families. But finances also played a pivotal role. A Gallup poll last year found that the main reason Americans were delaying parenthood was concern about money and the economy — even as the stock market rallied and broad indicators pointed to a brighter future, highlighting a disconnect felt by many Americans. A report by the Pew Research Center showed birthrates in many states rise and fall in tune with personal incomes.

BIRTHRATES HAVE SLOWED so sharply that researchers note that future economic growth could be stunted by a smaller labor pool. Immigration is often considered a fix. But the downturn crimped supply lines for babies as well as new foreign faces. The change was so great that the Census Bureau in 2012 was forced to revise the 2050 U.S. population projection it made just four years earlier, dropping it 9 percent, to just under 400 million.

The languishing economy has caused people to doubt whether they can afford to be parents.

The barriers are even higher for the Myricks, among the 6 percent of U.S. married couples facing fertility problems. Living in Missouri, one of 35 states that don't mandate insurance coverage for infertility, they would be on the hook for related doctor's visits or drugs. They face a huge up-front price tag — a cost that can't be pushed down the road, when their economic outlook might be better. That's frustrating to them.

"Why should the economy play into my family planning?" Melissa asks.

She worries about a future that doesn't include what she always assumed would be theirs.

"What if we never have children?" she asks her husband. "What are we going to do, go on vacation all the time?"

Rick, 35, reaches his hand toward Melissa across the kitchen table.

"Oh, we'll just play a bigger role in your niece's life," he tells her.

THEY ADORE HER 4-year-old niece. She stays at their house most weekends. But Melissa recently asked Rick to remove the girl's car seat from their sport-utility vehicle. She couldn't bear to glance in the rearview mirror during the week and see it empty.

Melissa and Rick, who attended high school together in the St. Louis suburbs but didn't begin dating until later, were in no rush to get married and have children. They wanted to be prepared. Their parents divorced when they were young. Money was tight in their households growing up. Rick recalled how his mom tried to support him and his sister by working overnight nursing shifts. It wasn't always enough. Sometimes they relied on public assistance. He didn't want that for his children.

By 2008, the Myricks felt ready. Rick was 29. Melissa was 27. They got married in Las Vegas, at the top of the Stratosphere Tower, surrounded by friends and family members. It was August, one month before the financial meltdown. It didn't take even that long to hit them. The day after their wedding, Rick received a call. The small shop where he worked was closing. On their honeymoon, another call. Melissa lost her job helping a real estate appraiser.

"There was no way we could start a family," she recalls.

They decided to delay pregnancy for one year. Just one year. When the year passed, they had new jobs. A month after stopping birth control, Melissa began having severe cramps. She was found to have endometriosis. Getting pregnant would take help. The next summer, she started taking Clomid, a common prescription drug that increases pregnancy odds. Nothing happened. That fall, they tried intrauterine insemination, the first of two rounds that cost $2,500 each. Melissa was certain it would work. They baby-proofed the house. She bought tiny shoes and pink onesies. Disappointment followed.

Then, in January 2013, they met with a doctor who specializes in infertility. He told them Melissa was an ideal candidate for in vitro fertilization. IVF offered the best odds. About 1 percent of babies born in the United States are conceived this way. But the procedure requires close medical monitoring and daily injections. A single attempt can cost at least $15,000. And even then, her odds were maybe 50-50.

Despite the recession, the overall number of IVF cycles in the country has grown steadily for more than a decade, even though the annual growth rate briefly stalled out in 2009, according to the Society for Assisted Reproductive Technology. But the recession does appear to have changed who is having IVF: The number of cycles for women younger than 35 has fallen or stayed the same since 2008, a possible indication that younger women are delaying treatment.

"Older women don't have the luxury of waiting until the recession ends," said Gretchen Livingston, a senior researcher at the Pew Research Center.

Rick asked around work about IVF and learned that a co-worker had had twins that way. The co-worker opted for a shared-risk program, one of several creative financing options, which charges a flat rate for multiple IVF cycles, until a baby is born. It cost $30,000.

But Rick and Melissa struggle with the idea. When they are both working full time, they earn good money, reaching as much as $125,000 a year. Melissa has a seemingly solid job at a prison health-care company. Rick's job as a union electrician is less predictable. Two years ago, he struggled to get enough hours. Last year, he logged more time, and his paycheck grew. This year has been the worst since he started in the trade 16 years ago. Now, they risk losing their health insurance if his hours don't pick up.

"If we could stay consistent and know he's not going to be off work, we could do it," Melissa says. "It's just that as soon as we start thinking about it, it goes straight back down."

The couple needs to make a decision. Does it make sense to wait? Will things be better in six months or a year?

"And I watch the clock," Melissa says, knowing that most doctors believe fertility begins to decline rapidly after age 35. Any delay will not improve her odds of getting pregnant.

But Rick is unsure about work. Summer, especially, should be a busy time. Construction work seems slow, but his boss said he expects it to pick up. The schools that sustained the electrical crews last year with jobs running telecom cables have cut back. Rick hopes he doesn't get laid off and fall to the back of the union's rehire list. With hundreds of names in front of his, he could be unemployed for years. "I'd probably have to find another career," he says.

MELISSA WORRIES ABOUT finally taking what feels like their last chance at having children. She can close her eyes and imagine her son and daughter. But she can't bear to imagine not having a child.

Just calling the IVF doctor and setting up an appointment feels like a huge step, no matter the cost.

"I probably should make it," Melissa says. Maybe soon. Maybe later this summer. Maybe by then, their future will seem more certain.

Later that night, they leave their quiet home and hop in their truck to run errands. It has been a good day. Rick is back to work. For now. Melissa has a plan. For now.

Their house sits at the top of a cul-de-sac, where two young boys bounce a red ball. A little girl rides her bike in the street, training wheels holding her steady. Another girl, maybe 2, stands in a neighbor's yard and points at a passing dog.

Here, then, is everything they want.

Reprinted with permission from The Washington Post.


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