We often talk here about childlessness that comes because one’s partner is unwilling, but what if that partner wants children but has health conditions that make pregnancy impossible or dangerous for mother and baby? What if you find out after you’re married?

Fans of the movie “Steel Magnolias” will remember when Shelby, the young woman played by Julia Roberts, defies her mother and her doctors and gets pregnant despite her Type 1 diabetes. When the child is a few years old, Shelby dies of kidney failure. The pregnancy was too much strain on her body. It’s melodramatic, not totally realistic, and the movie comes from an era when childless marriages were much less common, but it does shine a light on that horrible decision some people are forced to make. Do I want a baby enough to risk my own health and the baby’s?

On the Nov. 22 episode of The Full Stop podcast, three guests told their stories of health problems that forced them to give up on motherhood. Charlie Bishop has MRKH (Mayer Rokitansky Kuster Hauser) Syndrome, in which females are born with absent or underdeveloped reproductive parts. Pregnancy is not possible for the one in 5,000 women with this condition. Bishop is planning for a childless life, which includes getting married next year, travel, writing, and directing an organization called MRKH Connect, which sponsors research and offers support. She can be found across social media via @mrkhconnect.

For Palo Barker, a condition called myasthenia gravis has prevented her from even considering pregnancy. Myasthenia gravis is a chronic autoimmune, neuromuscular disease that causes weakness in the skeletal muscles. Some days, Barker says, it takes all her powers just to breathe. She is in and out of the ICU and takes high dose steroids that could harm a fetus. She is active in a group called Chronic Survivors Childless Warriors and myasthenia gravis groups in the UK. She also has a private group for Asian childless women, open by invitation only.

Steph Penny suffers from lupus, an autoimmune condition which makes the risk of miscarriage or congenital deformities too great. She has written about her own situation and that of others who are childless not by choice in her book Surviving Childlessness: Faith and Furbabies. She has also carried her message into her work as a singer-songwriter with songs like “Angel at my Keyboard”, which you can listen to at stephpenny.com.au.

While Bishop and Barker didn’t really have much of a choice, Penny says she faced what she calls a “forced choice.” When told there was a 50 percent change she would miscarry or the baby would be born with severe deformities, she and her husband decided the risk was too great. It seemed like the only rational choice.

For these women and others like them, their reasons for not having children are not visible from the outside. People may assume they don’t want kids when that is far from the truth. They face the same clueless questions and dire predictions about a lonely old age as the rest of us, but what choice do they really have?

Although the podcast guests were all women, men also deal with illness, injury, or congenital problems that make pregnancy risky. They too may face a “forced choice.”

These conditions may not show up until after one is grown and in a relationship, wanting to have children. How do you deal with this? If you’re the spouse, do you give up on having children? Do you leave and seek someone else? Or do you accept this loss together as a couple and support each other through the difficulties of the illness?

What do you think? Do you or someone you love have a chronic condition that would make pregnancy impossible or inadvisable? How do you live with that? If it was possible but risky, would you take the chance?

Photo by Pixabay on Pexels.com