What to Expect for Your Second Pregnancy

Trying for another child

Your little bundle of joy is now toddling around the house, melting your heart with wet kisses. They may even now be going to school, looking so adorable with that little backpack.

Your partner and you may have begun discussing the possibility of having another child, but questions may swirl in your head as you talk about this. The common questions parents often ask are "Is this the right time?", "Are we ready?", and "How will my child react to a new baby?".

The choice of whether to have another child, and when to do so, is very personal and unique for each couple. There is also no standard answer to these questions as it depends on many factors.

To help, here's a guide on some key factors a couple can consider when making a decision.

When should i get pregnant again?

There are several factors to consider if you're trying for your next child, such as:

Timing

The American College of Obstetricians and Gynaecologists recommends for couples to wait at least 18 months from the birth of the first child before trying to get pregnant. This time period allows the mother-to-be to restore needed vitamins and nutrients in her body, and to allow her reproductive organs to recover. A gap of less than 17 months increases the risk of the second baby being underweight and born prematurely. This risk is highest for babies conceived less than 6 months from the birth of a previous child. A gap of more than 5 years also increases the risk of the next baby being premature and underweight.

Some couples prefer to try for another child when the first child is older, so that the first child can better understand and communicate the impact of another child in his/her life. Other couples prefer smaller age gaps, so that their children will more likely to have common interests and have playmates in each other.

Age and fertility

Another important consideration for most couples is their age and, as a consequence, their fertility. Although fertility rates for women generally decline by 35 years of age, some women are still able to get pregnant in their 40's.

If you are experiencing any difficulty conceiving or have any questions about fertility, it may help for you to speak to a specialist, to help identify any underlying conditions affecting your ability to conceive.

Financial considerations

You would also need to consider if you are financially ready for another baby, and if you have the proper accommodations to handle a bigger family size. The right timing of when to try again is ultimately a decision by you and your partner.

Difference between first and second pregnancy

You've probably heard contradicting advice when it comes to having a next baby. Some would say that having a second baby is much easier, since you are already a pro when it comes to taking care of a baby. You would already have experience with breastfeeding, bathing a newborn, diaper changes, and other tasks associated with infant care.

Others would say that having a second baby is going to be more difficult. You would have to attend to the needs and demands of your older child while pregnant, and subsequently need to care for both of them.

Most mothers would also tell you that every pregnancy is a unique experience.

Regardless of perspective, you may experience the following changes during your next pregnancy:

• Your baby bump will show sooner since your stomach muscles have already been stretched out.
• You may feel your baby move sooner, since you already know what it feels like.
• Labour and delivery may take less time, when compared to the first.
• Some studies also report that breast milk production will be easier for the second baby.

How to increase your chances of getting pregnant again?

Women preparing for pregnancy – whether their first or second – should take steps to be in good health.

Nutrition

You should eat a healthy and balanced diet, comprising grains, vegetables, fruits, protein and dairy. It is also recommended to consume at least:

• 400mcg of folic acid to help prevent birth defects
• 1,000mg of calcium to support the healthy development of teeth and bones, which can be found in dairy products and fish with soft, edible bones
• Iron, which can be found in meats, especially organ meats, legumes and whole grains

Remember to speak to your doctor about any other vitamins or supplements you wish to take.

There are also certain foods you should reduce or eliminate from your diet, such caffeine and raw or undercooked foods. In addition, you should also avoid processed foods, which often contain high levels of salt, fat, sugar and/or preservatives.

A balanced diet will also help with maintaining a healthy body weight, which can improve your chances of getting pregnant and avoid complications in pregnancy and delivery. The Body Mass Index (BMI) for adults is between 18.5 to 24.9. Having a BMI that is either too low or too high – being underweight or overweight – may negatively affect your fertility and pregnancy.

Lifestyle changes

To improve one's chances of getting pregnant, it is advisable to avoid smoking and excessive alcohol consumption. It is also important to consult your doctor to make sure you have received all the recommended vaccines before you become pregnant.

Pre-pregnancy and fertility screening

Pre-pregnancy screening and check-ups may include:

• Blood tests to check for conditions like anaemia or abnormal thyroid levels, as well as immunity towards infectious diseases like rubella (German measles) and hepatitis among others
• Genetic conditions, which includes blood disorders such as thalassaemia
• Gynaecological conditions such as polycystic ovarian syndrome (PCOS), uterine fibroids, cysts and others
• Urine test to check for urinary tract infections and kidney disease

There are many factors that might affect a woman's fertility, from age to certain medical or hormonal conditions. Medically, infertility is defined as being unable to conceive after 12 months or more of trying and causes include reproductive issues in both men and women.

If you are above 35 years and having difficulties conceiving, a fertility specialist may be able to help identify the possible causes of infertility.

Fertility treatments and procedures

Treatment for fertility will depend on its cause. They may include:

• Scheduled intercourse
• Intra-uterine insemination (IUI), a form of artificial insemination
• In vitro fertilisation (IVF), in which the egg and sperm are fused externally and then reinserted
• For men, a Vasovasostomy or surgery to remove blockages in the sperm transport system in the genital tract or anti-oxidants to improve sperm count and quality

Delivering your second child post-caesarean

If your first baby was delivered via Caesarean, it may still be possible for you to deliver your second child naturally. This is known as vaginal birth after caesarean (VBAC).

There are many factors to consider when choosing between VBAC or having a repeat caesarean section. These factors include:

• Age of the mother
• Previous surgeries of the uterus
• Presence of pregnancy complications such as preeclampsia
• Type of caesarean section done in the first pregnancy
• Weight of the mother

Although up to 70% of women have successful VBACs, you should deliver your baby in an institution that can perform an emergency caesarean section in case it is needed.

It is advisable to discuss your options with your doctor during your prenatal check-ups so that you can prepare for your delivery.

If you have any questions or concerns on trying for your next child, it is best to consult your obstetrician.

Other lifestyle considerations with a second child

Childcare

Given that parents are probably going to have their hands full with a new baby in the family, they may want to consider asking for a helping hand. A family member could be asked to help out with childcare, or a housekeeper could be employed to help you with the household chores while you are busy taking care of the children.

Preparing baby necessities

It is also good to prepare all your baby gear early. Since you have most equipment already at hand, there are fewer things you may need to buy. Make sure that your baby equipment, including strollers, cribs and car seats are in good working condition. It is probably a good idea to stock up on diapers, wipes, and other toiletries. Not having to go to nearby stores to buy supplies will save you precious time and energy when your new baby arrives.

Helping your firstborn child adjust

It is also important to help your first child adjust to the idea of a new baby. Children react differently to the news of a new baby coming into the family. Some may be excited, while others may be jealous or resent the new baby. Your child may feel more positively about a new baby when you include him or her in the preparations. You could ask them for help in preparing the baby’s clothes and supplies and talk to your child about their important new role as big brother or sister to help them feel excited about the baby.

Most importantly, try to enjoy the process of welcoming the addition to the family together.