Every morning, I open my eyes and feel grateful to be here, but I’m never fully rested. And that’s not because I’m the mother of an energetic three-year-old (well, OK, that’s part of it). That persistent sluggishness is more a result of my myriad chronic physical and mental illnesses, which include hypermobility spectrum disorder (HSD), autoimmune symptoms and depression – all of which cause me pain and fatigue.

In bed, I plan what I’d like to do with my son that day: the crafts I want us to make, the places we could go and the fun I’m desperate for us to have. But however meticulously planned those ideas might be, it’s my health that dictates how many activities we’ll get through. I never know what each day will bring. Will my symptoms flare up and cause my body to crash from fatigue, leaving my poor husband to juggle working from home with keeping an eye on our toddler? Or will my depression decide to make a guest appearance, making it difficult for me to do anything beyond taking care of his basic needs? When my joints hurt, even being able to carry my son is impossible. 

I had concerns about getting pregnant with my health record. I joined support groups on Facebook and scoured posts for positive pregnancy stories from women in a similar boat. I also worried about my child inheriting my conditions – my epilepsy and hypermobility disorder are both inherited and three of my siblings suffer from obsessive compulsive disorder (OCD) like me.

Fast forward three years, and I now constantly feel guilty about not always being physically and mentally able to care for my son to the same levels as a more able-bodied mum. Right now, he’s too young to care if an outing has to be cancelled at the last minute, but in a few years’ time, he might. What if I continually let him down? Was I selfish to have a child with all my health issues?

It’s because of this guilt – and the toll that having a child has had on my health – that I’ve decided not to have any more children. The rational part of my brain knows that this is the right decision; my son needs all the care I can provide, rather than having to share scant resources with siblings. But when I’ve explained that to family members and friends, I’ve been met with blank stares. “Just put your trust in God,” they tell me. However, my faith also teaches the importance of making informed decisions and as we don’t have any childcare support from our parents, this seems like the only logical choice.

Psychotherapist Georgina Sturmer tells Strong Women that making an informed decision is a step in the right direction towards shedding feelings of guilt and doubt. In a society where every man and his dog has an opinion about fertility and decisions about pregnancy, she says it’s important to separate our own feelings and agenda from everyone else’s.

“The challenge here is to rule out the noise,” she advises. “Seek as much sensible medical advice as possible so that you’re making informed decisions. And find a way to then balance out the emotional burden of it all. Explore any anger, sadness, guilt, frustration or resentment that you might be feeling. Think about how your future might look and what compromises you might need to make. Do you have the support in place to remain resilient if our choice brings difficulties?” 

There is not much in the way of statistics and research when it comes to the number of chronically ill mothers in the UK or how their health affects their parenting. That might not be a surprise, but given the staggering number of women who suffer from life-impacting conditions, it’s an obvious information gap. According to a 2022 NHS health survey, 43% of women over the age of 16 reported having a long-term illness, and a Trades Union Congress survey from May 2024 reported that there are 1.54 million women in the UK whose long-term illnesses prevent them from working.  

Existing research tends to examine the effect of pregnancy and motherhood on women with acute illnesses or diseases like Aids and cancer, rather than chronic conditions with symptoms that fluctuate.

Author and mother-of-two Jessica Taylor-Bearman lives with ME (myalgic encephalomyelitis), and she’s all too familiar with those feelings of guilt and selfishness. In her most recent book, A Girl Beyond Closed Doors, she chronicles the double whammy of becoming a mother with a chronic illness and disabilities during the Covid-19 pandemic. 

“I was made to feel that because I was chronically ill and disabled, I was less of a mum and that I would have to do more to try and stop my condition negatively affecting my child,” she tells Strong Women. “I [felt that society was telling me that] I was selfish for wanting a child when they would have to watch me suffer and would be unable to provide what they needed. 

“Society has perpetuated this idea that disabled mums and chronically ill people aren’t able to give fully. And never really seeing other chronically ill or disabled mums feeds into that feeling of guilt.”

Dr Louise Goddard-Crawley, psychologist and author of If Only I Knew, explains that at the root of these feelings of anxiety, stress, and guilt is society’s outdated notions of what motherhood is: that a woman’s worth is determined by her ability to have children and look after them in the most selfless manner.

When you have limitations on your caregiving abilities, not being able to stand up to those standards of what a mother should be like can be a catch-22. You’re selfish for wanting to have kids, and selfish for not wanting more.  

“First and foremost, the ‘selfish’ narrative needs reframing,” Dr Goddard-Crawley says. “Instead of viewing these decisions through a lens of guilt, I try to help my patients see them through a lens of self-awareness, responsibility and self-preservation. Choosing to have a child despite a chronic illness can be an act of resilience, not selfishness.”

She also says that choosing to stop at one child for health reasons is an act of responsibility, not failure. “Motherhood should be about sustainability, not sacrifice. In therapy, I try to guide my patients to recognise that parenting is not about achieving an ideal state of health before becoming a mother – it’s about adaptation, balance and showing up in ways that work for both mother and child.”

Jen Parker, author of Unflip – a book about coming to terms with life-changing illness diagnoses – also worried if she would pass on her hereditary health issues if she ever got pregnant. Parker has ankylosing spondylitis, psoriatic arthritis and fibromyalgia and says that her anxiety hasn’t fully gone away – especially if her daughters (now eight and six) complain of aches and pains. However, she also believes that her condition has taught them all valuable life lessons.

“I haven’t been able to be as physically active with my girls as I wanted to be, especially during flare-ups,” she says. “There have been times when I’ve needed to put on a Disney film so I could rest my eyes for five minutes. Now they’re older, they’re really empathetic and wonderfully understanding. I think that’s the silver lining to it all – that they’ve learned we’re all different and that empathy is powerful.” 

She does, however, sometimes wonder if other people think that she’s brought a lot of her problems on herself by pursuing motherhood with a disability.

Of course, chronic illness isn’t exclusively physical. Krisha Davies, a mum of two, has clinical anxiety, OCD and ADHD. After struggling with her mental health after the birth of her second child, she created Super Mumma to raise awareness of the mental health challenges mums can face. As many as one in five women develop a mental health condition during pregnancy or in the first year of motherhood, and 68% of women with mental health conditions are mothers.

Mothering with anxiety isn’t easy at the best of times, but being neurodiverse means that Davies is easily overstimulated and overwhelmed, which is triggered by having energetic children running around the place, screaming and talking loudly.

“The hard thing about mental health is that it’s often invisible and can change from day to day. You never truly know what someone is going through, so there’s no place for judgment; only a mother can make the right decision for herself [whether or not to have more children],” Davies says. “If someone chooses not to have children due to their mental health, they should never be made to feel guilty for that choice.”

For those who do live with poor mental health, guilt can be a trigger. If I’m feeling stressed, my physical symptoms tend to flare. Mum-of-one Ruth Chipperfield says the same about her narcolepsy: “If I find myself under lots of pressure or stress, my health condition tends to get worse. I’ve learned over time that I need to be very careful about what I focus on; feeling guilty about stuff unnecessarily isn’t going to help my family.” 

Dr Goddard-Crawley says: “Rather than focusing on whether a mother is better able to show up, the emphasis should be on the fact that motherhood is not a standardised experience. Women parent in different ways, and those with chronic illnesses or mental health challenges bring unique strengths to their role, whether through resilience, deep emotional awareness or the ability to model self-care. A mother does not need to be in perfect health to be a good parent. What matters is that she parents in a way that aligns with her own needs and realities. Instead of measuring motherhood by sacrifice or outdated ideals, the focus should be on sustainable, realistic and fulfilling motherhood – whatever that looks like for each woman.” 

Images: Getty; Yousra Imran; Jen Parker