It’s not like before where you need to think about the future – you can do something more permanent if you want – tie those tubes, get that Essure, have him clipped. It’s not like we’re 25 and might want to change our minds and have another child in 5 or 10 years. We’re 40-something and we’re done. Sure, there are technically a few more years for us, and I don’t want to be agist, but seriously, there aren’t too many of us that want to go the route of being pregnant and closing in on 50 – never mind that that it’s practically impossible for most women to do it (though not impossible for some).

According to Web MD, perimenopause starts at 47, and the average woman starts menopause at 51. Yes, it it possible to get pregnant through perimenopause, and right through to the time you stop having periods, but it’s not likely.

When I was 6 weeks post partum I had my IUD put in. I decided to go the route of no hormones and opted for the copper Nova-T IUD. I’m completely happy about my decision – except for the fact that it starts losing its effectiveness at 5 years. When my doctor put it in (and she’s a mom and the same age as I am), she was pretty nonchalant about the fact that I could probably keep this one because at 44 I would start to lose the ability to get pregnant, and even if I did, it wouldn’t stick.

It’s an interesting distinction. It’s not black and white. Fertility is highest up to your late 20s. Then into your early 30s, while not at its peak, fertility is still pretty good. Web MD pegs the decline starting at 35, which is the whole ‘late maternal age thing’ I heard a lot during my pregnancies. Fertility declines, and it declines hard. Eggs are getting older, the chances of chromosomal issues increases, the fertility factor decreases. You may feel that you’re in your sexual prime, but your ovaries are shouting out last call.Dr. David Adamson, president of the American Society for Reproductive Medicine explains on Web MD that, at 39, your chances of conceiving are half of what they were are 31. Over the next 3 years it declines by half again. 41 is where things really dive – about 10 years before menopause hits is when fertility ends. Some women have fertility longer, some much shorter. But you don’t know until you try.

It’s just so ironic. You spend so many years preventing, and then when you’re finally ready, BOOM. You find out it’s not so easy after all.

Now, my son turned 5 last year. I am in that grey area. Do I *need* birth control? It wasn’t that easy to get pregnant at 36, how likely is it that I can get pregnant at 44, especially with a semi-effective IUD?

Birth control at 44 is different than at 22 , or even at 32. We had our babies just before the cut-off, didn’t we? Birth control is, of course, still a consideration, but not *as* important. Though plenty of us are throwing the tubal in with our last birth, and doing something because, we don’t want to take a chance and well, we are just so used to it. At 39, I realistically felt that I should still use birth control, but I didn’t want to do anything permanent. I wanted to keep the lines of conversation open, just in case.

The IUD was it. I just couldn’t see any other form of birth control. My husband had made it clear he was never getting the big V. (It was actually one of his three dealbreakers when we got serious about our relationship and had ‘the talk’ so I knew that was out.) I’d used the patch, briefly, and wasn’t a huge fan of it – or hormones in general. We’d done sponges for the brief period after I’d decided I was never using hormones again. I could get a diaphragm, he could use condoms – what other forms of birth control are out there? NFP was out of the question. Charting and tracking are not my strong suit.

I think coming to the other side of childbearing is just something that messes with you – and birth control is the icing on the crazy cake. Do you or don’t you? At 44, feeling fertile is just a state of mind.