Ask Ada: I Have The BRCA Mutation. Should I Have Kids?

Welcome to Ask Ada, Folks’ bi-weekly advice column for people impacted by health issues or disability. Want Ada to help you with a problem? Email Ada at askada@pillpack.com or tag @folksstories on Twitter with the #askada hashtag.

I Have The BRCA Mutation. Should I Have Kids?

Dear Ada,

I found out about five years ago, at 23, that I had the BRCA mutation. At the time, I opted to do a double mastectomy, but held off on a hysterectomy because becoming a mom has been a dream of mine ever since I was a little kid. However at the time I wasn’t even in a relationship! I’m now engaged, and my fiance has given me the go ahead to start trying for children, but now that the time is here, I’m frozen in fear. There’s a 50% chance I can pass the BRCA mutation to my child, and I’m not sure I could forgive myself knowing that I willingly did that to start a family. Should I be trying to conceive now? 

I understand why you’d feel frozen.

If you decide not to conceive, you’ll grieve for a part of your life you hoped for, but will never get to see. If you do have a child, you may be filled with anxiety, or worse, guilt, if you learn that they too have the gene.

But it seems like, even though you’re hesitant, you’ve had your mind made up for a while now.

When you first learned that you had the BRCA mutation, you were educated on your choices and made the decision not to remove your uterus so that you could start a family. You and your fiancée have also discussed this at great length, and have seemingly agreed that this is something you both want. It sounds like you’re second guessing a decision you’ve already made.

There’s no “right” decision for you to make here, just as there’s no “perfect” way to make a family. 

If you choose to go forward with having a baby, there are some options to potentially lower your anxiety, such as IVF with preimplantation genetic testing that can determine if there are any mutations before implantation. 

If you’re unable or unwilling to try this, remember that a BRCA mutation doesn’t mean that your child will definitely develop cancer…just that their risks are higher. When they get old enough, they can make their own decisions on whether or not to get tested, and how to proceed if they do get the news that they have the BRCA mutation.

Plus, they’ll have you for emotional support and educational guidance on how to make these decisions for themselves.

If you’ve changed your mind and don’t want to conceive, remember that you can attain your dream of having a family with the help of fostering or adoption. There’s no “right” decision for you to make here, just as there’s no “perfect” way to make a family. At the end of the day, it’s about what you want, not what is right versus wrong.

I’m Scared Going Back To School Might Kill Me

Dear Ada,

I’m a teacher, but I’m also a mom and a person who has lupus. I can’t begin to tell you how much of an anxiety problem I have since the pandemic originated. I was fortunate to teach at home for months this spring — which was the hardest thing I ever had to do with my own kids home with me during that time — but I haven’t been able to relax at all while on summer break. I’ve been in meeting after meeting advocating for myself and my students about proper planning for the year ahead, and all I do is think about what will happen this school year. 

Will I get sick? Will I die? Will my kids (both my students and my biological children) get sick and suffer? My level of anxiety is at panic-mode most of the time. School is supposed to start in just about a month and even though I’m employed by the school department, I have NO CLUE whether I’ll be returning to the classroom in the fall. How can I manage my anxiety and plan for the school year without any information?

ᐧYou’re in a conundrum. Like many other educators all over the country, you’re being forced to choose between your job and your health. And it sounds as if COVID-19 is taking a major toll on you already — even though you’re not yet standing in the front of a classroom. 

The questions you’re asking are bound to fuel anxiety and cause you more duress. There’s no way to know who will get sick, who will develop major complications, and worse, who will not survive this pandemic. Worrying about these questions — as justified as your concerns here — is not serving you.

Let’s focus on what you can do here and now. 

I commend you for spending your unpaid hours advocating for the safety of yourself, your team, and your students. But, maybe in the few weeks that you have left before school resumes, you should focus on your mental health instead. 

Teaching in a pandemic took an already intense profession and turned it on its head. Worrying about a return to school — whether virtual or in-person — is enough to cause massive stress. Adding to that is the lack of information you have about what school will actually be like in the coming weeks.

If you aren’t seeing one yet, I recommend working with a mental health counselor right away. They can help you work through some of your fears, concerns, and help you determine a plan on how you’ll approach your job moving forward. I suggest starting now, because there’s probably a lot you can unpack and work through before your school district announces their reopening plans, and at that point, you’ll have more to figure out.

It can be hard to get a therapist at such short notice, so if you can’t, consider using a therapist app, like Talkspace, to connect to someone virtually. In fact, a virtual route might be safer right now anyway, even if it’s at the expense of building a permanent relationship with your therapist.

Something else that might help you is to create a list of possible scenarios in preparation of your appointments. Write down everything that might happen to you and try to drill down what your plan or reaction could be. Start with the questions you’ve asked here, and understand that for each answer you give, multiple more questions will appear. You don’t need to know the answer to everything right now. Just try to brainstorm what things could look like and how you’d handle it. Be open to fluidity as you plan. For some people, just the act of planning, especially when it feels like you have no control over things, can make them feel more empowered.

Finally, thank you for all the work you’re doing and the dedication you have to your students. Being a teacher is no easy feat, and you’re doing an incredible service to your local community and the world at large!

Are you facing a problem that is being complicated by a health condition or disability? Folks’ advice columnist Erin Ollila wants to help. Email askada@pillpack.com and tell us your problem.