Each pregnancy is different, a second pregnancy will not necessarily be like the first. Nor to a third. However, it is essential to take into account the course of this first pregnancy to adapt the follow-up accordingly.

During a first pregnancy, the uterus, which is a muscle, stretched. During the following pregnancy, the distension of the uterus will therefore be easier, and the first curves of the pregnant woman will generally appear earlier.

Likewise, the baby’s first movements are often perceived earlier because of this distension of the uterus, but also because the expectant mother, who has already experienced this sensation of “bubbles” or “butterflies” in the belly, will be able to recognize them more easily.

Signs of the onset of pregnancy may be different from pregnancy to pregnancy, as the body may respond differently to the hormonal impregnation of the onset of pregnancy. The state of fatigue, the psychic state of the mother-to-be, her lifestyle also come into play in the manifestations of the first trimester.

The sex of the baby could also have an influence on the signs of pregnancy, and more specifically nausea. Thus a study (1) showed that nausea was more frequent when the mother was expecting a girl. This does not mean, however, that waiting for a boy prevents nausea …

Every pregnancy, every baby, every birth is different. Different parameters influence the progress of labor: the baby’s build, its mode of presentation, mobility and the different positions adopted by the mother, etc. As birthing specialists often say, it is impossible to know how a childbirth will go… until it has happened.

However, it has been found that generally, the working time for the multipara (mother who has already had one or more babies) is shorter than for the first time (pregnant woman for the first time). For a first child, labor lasts an average of 12 hours, compared to 8 hours for a second baby (2). But this is only the average, which in fact can vary greatly.

Having had a first obstructed labor, that is to say with a complication, does not necessarily mean that the second will be too. However, some history of obstetric complications is associated with an increased – but not systematic – risk of this same complication during a subsequent pregnancy. This is particularly the case with a history of premature delivery, pre-eclampsia, placenta previa. To limit these risks, the follow-up of the second pregnancy will be adapted, and everything will be done to ensure that the birth and pregnancy go as smoothly as possible.

I gave birth by caesarean the first time

“Cesarean section one day, always cesarean section” says an adage which, fortunately, is no longer true. Having a cesarean does not mean that you can no longer give birth vaginally. According to the recommendations of the HAS (Haute Autorité de Santé) on the indications for scheduled cesarean section at term (3), a scarred uterus is not in itself an indication for scheduled cesarean section. A vaginal birth after a cesarean or VBAC will generally be proposed, except in the case of a body scar (vertical scar). However, a first cesarean considerably increases the risk of cesarean section in subsequent pregnancies, specifies the same report from the HAS. As evidenced by the figures: the rate of caesarean section in mothers with a history of caesarean section is 64,6%, against 8,8% in multiparas without a history of caesarean section. For a third pregnancy, a second scheduled cesarean section will lead, in the majority of cases, to systematic cesarean sections in subsequent pregnancies.

I suffered one? episiotomy for my first child

Having had an episiotomy during a first childbirth does not mean that another will be systematically performed during a second childbirth, especially since it is a medical procedure more frequently performed in the first childbirth. In 2016, 34,9% of first-time mothers had an episiotomy, compared to only 9,8% of multiparas, according to the 2016 national perinatal survey (4).

In addition, following the recommendations of the CNGOF in 2005 not to perform a systematic episiotomy, the rate of episiotomy decreases from year to year. From 27% in 2010, it rose to 20% in 2016, the report says.

Physiologically, it is possible to start a second pregnancy as soon as the ovarian cycle begins again. If the mother is not breastfeeding, estrogen secretion starts again towards the end of the first month after childbirth. Ovulation, and therefore pregnancy, is possible from the start of the second month, even before the return of childbirth (first menstruation after childbirth). If the mother breastfeeds on the other hand, each feeding causes the secretion of prolactin which blocks the secretion of the hormones LH and FSH which cause ovulation. However, if the number of feeds decreases (less than 6 per day), the prolactin level may be insufficient to block ovulation, and pregnancy is therefore possible.

The new mother’s body, however, needs to recover and replenish its reserves for a future pregnancy. This is important for the successful course of the pregnancy and the health of the baby, as suggested by a large Colombian meta-analysis from 2006 (5). The results showed that compared to babies whose mothers waited between 18 and 23 months before becoming pregnant again, babies born less than six months after a first pregnancy had a 40% increased risk of being born prematurely, of 61% have a low birth weight and 26% are short. Waiting too long (59 months in the study) before a second pregnancy also increases the risk of perinatal complications.

A 2016 meta-analysis (6) looked at the links between the time between two pregnancies and the risk of autism. The results showed that children born to a pregnancy that started less than 12 months after a previous pregnancy had an increased risk of autism spectrum disorders. Insufficient maternal reserves of folate, a vitamin essential for the neurological development of the fetus, could be to blame, suggest the authors.

In the end, it therefore seems that waiting 18 to 24 months before a second pregnancy is preferable for the baby.