For many nurse couples, the question of when to have children collides with everything else: licensing exams, a move abroad, visa conditions, shift patterns, student loans, supporting parents, and pressure from relatives asking “Where is the baby?” There’s no perfect time. But an honest, informed conversation helps couples make a choice that’s right for them.
Start with the big questions
- Do we both want children? How many, roughly?
- How important is it to have children soon, versus after certain goals?
- Where do we want to raise them: here, home, somewhere else?
- What support do we have, or will we need?
- How will we share parenting and work?
- What would we do if we had difficulty conceiving?
It’s normal for partners to differ. Keep talking, and avoid making assumptions.
The facts about age and fertility
- Female fertility declines gradually from the late 20s and more steeply after about 35, with fewer eggs and a higher chance of miscarriage and chromosomal conditions.
- Male fertility also declines with age, more gradually.
- Most couples conceive within a year of regular unprotected sex. Guidelines generally suggest seeking assessment after 12 months of trying, or after 6 months if the woman is 35 or older, or sooner with known issues (irregular periods, previous pelvic infection, endometriosis, previous surgery, low sperm count concerns).
- Fertility treatments such as IVF are less successful with increasing age, and egg freezing is not a guarantee.
These facts aren’t meant to create panic, but to inform planning. Many people have healthy pregnancies in their late 30s and beyond.
Preconception health for both partners
- Folic acid for the woman, ideally starting at least a few months before conception, to reduce the risk of neural tube defects.
- Check immunity to rubella and other infections; update vaccinations.
- Screening for HIV, hepatitis B, syphilis and genotype/sickle cell status. See our premarital health checks guide.
- Manage long-term conditions (diabetes, hypertension, epilepsy, thyroid disease) and review medicines with a doctor before trying.
- Stop smoking, reduce alcohol, and aim for a healthy weight. These affect both egg and sperm quality.
- Nurses: consider occupational exposures (some cytotoxic drugs, radiation, infections) and discuss with occupational health.
Working abroad: practical considerations
- Maternity rights vary: check your eligibility for maternity leave and pay, which may depend on length of service.
- Healthcare access: confirm what maternity care costs, and whether insurance covers it (particularly in the Gulf and the US).
- Visa rules: check how a baby’s immigration status will work; being born in a country doesn’t always give citizenship.
- Exams and probation: some nurses prefer to complete OSCEs, licensing or probation periods first.
- Childcare: without extended family, childcare can be a major expense. See our guide to parenting around the rota.
Handling family pressure
Questions about pregnancy can be painful, especially if a couple is having difficulty conceiving or has had a miscarriage. It’s okay to set boundaries: “We’ll share news when we’re ready.” Partners should protect each other from blame. Infertility can involve either partner; in many couples, male factors contribute. See our guide on family pressure.
When it doesn’t happen quickly
- Seek medical assessment for both partners, not only the woman.
- Look for reputable clinics; be cautious about expensive, unproven treatments.
- Support each other emotionally. Infertility can bring grief, anger and strain.
- Counselling and support groups help many couples.
- Pregnancy loss is common and deserves compassionate care. See our miscarriage guide.
Choosing not to have children
Some couples decide not to have children, or find that it isn’t possible and build fulfilling lives in other ways. That decision deserves respect too.
More on love and relationships: Rekindling romance after a baby · Family planning
Based on NICE CG156 (Fertility problems), WHO preconception care guidance and general public health advice. General information: speak to a health professional about your situation.