How Pregnancy and Preparing for Your Baby Changes With Each New Child

What's Better, What's Harder, and Coping With People's Reactions

Busy mom in the kitchen with three children

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So, you are pregnant… again! Or, perhaps, you are only considering getting pregnant with baby number four (or more.) How is pregnancy and preparing for a new child different when you’re building a big family? Here’s a guide to the practical, emotional, and medical issues you may face.  

Three Ways It Gets Easier

Of course, adding a new addition to your family will mean more work, more cost, and more stress (both the good and bad kinds of stress!) But not everything is harder. Some things get easier.

You Know the Routine

This is not your first rodeo. You probably won’t spend much time reading books like What to Expect When You’re Expecting. That isn’t to say you won’t have practical and medical questions. You will, however, have a good idea of what your pregnancy care looks like.

You probably already have a doctor or midwife you prefer to see. You probably have an idea of where you want to give birth and even how you want to give birth (in terms of comfort, epidural or not, doula support, and so on.) You have a good idea of what normal prenatal care looks like for you, what tests to expect, and which tests you want or don’t want.

You may not remember how much thought went into all these normal aspects of pregnancy and birth the first or second time around. However, this familiarity with the routine of a typical pregnancy and birth will take a good deal of cognitive stress off your shoulders.

You Probably Don’t Need to Go Shopping for the Basics

Unless you have a big age gap between children, you likely have the basics you need. You probably have the big baby-care items at hand, like car seats and baby swings. (Though you may need to purchase a new car seat if your older children haven’t outgrown requiring them or your car seat expired.)

You likely have maternity clothing to dig into, and things like a breast pump (if you need one), a playpen, and even baby clothing. 

Your Older Kids Are There to Help

Assuming you’ve got at least a two-year gap between each kid, you likely have at least a six-year-old at home. You might be thinking a six-year-old isn’t much help, but they can fetch a fresh diaper for you, hold the baby for a moment with supervision, or grab you a snack.

If you have children age eight and older, then you’ve got even better help. Age ten and older? Depending on their personality and individual maturity, they can help cook and clean, and they may be able to change a wet diaper.

During your pregnancy, if you have older kids, they can watch the little ones while you take a nap. You may even have kids old enough to babysit while you go for a prenatal check-up.

This is a luxury most moms don’t have when they are pregnant with baby two or three, especially if their first kids are still toddlers.

Five Things That May Be More Difficult

While there are many aspects of pregnancy you'll have under control, keep in mind that there will still be new challenges, even when you've done this before.

You’ll Need to Juggle Several Schedules

With baby number one or two, you only had to consider your own schedule, maybe a partner’s schedule, and maybe one baby or toddler. But if you’re on baby number four or more, not only are there more people to care for, but you’ve also got older children who likely have fuller lives.

There will be school drop off and pickups, extracurricular activities to juggle, and doctor appointments and well checks—plus your own prenatal care and life activities—for six or more individuals.  

When you’re pregnant and tired—or with a newborn and tired—sometimes just taking care of yourself (and the baby) feels like more than enough to handle. Adding in all the other members of your family, expect to feel exhausted. Also, plan to ask for help from friends, family, or professionals (like babysitters, house cleaners, grocery delivery, etc.) 

Funds May Be Already Tight—and They’ll Get Tighter. 

Another child requires more expense. According to the United States Department of Agriculture report, the annual cost spent per child in a family with two children is between $12,350 and $13,900. The cost per child are likely slightly less in larger families, just due to the ability to share resources, buy food in bulk, and so on. But your budget will need to expand to fit the newest member of your family.

You May Feel Guilty for Taking Time Away From the Others

The parent-guilt that comes with needing to split your attention between children occurs with your second or third baby too. However, when you’re on baby four or more, your focus is already divided thinly. You’ll need to share your time even more.

Of course, you likely give attention to more than one child at a time already. And your capacity to love another child won’t diminish with another—love just expands.

It would be untrue to say your older children won’t receive less time from you than they do now. You'll have to acknowledge that challenge and addressing with a plan to give each child the time they need.

You May Feel Guilty for Taking Time for Yourself

When your kids and possibly your partner are vying for your attention, how can you find time for yourself? And the answer is, you must find time for yourself. You may feel guilty for it, but you need that time. Your family also needs you to take that time.

If you’re feeling depleted and exhausted, you can’t really be there for them. If you begin to feel resentful that you have “no life of your own,” that will also backfire on your family.

Taking time for yourself won’t be easy—but you need to make that happen. Even if you only find 30 minutes a day to do so.

You May Have Less Time to Focus on Baby

With your first and even second baby, you had time to bond and just be with your newborn. When you’re building a big family, finding time alone with the new baby will be challenging.

Keep in mind that a newborn will feel loved and cared for as long as someone is holding them, the baby is getting fed on demand, they have time to sleep, and they are kept clean and dry. Newborns don’t get jealous that a toddler and a preschooler are sharing your time.

Health Issues Associated with Having a Large Family

In medical terms, a woman having her second or third pregnancy is called multipara. A woman having her fifth or more pregnancy is considered to be a “grand multipara.” Are there risks to having a large family?

While there is an increased risk of some pregnancy and birth complications, the end result for the mother and baby is similar to moms having their second or third baby, as long as modern medical care is readily available and the mom gets good prenatal care. 

Potential Risks and Complications

Moms having pregnancy number five or more may face an increased risk of the following complications:

There may be individual medical issues that increase the risk of further pregnancies, but this is something specific to you. Only your primary care provider knows your medical history and can say if having another baby is risky or not.

Keep in mind that research on grand multiparity often includes moms who are over age 35, because a mom is going to get older as she has more kids. When moms of five or more have complications, it’s not always clear if it’s because it’s baby number five or because they are in an older age bracket.  

While you can’t stop yourself from aging (if only!), there is a risk factor you may have control over—your weight. Research has found that obesity is associated with increased risks of pregnancy and birth complications. Moms of many children may tend to be heavier because they may not haven't had a chance to lose the weight from previous pregnancies before having the next.

If you’re obese and worried about your weight and pregnancy risks, talk to your primary care provider.

What About Multiple C-Sections?

If you’ve had one or more cesarean sections, you may be wondering if there are risks to having multiple C-sections.

In a study comparing women having their second or third C-section to women having their fourth or more C-section , they found that the mothers having four or more C-sections were more likely to...

  • Experience adhesions, or internal scarring
  • Require blood transfusion due to surgical or postpartum blood loss
  • Have an increased hospital stay time

The study authors noted that while these specific risks were higher, the risk of serious complications was not necessarily higher.

There was another study that compared women having their fifth or more C-section to women having their second to fourth C-section . This study did find an increased risk of serious complications in the five-or-more C-section group. This was primarily due to women experiencing placenta previa and placenta accrete. Both of these pregnancy complications can cause postpartum bleeding.

Only your doctor can say what your personal risks are for subsequent C-sections, since this also depends on other health issues, your overall pregnancy and birth history, and how previous C-sections went.

People’s Reactions to Pregnancy Four or More

Something that does change significantly when you’re having baby four or more is people’s reactions and comments. Unless you tend to surround yourself with other big families, your newest pregnancy may not be as warmly welcomed as your first or second. Pregnant mothers with families of four or more are likely the hear all kinds of comments, not all of them supportive.

Rude comments are based on stereotypes and wrongful assumptions on what it means to have a big family—assumptions that you must be on government assistance (and if you are, the implication that this is shameful), assumptions that you’re only having another baby in order to have a child of a specific sex, or the assumption that large families are eco-destructive. Hearing these comments can be very hurtful.

You may also find that you receive fewer offers of help from friends and family than you did with your first few children.

Knowing why you want a big family and finding friends who support your decision can help you cope with the negativity from those who don’t get it.

Taking Care of Yourself

Big families are a big blessing, but they are also a lot of work. Taking good care of yourself is important for your wellbeing and your family’s well being.

Here are some things to keep in mind.

Even though you don’t have time, make time for you

That may mean going to bed when the youngest kids do and waking up before dawn, or this may mean staying up later than your last kid going to sleep. Whatever it takes, find a quiet moment for yourself.

This pregnancy requires as much special care as your first

It’s easy to start feeling like pregnancy “isn’t a big deal” when it’s your fifth or sixth time. But this pregnancy requires as much special care as your first, and perhaps even more since you’re taking care of more people in the family. Eat well, stay hydrated, get naps, and good sleep at night, and keep those prenatal care appointments. 

Ask (or Hire) Help

You can’t do this on your own. Funds are typically tight for big families, so you may need to go to your church for assistance or ask friends and family. But ask. The worst that can happen is they’ll say no.  

Allow for Imperfection

A lot of imperfection. Potty training your toddler before the new baby comes may sound like a great idea, but it may also just add more stress to your life without actually solving the potty issue. (Especially since toddlers often regress for a time when a new baby arrives.)

This also isn’t a time to start making elaborate meals, resolve to be an even “better parent” (whatever that means), or become house-cleaning obsessed. Honestly, it’s in your best interest to let your standards slide while you’re expecting. You need to reserve your energy.  

Be Okay With Putting Things on Hold

Maybe it’s too much to drive three kids to piano lessons right now. Perhaps this isn’t the best time to start your middle-schooler in a new after-school club. It’s not easy taking things away or saying no, but this isn’t forever. It’s temporary.

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Article Sources
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  2. Simonsen, S., & Varner, M. (2019). Grand multiparity. Retrieved 31 December 2019, from https://www.uptodate.com/contents/grand-multiparity

  3. Biler A1, Ekin A2, Ozcan A3, Inan AH4, Vural T5, Toz E6. "Is it safe to have multiple repeat cesarean sections? A high volume tertiary care center experience." Pak J Med Sci. 2017 Sep-Oct;33(5):1074-1079. doi: 10.12669/pjms.335.12899.

  4. Cook, J., Jarvis, S., Knight, M., & Dhanjal, M. (2013). Multiple repeat caesarean section in the UK: incidence and consequences to mother and child. A national, prospective, cohort study. BJOG: An International Journal Of Obstetrics & Gynaecology120(1), 85-91. doi: 10.1111/1471-0528.12010

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