ANN/THE STAR – Children are often seen as a blessing, bringing joy, purpose, and meaning to life.
In a chaotic world, many find solace in returning home to the warmth and love of their children. For some, having kids is a natural progression after marriage.
However, an increasing number of couples are choosing a child-free lifestyle. While not a new concept – having existed in Western cultures since the 1960s – it was once considered rare.
Today, social media has propelled the child-free culture into mainstream recognition, particularly among millennials and Gen Z.
This trend is also gaining traction in Asia, with many newlyweds opting to remain child-free by choice. These dual-income, childless couples are often referred to as ‘double income, no kids’ (DINK).
Reasons for embracing this lifestyle vary. They include prioritising career ambitions, financial stability, personal freedom, environmental concerns, a greater focus on relationships, lifestyle flexibility, and preserving physical and mental well-being.
Additionally, some couples are daunted by the challenges of raising children, particularly the responsibility of parenting effectively and responsibly in an increasingly complex world.
Another aspect that women who opt to be child-free should consider is their increased risk for certain medical conditions due to this choice. Studies have shown that women who have never given birth to a live baby are at greater risk for some diseases.
INCREASED BREAST CANCER RISK
This group of women are known as the nulliparous, a term derived from the Latin root null, meaning ‘not’, and the verb parere, meaning ‘to bring forth’.
Nulliparity puts a woman at risk for cancers in the reproductive organs, like breast, ovarian and endometrial cancer.
Women exposed to the hormones oestrogen and progesterone produced by the ovaries over long periods are at higher risk of breast cancer.
This hormone exposure is reduced with each pregnancy.
Nulliparous women have a 20-40 per cent higher risk of postmenopausal breast cancer than parous women who first gave birth before the age of 25. Mothers with five full-term pregnancies are about 50 per cent less likely than nulliparous women to develop breast cancer.
In a case-control study by British physiologist Dr Janet Lane-Claypon, published May 1926 in Ministry of Health. Reports on Public Health and Medical Subjects No 32, it was found that lack of breastfeeding was associated with higher breast cancer risk.
Women who breastfed for at least a year were shown to have lower breast cancer risk, as most women do not experience ovulation when breastfeeding, thus reducing their exposure to oestrogen and progesterone. Breastfeeding might also change breast cells in a way that may make them less likely to develop malignancies.
Nonetheless, all women, including nulliparous ones, can reduce their overall risk of breast cancer or detect any changes early by doing these simple steps:
Regular breast self-examination (BSE)
Conduct a BSE on the fifth or seventh day after your period. Do choose one specific day or date, so that you can remember to do it consistently. This examination should only take 10 minutes. You can do your BSE before taking your shower in the bathroom. Do it in front of a mirror so that you can see any differences between your left and right breasts.
Clinical breast examination
It is suggested for women aged 20 to 40 to have clinical breast examination performed by a doctor. The doctor may also suggest doing an ultrasound to see if there are any signs of cysts or fluid-filled sacs in the breasts.
Mammogram
For women aged 40 and above, it is recommended to do a mammogram once every two years to detect any breast tumours before they are large enough to feel. This will help to reduce the risk of potential breast cancer, or if detected, enable treatment to be started at an early stage.
OTHER MEDICAL CONDITIONS
An analysis from the Ovarian Cancer Cohort Consortium found that the risk of ovarian cancer increases with an increase in the lifetime number of ovulatory cycles.
Again, pregnancy reduces the lifetime number of ovulatory cycles, and thus, the risk of ovarian cancer. For those who are particularly at risk for ovarian cancer – such as women with a family history of ovarian cancer or who are BRCA1 gene carriers – a risk-reducing prophylactic surgery to remove both their ovaries and fallopian tubes can be done.
Meanwhile, endometrial cancer is the sixth most common cancer in women worldwide.
It also carries the highest co-morbid (associated) disease burden of any cancer.
Multiparous women (women who’ve had multiple pregnancies) are known to have a lower risk of developing endometrial cancer than nulliparous women. The lack of ovulation and the shifting of the balance of sex hormones with decreased oestrogen levels and increased progesterone levels during pregnancy, has traditionally been thought to be the major contributors to this decreased risk.
Osteoporosis and cardiovascular (heart) health impacts are also among the other risks
of nulliparity.
Regrets have been expressed by some who have led a child-free lifestyle – a change of mind that happens more often than not at a later age when conceiving is more difficult.
Some women are also childless not by choice, but because of health issues or fertility challenges.
For such cases, it is worth a visit to a fertility specialist for a thorough consultation, as advancement in medical technology provides many opportunities for conception.
Procedures such as in vitro fertilisation (IVF) have been fruitful to many desiring to build a family. – Dr Deepashni Thulasiraman
