Getting pregnant, whether you're trying for the first time or you've been pregnant multiple times before, can be a more emotional journey and more stressful, overwhelming experience than you might think it will be when you first decide to try. It's not always as simple and straightforward as it seems for some. And, sadly, just because you've gotten pregnant before and you didn't experience many struggles doing so, doesn't mean that you'll have it so easy the next time. There are some physical signs that it may be difficult for you to have more than one child, according to fertility experts, that you might not be anticipating. And while the difficulties can be biological, you may also find that you experience mental and emotional roadblocks when the time comes to grow your family, particularly if your previous pregnancy or birthing experience was especially taxing or traumatic.
If you're concerned about difficulties that you experienced during your first pregnancy or birthing experience impacting any future pregnancies or births, talking to your healthcare providers could potentially help. "I would say that the best way to handle this question is to speak to the obstetrician [or] midwife who took care of you during the first pregnancy, and frankly ask them what are the chances of this particular difficulty happening again," Dr. Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale University, tells Romper by email.
Knowing what you may want to expect and knowing how your circumstances might affect your ability or desire to have another child is important because it can help you feel more in charge of your own life.
1. You're Getting Older
Even if you didn't experience any difficulties conceiving the first time, if you wait a bit before trying for a second, you might have a more difficult time doing so. "There is an age-related decline in fertility, which is most pronounced after age 35," Dr. Juan Alvarez of Fertility Centers of Illinois tells Romper by email. "If a woman who is less than 35 years of age has not conceived after 12 months of unprotected intercourse or for a woman who is over 35 after six months, this indicates that there is a problem."
2. You Experienced Very Severe Back Pain During Your First Pregnancy
Not everyone loves being pregnant. Some people have extreme symptoms and complications that make pregnancy really difficult. Take something like really severe back pain, for example.
"It [is] likely that this would recur in another pregnancy — so although it doesn't preclude another pregnancy, it could make one unwilling to go through that pain again," Minkin says.
It's not that you're necessarily physically unable to get pregnant, but that something with which you dealt during your first pregnancy resulted in a mental roadblock that makes it difficult for you to experience another.
3. You Have Diabetes
Alvarez says that having diabetes can also make conceiving more difficult. If the diagnosis comes after you got pregnant with your first child, you may experience greater difficulties having another.
4. You Experienced Difficulties Exercising During Your First Pregnancy
"If you have some type of heart disease, and have continuous problems of shortness of breath, and inability to exercise comfortably, you probably aren't going to have an easy pregnancy in the future," Minkin says. "During pregnancy, your circulating blood volume increases about 50 percent over your non-pregnant blood volume — and that puts a tremendous strain on your heart."
Though pregnancies can be very different from one another, if you're dealing with something like this, it could be something that would happen again in future pregnancies, which might make those pregnancies difficult for you to handle.
5. You Have A History Of High Blood Pressure
"If a woman has a history of elevated blood pressure or preeclampsia in pregnancy or a history of early labor, a subsequent pregnancy is higher-risk," Dr. Jennifer Hirshfeld-Cytron of Fertility Centers of Illinois tells Romper by email.
Again, this doesn't necessarily mean that you would be unable to conceive, but that it'll be a higher-risk pregnancy and could certainly be something that takes a mental and emotional toll.
6. Your BMI Is Higher Than 30
"Weight, when it is measured as the body mass index (BMI) is a strong predictor of the chance to conceive," Alvarez says. "The higher the weight, the more difficult it is to conceive. When we look at natural conception and BMI, pregnancy rates start to significantly decline after a BMI 30 (obesity)."
Additionally, Hirshfeld-Cytron says that if you're dealing with insulin resistance, which can be associated with obesity, you might notice a skin condition called acanthosis nigricans, which results in darker patches in skin and body folds.
"With few exceptions, most factors are modifiable and that is the most important part to remember," Hirshfeld-Cytron says. "If a prior pregnancy was complicated or a person has a complicated medical history, optimizing and planning prior to pregnancy is key."
7. You're Experiencing Irregular Periods
Irregular periods can happen for a variety of reasons, but if you're dealing with irregular periods all of a sudden, it could, in fact, mean that you might have more difficulty having another child. "When a woman has irregular menstrual cycles it could be because she is not ovulating," Alvarez says. "If a woman is experiencing irregular menstrual periods she should see her gynecologist to have a work-up. There are medications that can be given to women to help them ovulate every month."
Whether it's because of something physical or something mental and emotional, you might experience difficulties in having another child. No matter the reasons, that can feel overwhelming and sad and so many other things. Talking to your doctor (and maybe a therapist, as well) might help you feel like you have some more clarity and ensure that your difficulties aren't something that you could potentially fix, if that's what you want.