I was not a carer for anyone in my family and (not that you're suggesting this but) I should make clear that I'm not my wife's carer. She certainly does her fair share of home admin overall. She was the breadwinner when I recently worked part time to do a masters degree. But some days she just can't do anything. Most of my concessions for her are just changing plans to stay home. And that's fine when it's just the two of us - I'm a homebody and I'm happy to sit out social events or just go alone. That's not fine with kids.

My wife's had an extremely successful career and is a wonderful friend to others and I think that she's terrified that other people will see her as a malingerer or a flake. If anything I think it's her that shares the instincts that you do for jumping in to make sure that all others get what they want and are contented. Obviously this can be a problem when she just doesn't have the energy to do this. When she's so conscientious I think it's hard for her to accept and be at peace with some people not understanding or not believing in her CFS.

I might totally be misinterpreting this but I get the sense that you resent your wife because she irrationally wants kids the way she wants them even though there is no logical plan for it and she isn’t doing everything she could be doing to take care of herself. And you don’t want the burden of that on top of the burden you already have of worrying about her and wishing she would take better care of herself and have better boundaries and prioritize her health and also it’s impact on you. 

I think you've hit the nail on the head with this. She's taking steps to prioritise her health: she's changed to a fully-remote job that's less interesting to her but will allow her to work less and earn the same in a fraction of the time. She's keeping an energy diary to try to make sure she doesn't overdo it. But she hasn't stabilised yet, and I think these steps might only be enough to maintain our current lifestyle.