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Your Second Pregnancy
What to Expect This Time
By Katie Tamony
Chicago Review Press IncorporatedCopyright © 1995 Katie Tamony
All rights reserved.
Congratulations! You're Pregnant ... Again!
I KNEW I was pregnant again when my gums started feeling sore. I know it sounds crazy. I had other symptoms, too, but the sore gums clinched it for me. I remembered that feeling from my first pregnancy just a year earlier.
And this pregnancy was a shock; we didn't plan it, so my reaction to the news was very different. Everything in my life is pretty planned out — including how far apart our kids were going to be. My husband and I were both speechless for awhile, just letting the news sink in. I kept looking at our baby and imagining doing it all again.
The smell of fish was the first sign — I smelled it in every grocery store. And I couldn't stand it all of a sudden. And then everything started to fall in place — the late period, the tiredness. It was kind of fascinating that I just knew it this time. Oh, sure, we bought a pregnancy test, but I knew it before we took it. I felt like an old pro, even though it had been two years. All the same feelings came rushing back: Are we ready for this? How is our life going to change? Can we afford it? Only now I was more confident that we could handle whatever changes came our way.
I kept thinking that I should be more sick. During my first pregnancy, I was bedridden for a month. Was something wrong this time? I read all these books that said morning sickness was good, and I kept thinking, "Is this pregnancy going to take?" — because I had already had one miscarriage. So I told myself not to think I was pregnant until the thirteenth week, and then I'd be excited. Even though the doctor said everything looked fine, I couldn't let myself think baby — but I couldn't help it. And once the thirteenth week started, I was elated. I told everybody. And they were all kind of ho-hum about it, like big deal, another kid. But I was so excited.
My periods were never very regular, so my first pregnancy was two months along before I had an inkling I might have something more than the flu. The nausea hit in the afternoon, so I was sure it wasn't morning sickness. Sure, that is, until I bought a home test and my husband and I pored over the results like chemists making a breakthrough discovery. We had created a child, or what looked at this point to be two little pink lines on a stick. We were elated, and giddy, and stared at the pregnancy test as if it were a crystal ball.
The pregnancy test for the second child was a bit less exciting. My husband was trying to get our daughter fed and dressed for day care while I slapped lunches together before work. The tiny tube foretelling our future was left unattended longer than the five minutes required, but the results were just as dramatic and unreal. Another child? Another nine months? My husband and I looked at each other incredulously. We asked the same questions we had the first time: Were we ready? Does anyone ever feel totally prepared? I immediately dumped out my coffee and looked in the medicine cabinet for the prenatal vitamins I'd stopped taking when I gave up nursing just four months earlier.
There's an immediate recognition when you find out you're pregnant with your second child. It's as if those first nine months are played in fast-forward right there in the doctor's office. You're on your way to 3 A.M. feedings, infinite diaper changes, first words, and first steps for a second time. As you haul the baby swing out of storage and try to remember who borrowed your maternity clothes, some old feelings and questions from your first pregnancy are bound to resurface. The tired-excited-sick-anxious-peaceful mood swings will start up again soon, but with a different twist. After all, you are a veteran decorated with stretch marks of pregnancy and childbirth and a mom who knows what taking care of and loving a child truly means. So what's left to worry or be excited about during the next nine months?
It's impossible to predict what a second (or third or fourth) will be like. As anyone who's ever been pregnant has been told, every pregnancy is different. That obstetric rule even applies to two pregnancies in the same woman, whether she has her children ten months apart or ten years.
There are bound to be physical differences, of course. You're older, in an older body. You have a uterus that's already been stretched to accommodate a watermelon, and this is going to impact how you carry your second child. Some physical symptoms may repeat themselves; some may not. It depends on your health, your level of stress, and plenty of other variables. Even though every second pregnancy is different, there are some symptoms and feelings many pregnant moms share.
Because you're more in tune to what pregnancy feels like (especially if you had your first within the last four years), you are apt to suspect your second pregnancy earlier and more accurately. On the other hand, a woman who's been pregnant before is suspicious of every dizzy spell, every wave of nausea, and any late period — even if they have nothing to do with being pregnant. So how do you know for sure?
Second pregnancies are not necessarily sequels. You may not experience the same early symptoms this time around. That said, there are certain cues and nuances to the hallmarks of a second pregnancy.
Are You Pregnant Again?
Breast Tenderness and Fullness
If you've just finished nursing your first baby (or if you're still nursing a toddler), breast changes can be tricky to detect. The natural ebb and flow of hormones and a changing milk supply governed by your nursing toddler's needs may distort the size and shape of your breasts and the appearance of your nipples. If you've stopped nursing altogether, your breasts may appear smaller than they were before your first pregnancy. Some women note that a first pregnancy and breastfeeding forever change the shape of their breasts and the size and color of the areola, making it difficult to judge what's normal.
Some specific signs to watch for include a fullness similar to the way breasts appear just before menstruation and a tingling or tenderness of the nipples. Breast changes may be accompanied by other early signs of pregnancy, such as nausea, extreme fatigue, a lack of a period, or frequent urination.
If you've had it before, you know that this least popular of pregnancy clues doesn't come only at 7 A.M. You can feel woozy any time of the day, especially if you're a busy mom who isn't eating properly. Running after a toddler all day or juggling a car pool, staff meeting, and school play, combined with skipping meals, can drop blood sugar levels. Of course, illness, food poisoning, and anxiousness can also cause you to feel queasy, but, if you're getting enough to eat and still feel nauseous — especially when confronted with sharp odors — take note. If nausea continues day to day and you have no fever or diarrhea, then you might have morning sickness. Women who've had it before tend to recognize it instantly, but they're also more likely to mistake simple lightheadedness for morning sickness if they're trying to conceive a second child.
More than half of all pregnant women experience some nausea during the first trimester. If you had morning sickness during your first pregnancy, your chances of experiencing it again are slightly higher, although it probably won't be as severe. If you didn't experience it the first time, you may be in for an unpleasant surprise: plenty of mothers who skated through the first nine months are practically chained to a toilet the next time around.
If you don't experience it during your second pregnancy, don't be alarmed. Because so little is known about the causes of morning sickness, doctors don't think of it as a positive or negative influence on your baby's health. If you've got it bad, take heart: after looking at the records of more than nine thousand pregnant women, researchers at the National Institutes of Health found that expectant mothers who reported throwing up during the first trimester were a little less likely to suffer miscarriages or stillbirths than those who said they didn't vomit. They also had a somewhat lower chance of delivering prematurely.
It's commonly thought that nausea during the first fourteen weeks of pregnancy is caused by elevated levels of certain hormones. These hormones affect the entire digestive system, causing waves of nausea, constipation, and gas. Estrogen, in particular, may cause special sensitivity to odors. Mildly offensive smells grow more powerful, even sickening, during the first couple of months: the aroma of coffee, your daughter's soiled diaper, your cat's litter box. Even ordinarily benign food smells such as chicken — raw or cooked — can become unbearable. Nausea can also be triggered by other sensory perceptions, such as loud noises, bright light, closed spaces, or constant motion.
Do you remember the fatigue of your first pregnancy? Well, it's probably going to be even more constant during your second. You've got a growing baby on the inside and a growing child demanding attention on the outside. You may be working part- or full-time. You also have a marriage, a home to manage, and about five minutes of free time a day. The demands on your mental and physical energy add up to exhaustion for a pregnant mom. You'll likely notice this symptom earlier than the other ones the second time.
If you've waited more than four years between births, you may not experience the kind of physical exhaustion that comes from playing tag with a rambunctious two-year-old. On the other hand, you're older this time, and your school-age child surely needs as many ballet lessons, scout field trips, and visits to playmates as you can manage. Just having to make decisions about another human being every day can be tiring. "Mental fatigue can be just as exhausting — sometimes more so — than physical fatigue," says Dawn Gruen, a Seattle family therapist who specializes in postpartum adjustment issues. "As mothers, we tend to shoulder all of the responsibility for our kids' schedules, moods, and needs." Couple that kind of mental fatigue with the physical demands of growing a baby, and it's easy to see why many mothers say they crave sleep more the second time.
A Missed Period
If you're still nursing your first child, you may not be having periods, or they could be irregular. You can become pregnant before you resume regular periods and not even realize it.
If you have resumed your periods after your last pregnancy, then amenorrhea, or the absence of menstruation, is usually a symptom of second pregnancy. However, a great many other things can cause you to skip a period or stop having them altogether: travel, stress, extreme weight gain or loss, and strenuous exercise can all affect your cycle.
Not every pregnant woman experiences food cravings, but most moms remember the extreme hunger pangs and food aversions that occur in the first trimester. Sometimes this is the first symptom you'll notice in a second pregnancy. That is, unless you're debilitated by morning sickness so severe that you're living on popsicles. When you do feel hungry, it's an almost overpowering need for a particular food — you want a strawberry yogurt and you want it now! One mom notes that she didn't feel any weird cravings during her first pregnancy, but her second brought bizarre yearnings for pickles and lemonade. "Sometimes I want relish and catsup — not bowlfuls of the stuff, but I have this intense need for a taste of it once in a while," says Tracy. "My husband is afraid anytime I mention I want to try out a new recipe. He knows our son will eat weird things, too, so he's got to be the voice of reason."
As the uterus grows, it puts pressure on the bladder. Your uterus is likely to expand up out of your pelvis sooner this time, so you may almost miss this symptom. Still, as the body begins to process fluids more efficiently and the kidneys pick up speed in preparation for the growing fetus, you'll probably be making more trips to the bathroom.
"It actually was a good thing I was always having to find a bathroom," says Gina. "My son was just starting potty-training, so we often had to search for one for both of us. It made me much more patient with him."
Increased estrogen in your system can cause your gums to thicken and swell; they can easily become inflamed and bleed. If you remember this from your first pregnancy, it could be one of those subtle changes in your body that only a pregnant mom "who's been there" would detect. Taken by itself, sore gums isn't a sure tip-off you're pregnant; combined with a constant feeling of nausea and utter exhaustion, it could send you to the store for a pregnancy test.
Although you may consider yourself an old pro in deducing pregnancy, a test can confirm your suspicions.
Home Test If it's been awhile since your first pregnancy, you'll be pleasantly surprised by the options available. Now you can take a test any time of the day, not just in the morning, and instructions are simpler than ever. Some things haven't changed: home tests are still as expensive as a twin-pack of diapers, and they still operate more or less the same way. A home test diagnoses pregnancy by detecting the presence of HCG (human chorionic gonadotropin), a hormone in the urine. Many can tell you if you're pregnant as early as fourteen days after conception. Home tests offer you privacy and convenience, especially when planning a trip to the doctor would take monumental schedule juggling. A word of caution: results are false-negative far more commonly than false-positive. If you have an overwhelming sensation that you're pregnant, trust your experienced instincts and make a doctor's appointment.
Lab Test The test taken at the doctor's office is more of a sure thing for most women. The test is administered by a professional, so the chance of an error is less likely. The test operates much the same as the home test: urine is checked for HCG levels.
Blood Test This is the most accurate way to find out if you're pregnant. You can also confirm a pregnancy as soon as eight to ten days after conception.
Choosing a Practitioner Again
When the test results are in and the symptoms of pregnancy become apparent, you'll need to make your first prenatal appointment. Are you going to use the same obstetrician who delivered your firstborn? Were you satisfied with him or her the first time? Are you ready to try someone new — perhaps even a nurse-midwife?
The decision you make will be influenced by many factors. Obviously, if you have moved three hundred miles between pregnancies, you'll need to start a new search for a birth attendant. If you haven't moved, you may still want to change doctors. "I was looking for a doctor who could make time for me during delivery," says one mom. "My first one was pretty good during my prenatal appointments but left me during labor once he saw everything was going OK. A resident I'd never met before actually delivered the baby." Angered by that experience, this mom knew what kinds of questions to ask the next time she interviewed a physician. "I was much more confident talking to doctors this time," she says, "I felt smarter, more experienced. I didn't mind asking pointblank who was actually going to deliver my baby."
If you were happy with your first delivery, chances are you'll choose the same birth attendant. "A woman develops a serious attachment to the person who counsels her for nine months and then delivers her first child," says family therapist Dawn Gruen. "An intimate bond develops between doctor and patient that grows over nine months when you're discussing your sex life, fears, hopes, and worries." It's only natural that a woman would prefer to maintain a good relationship with her first obstetrician or midwife rather than start anew. "On my baby's birthday, I sent my midwife pictures. After three years had passed and I was pregnant again, we both assumed she'd be involved," says one mom.
If you neither loved nor hated your birth attendant, or didn't keep in touch over the years between pregnancies, the decision to choose another may not be easy to make. You know what to expect if you keep your former birth attendant or physician — particularly if the last pregnancy was in the past three or four years. You've heard his or her lectures about weight gain, and you won't be quite as sensitive this time around. Your doctor or midwife already knows your pregnancy history, how your ankles swelled, and about the hemorrhoids that never quite went away. He or she also may have eyewitness knowledge of your first delivery: the dosage of epidural you received and how it affected you, or why and when the decision to do a cesarean was made. On the other hand, your doctor or midwife may feel he or she knows you so well that you get less time during your appointments. He or she may figure that everything was already covered the first time and may ask you fewer questions about your state of mind and your expectations.
Many women pregnant for the second time say their obstetricians spend less time with them during appointments. Even new patients can be treated a bit brusquely by their doctors if their medical charts show at least one normal delivery. "I looked forward to my doctor's appointments because it was time to concentrate on myself, but I was disappointed that the doctor seemed to rush through everything. He didn't ask how I was feeling, what I was experiencing this time. I guess he was waiting for me to speak up," says Melanie. To get more information or reassurance, pregnant moms have to come with questions. Saying "I'm not used to being this tired" or "I never had heartburn the first time" can spur a discussion with your birth attendant and remind him or her that this pregnancy is still new to you.
Excerpted from Your Second Pregnancy by Katie Tamony. Copyright © 1995 Katie Tamony. Excerpted by permission of Chicago Review Press Incorporated.
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