Question re: Multiple Pregnancies

[Kitty]

This. Not all womens' bodies are the same.

I once read an article that stated Michelle Duggar had to be "extremely healthy" to be able to carry 18 kids to term and have a 19th at all. I've heard of women who had to stop after 3 so that they wouldn't die.

[Maul the Koala]

No, it's not that easy. That's a myth that fundies are feeding you. It's not just about the calcium that is used up the fetus. Hormones affect how dietary nutrients are absorbed and used.

Yes this. It takes a woman's body 24 months to recover nutritionally from a pregnancy. A fetus is a parasite on a woman's body. A lovable parasite, but it still takes a very hard toll on a woman's body.

[bea]

I stopped at two kids not because I don't love babies (I do), but because pregnancy does such a number on me. I puke for six months - two bouts of hyperemesis left me with, among other things, $4,000 worth of damage to my teeth. I threw up so much that I damaged my hyoid bone, with the last pregnancy.

I also had SPD that didn't resolve itself, blinding headaches, vertigo that prevented me from standing upright, and developed a slipped disk with the second pregnancy. At the moment, I'm scheduled for an MRI and possibly a discectomy surgery over the winter.

So while pregnancy might be a walk in the park for a lot of people, it wasn't for me. One of the many reasons the fundies drive me crazy is because they're really dedicated to presenting pregnancy as easy - and if it's not easy for you, that's something you're doing wrong. You should try harder, surrender yourself to God, pray more, etc.

I call bullshit. For some women, pregnancy is really difficult.

[Rosa]

I've had 9 babies. AFAIK, the only real risk is an increased risk of hemorrhage because the uterus doesn't snap back as easily. Most of the other risks are the same, your just exposed to them more often if that makes sense.

I don't have morning sickness or other problems that would make me at risk for a nutritional deficiency. From what I understand from dr.s and midwives, calcium and iron are the biggies.

If a mother didn't take good care of herself, though, I can see how back to back pregnancies could run someone down. I have a friend like this - multiple back-to-back pregnancies, but her diet is very poor and her babies have been born earlier and earlier, with her last 2 being dx as failure to thrive. But she really does not take care of herself at all during pregnancy, I really think that's related.

Quoted for truth. There's a chance of something going wrong with every full term pregnancy - the death rate in the US is 24 per 100,000 births. Doing it 20 times means you've got that same risk, 20 times.

I disagree with the last paragraph, though - some women just have more problems with pregnancy, regardless of their behavior (though with pre-eclampsia at least, changing baby daddies can help). Unless we're defining "getting pregnant over and over again when you have already had complications of pregnancy" as not taking care of yourself. Pregnancy is hard on a lot of people, and many of the factors that cause preterm birth & other complications are worse for subsequent pregnancies after you've had them once, whether that one time was in your first pregnancy or your 15th. Including stress, which is a major contributor to preterm birth. Also, the treatments for most pregnancy complications (bed rest, low activity, monitoring, good hydration & nutrition) are harder to do when you have multiple other kids. When I was put on bed rest for early-onset pre-eclampsia, the hospital only released me because I had no toddlers at home and good support systems in place - moms with little kids at home often don't follow bed rest rules, and if I had a toddler they would have just kept me in the hospital.

Of course, if I were an anti-Western medicine unassisted homebirther I would have just checked myself out and drank some cherry juice. And then died, along with my baby. "God" would have decided the expensive medical care I needed wasn't necessary.

[Guest Anonymous]

Ack, I can't believe I typed "your" instead of "you're" and THEN got quoted! :o

Anyway, as for not taking care of herself- the person I was referring to has had multiple c-sections, a couple of premies, refuses to take vitamins, and doesn't eat meat. She's not a vegetarian and won't eat beans either, she just doesn't like meat and doesn't eat it. She lives off Pepsi, cheese, potatoes, and canned veggies. She also tandem nurses and nurses babies through her entire pregnancy (while not, IMO, getting adequate nutrition).

So yes, I do think that if a pregnant mom doesn't eat a balanced diet (or ENOUGH of a balanced diet) then that is "not taking care of herself."

Also my comments were about women without other complications. Obviously, HG, GDM, pre-eclampsia, etc. will have higher risks but the risk isn't 5 times greater for child #6 than it is for child #2, does that make sense?

[Rosa]

I agree it's not taking good care of yourself to not eat right - but it's the repeated pregnancies on top of the poor nutrition that make it so dangerous. She could fix either issue independently, and is choosing not to do either - but also there may be underlying problems you don't know about. I had terrible nutrition in pregnancy because of constant puking - the nutritional issues came *from* the pregnancy, they didn't make my pregnancy bad. Some women get weird taste & smell effects from both pregnancy and nursing that change their eating habits for the worse.

And for the way risk multiplies - it differs for all of those different issues. I've only ever done research on the ones that happened to me - for early-onset pre-eclampsia, there are no stats for more than 2 births after the first high-risk one, because there aren't enough women doing it (and living through it) to make a group big enough to study. But the rate for second pregnancies after the first one with pre-eclampsia is somewhere between 17-25%, depending on the study and the definition used, where for first pregnancies it's 6-8% for any blood pressure issues at all. For second and later pregnancies where there wasn't pre-eclampsia previously, the risk is really low - but again, there aren't that many people having double-digit numbers of babies, to even have good predictions on what the risk levels are if you have pre-eclampsia with #12 or #16.

And then if you take any damage - from caesarian scarring, or the kidney damage I got from pregnancy, or any ligament and bone damage from a difficult pregnancy, that's going to have a cumulative effect, it's not a flat rate of something going wrong.

[antifundie]

My MIL had 6 children--my husband has said she had miscarriages, too--but I don't know how many or when. Anyways, she's said that her pregnancies were easy, birth was easy--well, no C-sections and the last baby was born at home, and they aren't the type to do that if it was risky. She also had the six kids over 14 years, and she takes good care of herself in general, and I don't think she was ever on bed rest, she was able to breastfeed, etc. So I think some women's bodies are more able to bear lots of kids.

Our (my and Liltwinstars) mother had one pregnancy (twins) and it doesn't sound like it was that easy. She didn't have a c-section, but she was on bed rest for the last few months, I think, and she hemorrhaged pretty badly the day after we were born. We did go to term (born 40ish mins after midnight of our due date, 5+lbs each), although I do think our mom had preeclampsia, or was at risk for it. We were only breastfed for a few months (I think that's something my mom regrets--she let her mom talk her into formula, even though it sounds like we were ok)--anyway, point being, it seems like our mom didn't have an easy time, and bed rest with other kids would have been hard. Since we were her first/only pregnancy, she said she watched lots of TV and wrote out her Christmas cards and was bored. :)

Also, I've noticed with my sisters-in-law, they didn't seem healthy/energetic until 3+ months after their babies were born, and that's when QF types would get pregnant again. So (in my unscientific mind) if you have too many babies too close together, you'd just never have time to bounce back or heal or exercise or sleep, which over lots of years would just wear you down.

[bananacat]

Actually, I just read the whole article. Which didn't imply that pregnancy results in permanent, unfixable, killer lack of calcium, but that it's important to ingest enough calcium during pregnancy to avoid such a deficiency.

Well, you read an entire article on the internet so I guess you're an expert now. If women replace the lost calcium from pregnancy, they can usually recover well enough, if they only have a few pregnancies and have some time in between for recovery. But constant pregnancy for 20 years takes its toll, and it's not as simple as just ingesting more calcium, especially when there is constant breastfeeding in between. If the woman takes some time to stop the drain of calcium then it can be replaced, but constant pregnancy is not as simple as you seem to think.

[countressrascal]

I have been trying to find the link to the study regarding women with more than 4 children and the risk of depression. I can't find it. However, long and short of it more children that you have the more likely that women will have depression. Also it stated in the study that large families over 6 people in the family- will be less educated and more than likely be raised in poverty, also in a enviroment of food shortage.

[maybeizfundie]

Well, you read an entire article on the internet so I guess you're an expert now.

It was the article you posted to back up your statement.

That must mean we're both experts! :D

[Katiebug]

I think that the big reason people complain about Michelle Duggar is that she's had pre-ecclampsia several times, which gets worse every occurrence. I am not sure, but I think that played a role in Josie being born so very early. If she were to get pregnant again, the likelihood of her getting pre-ecclampsia again very early and very badly would basically spell a death sentence for her, the baby, or both.

Strictly speaking, that's not accurate. Recurrence rates for preeclampsia range from 5-70% depending on the severity of the condition and when in pregnancy it happened. Studies indicate that most women who have a recurrence of preeclampsia will actually have a milder case in the subsequent pregnancy.

My preeclampsia was of moderate severity but happened after the baby was full term, and the baby was healthy so all we had to do was induce a week before my due date. Fortunately we both came through it well. I have a very strong family history and prior to my first pregnancy my OB estimated a 20% chance of developing preeclampsia (the norm for a first pregnancy is 5-10%), and after having Little Bug the estimate is 10-15% chance in future pregnancies and he said the odds are that it would be less severe if it does happen. They will simply monitor me more closely next time around once I reach the third trimester (more frequent prenatal visits).

I personally wonder if Michelle had HELLP syndrome, which is believed to be an extremely bad form of preeclampsia and which does have very high recurrence rates. HELLP syndrome kills very rapidly unless the baby is born immediately. It may have just been severe pre-eclampsia but by definition to have it so bad that the doctors have to do a C-section right at the edge of viability, it's pretty severe!

Part of the problem is that scientists are not 100% sure what causes preeclampsia to begin with, so while they know that some women are at greater risk they can't offer much in the way of prevention, and the only cure is delivery of the baby and placenta. If the baby isn't full term it's a constant juggling of the mom's health versus the baby's. Personally if I'd had preeclampsia as severe as Michelle's, I would not be having another baby.