Pregnancy Advice from a Childfree Sex Educator
The Conversations We're Not Having About Childbirth
As a childfree woman, I often face criticism for my decision. But what I’m about to share with you isn’t a hot take, a justification for my choice, or an attack on yours. This is about addressing an urgent gap in how we discuss pregnancy and childbirth in the U.S. and empowering you with the information you deserve in today’s reproductive climate.
This week, I came across this Thread from Jocelyn Fitzgerald, MD URPS, FACS, a urogynecologist. Her message is one that should resonate with everyone, regardless of their parenting plans. Her plea? To educate yourself about the realities of pregnancy and childbirth before making the life-changing decision to become a parent.
“As a Urogynecologist I cannot emphasize more strongly, literally am begging, women to learn about what actually happens and can happen to your body during chilbirth before getting pregnant. Don’t be blindsided. Go in prepared, ready, and certain in your choice to be a mother.” (While she addresses women specifically, these issues affect all birthing people.)
I was struck by her words and reminded of my own experience. One of my reasons for being childfree is the fear of and lack of desire to experience pregnancy. While many celebrate childbirth as a beautiful, natural experience, this narrative often obscures the physical and emotional realities.
I learned about these realities not from a health educator, parent, or caregiver, but in a college psychology class about sexuality. I specifically remember my visceral reaction to learning about vaginal tearing—a condition affecting up to 80% of people during vaginal birth. If it’s so common, why are so few people talking about it?
The sanitization of authentic pregnancy discourse in American culture is alarming. While abstinence-based sex education frames teen pregnancy as a consequence of sex, it simultaneously positions parenthood as an adult's societal duty. The message tells people, “Don't have sex because you'll get pregnant, but make sure you have kids later because it's your destiny.”
This messaging creates a dangerous knowledge gap. Many people who crave motherhood haven’t been given the space or information to think critically about the choice—not just about raising children, but the physical and mental health implications of pregnancy itself.
This isn’t something anyone should be ignoring. The U.S. has the highest maternal mortality rate among high-income countries. Even more alarming, the Centers for Disease Control and Prevention reports that 84% of maternal deaths are preventable, with leading causes including mental health issues, hemorrhage, and cardiac conditions.
These statistics are even more devastating for Black women, who are nearly three times more likely to die from pregnancy-related complications than white women in the U.S. This disparity persists regardless of education level, income, or access to care.
Even when pregnancies and deliveries go as expected, the impact on the body (particularly the pelvic floor) deserves more attention. The pelvic floor muscles support organs like the bladder, uterus, and rectum, and can be significantly affected by pregnancy and childbirth.
Postpartum care in the U.S. falls notably short of international standards, and this doesn’t even take cost and insurance into consideration. While other countries provide extensive follow-up care and pelvic floor physical therapy as standard practice, the U.S. offers just one postpartum checkup. This “one and done” approach leaves many new parents struggling alone with physical and mental recovery, despite research showing that complete healing can take much longer.
France provides up to 20 sessions of pelvic floor therapy after birth. Meanwhile, many Americans learn about pelvic floor rehabilitation only after experiencing problems. The common advice to “just do your Kegel exercises” oversimplifies the complexity of postpartum pelvic health and recovery, as well as the limited education available and access to care.
I don’t share this to discourage parenthood or promote a childfree life—this is a call for informed decision-making. If you are pregnant, or are considering pregnancy, please research beyond morning sickness and planning your baby shower.
Learn about your pelvic floor before it becomes a problem. Ask questions about postpartum care before you’re overwhelmed caring for a newborn. Review your insurance so you’re aware of what’s covered before the medical bills arrive. Familiarize yourself with your state’s abortion laws, because if complications arise, you need to know your options and rights.
I hate that we live in a country that doesn’t prioritize or value your bodily autonomy and right to bear children (or not). I hate that so many learn these essential truths about their bodies only after it’s too late. But I’m glad you’re here now.
As Dr. Fitzgerald urged, don’t be blindsided. Be informed, be prepared, and above all else, be certain, especially as reproductive rights are increasingly at stake. Your health, body, and life may depend on it.