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“Is it OK to still have children?”

About one year ago, U.S. Rep. Alexandria Ocasio-Cortez (D-NY), referring to the era of climate change, posed the contentious question on Instagram live. In the era of COVID-19, I’ve been reflecting on that question even more.

For the last three years, my husband and I have been grappling with starting a family. I graduated from college in the middle of a recession, a reality that for years was reflected by my stalled career and bank account—so, we waited. We waited out a new administration, new jobs, and a cross-country move. We waited for things to become stable. We waited to be sure.

The decade turned, and we remained undecided. So we issued ourselves a deadline. Regardless of our level of certainty, by the end of the year, we would make a decision.

It’s April now. Stability is a construct, and I’ve never been less sure of anything in my life.

In 2019, bringing a child into a world with a less-than-certain future was already a concern for around 38 percent of young Americans surveyed. In 2020, as the U.S. health-care and public health systems threaten to buckle under the weight of the pandemic, unemployment is at an all-time high, and the economy is headed into another recession, the idea of trying for a child raises unique ethical considerations within me.

Do I still want a child? If I were certain I did, I wouldn’t let this pandemic stop me from trying. But since I’m still unsure, I have to acknowledge that COVID-19 has made me rethink my family planning.

Childbirth is the top reason people in the United States are admitted into hospitals, and like all health-care workers, obstetrics units are strapped for adequate personal protective equipment (PPE).

The thought of giving birth amid the pandemic brings me anxiety: What should family planning look like at a time when it’s impossible to plan for anything? Could I give birth in a hospital that is stretched thin by COVID-19 patients? If the PPE situation doesn’t improve, could I live with myself if I passed the virus to a vulnerable health-care worker? What if my newborn gets the virus? These are the questions that keep me up at night.

The world may look completely different in nine months—though not every pregnancy lasts nine months. (As many as 1 in 4 pregnancies end in miscarriage; in the United States, 1 in 10 babies is born prematurely; and as a developed country, we have one of the highest rates of maternal mortality. For Black and Indigenous women, the risk is exponentially greater.) Any pregnancy complications would require heightened medical supervision, creating additional hospital traffic and opportunities for the virus to spread.

Telemedicine can help, as can birth centers—home-like facilities that offer prenatal, labor, birth, and postpartum care, but access to these resources is limited.

The mayor of Los Angeles, where I live, estimates large gatherings won’t return until 2021. If expert predictions are correct, it could take two years to return to the status quo, with timelines largely predicated on how long it takes to develop and distribute an effective vaccine and implement widespread testing—which so far has not happened in the United States.

We question whether it’s fair to bring children into a world with depleted natural resources, an unstable economy, and inadequate health care. If I were to get pregnant tomorrow, what would the first year of my child’s life look like? It’s also hard to gauge the long-term effects the pandemic will have on daycare centers, schools, and programs where young children interact.

One of the cruelest characteristics of the virus is the way it isolates people from their support systems. I wonder if it’s fair to bring a child into a world where their early socialization may have to take place through a screen—a world where human touch and companionship are considered dangerous. I wonder how a lack of support from families, friends, and community will impact our abilities to raise an infant as first-time parents. Our most vulnerable communities are already being disproportionately impacted by COVID-19.

When we do emerge from our homes, we won’t know how the increased rates of unemployment, poverty, depression, domestic abuse, and suicide will impact society. Will we be too busy mourning what we’ve lost to embrace what we’ve gained? How will the fallout of the pandemic affect future generations?

Of course, the idea of waiting and further delaying the decision brings additional concerns. Mentally speaking, I can be patient, willing to wait for information to become available. Physically speaking, my body is less inclined. Ten years ago, I scoffed at fertility windows and was comforted by research that suggested these statistics were based on outdated models. At 33, I’m feeling less confident. The government can pad the economy, but there is no stimulus check to regain lost time.

The stakes have never felt higher. If I do want a child and I’m not able to conceive naturally, my options are disappearing. Fertility treatments have largely been put on hold during the pandemic. And as we edge closer to a global financial crisis, costly procedures like in vitro fertilization (IVF) and egg freezing that can extend fertility windows no longer seem financially viable. So many of my friends and family members are already out of work. Tomorrow, I could be too.

I read somewhere that none of us will escape this crisis without losing something. I don’t know what I’ve lost yet, but I can feel myself grieving. Maybe it’s the child I’ll never have; maybe it’s the world I’d like that child to grow up in.

Maybe what I’m grieving is the realization that all any of us can do in this crisis is continue to wait—wait until we know more, wait for things to get better. Wait, even if it means opening myself up to the possibility that by waiting, I may forfeit the ability to make any decision at all.