Pregnancy, Childbirth, and the Newborn: The Complete Guide, 4th Ed.

CHAPTER 19 When You’re Pregnant Again

When you find out that you’re expecting another child, you may feel just as you did after confirming your first pregnancy, or you may have a completely different reaction. You may be happy with the news or surprised by it. You may feel confident that you can handle pregnancy and birth again, or you may wonder how this pregnancy and birth will differ from your previous experience. You may have many questions and concerns about caring for another child. You may be unsure how your older child will adjust to a baby brother or sister. This chapter describes what you can expect emotionally and physically from another pregnancy, and it offers suggestions for preparing your child for your growing family.

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In this chapter, you’ll learn about:

• How this pregnancy may differ from a previous pregnancy

• Common emotions you may have when expecting another baby

• Preparing your child for the arrival of a sibling

• Including your child in your pregnancy, labor, and birth

• Ways to help your child adjust to a new baby

What to Expect with This Pregnancy and Birth

After you’ve been pregnant once, you may think that you’ll know exactly what to expect when you’re pregnant again. But every pregnancy is unique; a second pregnancy won’t be exactly like your first.

Subsequent pregnancies, however, do share some predictable characteristics that make them different from a first pregnancy. Physical changes may occur sooner, but you might or might not notice them. For example, you may feel the baby’s movements about a month earlier, because you recognize the sensation sooner. Or you may miss the early flutters because you’re not as preoccupied with this pregnancy. Your abdominal muscles relax more easily, so your belly enlarges sooner and your pregnancy becomes noticeable earlier. Your pelvic ligaments may soften sooner, and you may feel that you’re carrying the baby lower. Braxton-Hicks contractions may be more noticeable and numerous, especially toward the end of pregnancy, which can make it difficult to know when they indicate the start of labor.

On average, subsequent pregnancies are a few days shorter than a first pregnancy. Labor is typically faster, and pushing is much faster. Most women report that the first stage of labor is less painful than they experienced the first time (possibly because they’re less anxious), but that second-stage pushing is as painful or more so (possibly because it’s faster). Despite these general observations, it’s impossible to predict how labor will go in subsequent pregnancies. Each labor may be virtually identical to a previous one, or it may be completely different.

If your previous birth was a positive experience, you’ll of course hope that this birth will be, too. But if your previous birth was difficult or disappointing, you naturally may worry that problems will arise again. It’s common to feel anxious about labor, regardless of how many times you’ve given birth. Talking about your concerns with your partner, caregiver, or childbirth educator can raise your confidence and help make this birth a positive experience.

Even if you had excellent childbirth preparation classes for your first birth, it may be helpful to take another series. These “refresher” classes will not only review coping techniques for labor, but they’ll also prepare you for how this labor may differ from your first. In addition, classes provide updated information about maternity care, offer ideas for preparing your older child for the birth and managing your growing household, provide opportunities to talk to other parents, and give you time to bond to your new baby before the birth.

If you choose not to attend classes, refresh your memory by reading Chapters 9 through 14. If a previous birth ended in a cesarean section, see pages 323–327 to learn about having another baby after a cesarean.

Your Emotional Reactions to Having Another Baby

Compared to your first pregnancy, you may find that this pregnancy isn’t as emotionally exhilarating. Pregnancy discomforts may seem more annoying, or you may be too busy to notice them. You may think less about being pregnant, partly because your older child requires your attention. Instead of thinking about your developing baby, you may think ahead to her as a newborn, because you already have a clear picture of yourself as a new mother. Your partner may be less attentive to you, possibly because he or she has greater confidence in your well-being this time around.

Like many mothers expecting a second child, you may worry that you won’t have enough love for your new baby. Or you may wonder if your love for your older child will lessen with the new arrival. It’s helpful to know that you can never run out of love. Think of all the people you care for. Your love expanded to include each of them, and it will continue to do so to include all your children.

You also may worry that there isn’t enough time in the day to care for another child. It’s true that your growing family will keep you busy, but you’ll be surprised to discover that caring for a baby while parenting an older child isn’t as hard as you may have imagined. With your first child, it took a while to learn about baby care and time management. With your second child, these skills will come quickly, allowing you to adapt to parenting two children more easily.

Two Views on Being Pregnant Again

With my first pregnancy, we took all the classes, read all the books, and prepared the nursery—everything! With this pregnancy, I’ve barely had any time to think about it at all. I worry that this baby is getting shortchanged.

—Mary

I’d heard that it’s easier to care for a new baby and a toddler than it is to take care of a toddler while pregnant. I agree. I’m not so tired and sore now that the baby is here, and taking care of a newborn isn’t nearly as stressful as I remembered.

—Heidi

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Including Your Child in Your Pregnancy

When you’re pregnant again, it’s best to prepare your child for the pregnancy, birth, and new baby in a realistic and age-appropriate manner. The following sections offer ways to get your child ready for your family’s new addition. Use the suggestions that best match your personal preferences and your child’s maturity level.

One main question you may have is: When’s the best time to tell my child that I’m pregnant? Some parents choose to announce a pregnancy after the first trimester, when the likelihood of miscarriage is reduced. They also delay the announcement to shorten the wait for a young child who doesn’t understand the length of time until the birth. Other parents choose to announce the pregnancy earlier in the first trimester, especially if there’s frequent vomiting, in order to reassure the child that his mother isn’t ill. If you choose to delay announcing the news to your child, be careful not to wait too long, as he may hear about the pregnancy from someone else.

Books for Children about Pregnancy and Birth

Waiting for Baby by Annie Kubler (2000). Designed for preschoolers and younger children, this board book uses only pictures to tell the story of a child who’s waiting for the birth of a sibling.

How Was I Born? by Lennart Nilsson and Lena Katarina Swanberg (1996). This book is about fetal development (including photos), birth, and the baby’s homecoming.

Hello Baby (formerly Welcome with Love) by Jenni Overend and Julie Vivas (2004). Beautifully illustrated, this story tells of a child’s experience attending a home birth.

Mommy Has to Stay in Bed by Annette Rivlin-Gutman (2006). This story helps children understand the reasons for bed rest during pregnancy.

Hello Baby! by Lizzy Rockwell (2000). For ages two to five, pictures and simple explanations help children learn about pregnancy, hospital visits, and what to expect when the baby comes home.

Runa’s Birth: The Day My Sister Was Born by Uwe Spillmann and Inga Kamieth (2006). This wonderfully illustrated story of birth is told from a child’s point of view.

Waiting for Baby by Harriet Ziefert (1998). For ages three to seven, this story is about a boy who has trouble awaiting his baby sister’s birth.

Another question you may have is What’s the best way to tell my child about the pregnancy? Once you decide to tell your child that you’re pregnant, first talk to him about families, babies, and big brothers and sisters. When you see a family with two children, point them out to your child. Discuss families he knows who have a new baby. For example, you may say, “Did you see Cole’s new sister, Maya, when his mommy picked him up at preschool?” or “Pretty soon, Aunt Heidi will have a new baby, and Amelia will be a big sister.” Comments like these will help your child realize that it’s normal for families to have more than one child.

To help make the wait for the birth more understandable to your child, try linking your due date to a special event or season. For example, you may say, “The baby will arrive sometime when there’s snow on the ground.” Also consider making a calendar so you can count down the days together.

Use the time until the birth to include your child in the pregnancy by helping him develop positive feelings and realistic expectations about the baby. Here are some suggestions:

• Talk to your child about pregnancy and birth. Depending on his age, find out what he already knows, correct any misconceptions, fill in gaps in his understanding, and answer his questions. Use appropriate terms, such as by saying that the baby is in your uterus or “a special place,” not in your stomach. At the same time, avoid overwhelming your child with too much information.

• Attend a sibling preparation class, if available in your community. This class typically gives a demonstration of a birth using a doll, which can help your child understand the process.

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• Read together children’s books about pregnancy and birth, about families having another baby, and about becoming a big brother or sister. (See pages 442 and 446.)

• Show your child where you’ll give birth. If appropriate, talk about the possibility of his visiting you there after the baby is born.

• Let your child feel the baby move. Point out when the baby has the hiccups. Talk about how the baby can suck his thumb, wiggle, kick, and hear voices. Encourage your child to rest his cheek on your belly and talk or sing to the baby. Bring your child to a prenatal visit to hear the baby’s heartbeat.

• Show your child photos or DVDs of himself as a baby—especially ones showing you caring for him as a newborn. Help him make a picture book about families with two or more children.

• Talk about the care a newborn needs. Have your child interact with a friend’s baby to see how small a baby is and what a baby can and can’t do.

• If the baby’s arrival will change where your child sleeps, move him to his new room or make new sleeping arrangements months before the birth to prevent your child from feeling suddenly displaced. Also, because accidents can happen with your child when you’re busy with the baby, safety-proof your home if you haven’t already done so.

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IF YOUR CHILD IS YOUNGER THAN TWO

If your child is younger than two, she can’t easily tell you how she’s feeling—but she probably understands more than you think. Use simple terms to talk about babies and to explain to her about becoming a big sister. You also may try the suggestions on page 442 and above, or simplify them.

A younger child’s adjustment to a new baby usually occurs more rapidly than an older child’s adjustment. In fact, a younger child may have trouble remembering her life without the baby. However, when the baby is older and begins playing with her sibling’s toys, you may notice a period of adjustment, especially if your older child is still younger than three and has trouble sharing toys.

Although caring for multiple young children can be challenging and exhausting, the upside is that the overall duration of the babyhood phase will be shorter for your family than for families with siblings who are many years apart in age.

Including Your Child at the Birth

Many parents feel that a birth is a family event. They believe that including their older child at the birth will help him bond to his new sibling and encourage positive, healthy attitudes about birth.

Other parents feel that birth is a process that’s too complicated or too disturbing for their child to witness. They worry how their child would react to seeing his mother’s discomfort in labor or the blood from the birth. They wonder about the logistics of his care during the event. What if he became bored? What if he needed a nap? What if he began to disturb the staff? Who would care for him?

Most home birth providers and birth centers welcome the inclusion of children at births, as do some hospitals. They support the idea that having a child spend time with his mother and sibling soon after the birth will reduce separation anxiety and help him adjust to the change in the family structure.

Even if your caregiver is fine with including your child at the birth, only you and your partner (and your child, if he’s old enough to have a say) can decide whether your child should attend. To help you make your decision, assess your child’s physical health, emotional readiness, personality, and maturity. Whether you choose to include your child at the birth or decide that he shouldn’t attend, the following sections offer suggestions for preparing your child for the event.

IF YOU PLAN TO HAVE YOUR CHILD ATTEND THE BIRTH

If you decide to include your child at the birth, following these guidelines can help ensure a positive experience for everyone.

• Take childbirth preparation classes or review what you learned in previous classes. To make your child feel comfortable at the birth, you’ll need to be confident in your ability to cope with labor.

• Choose a birth setting that easily allows for your child’s inclusion. An ideal setting is one that provides ample space and flexibility to come and go if your child becomes bored or uncomfortable. To reduce stress, set clear guidelines for your child’s participation and familiarize your child with the birth setting, your caregivers, and any equipment that may be used at the birth. Make sure to bring your child’s favorite toys and comfort items, such as a special blanket, to the birth.

• Arrange for someone to look after your child during the birth and help explain what’s going on to her. This person should not be your partner or another labor-support person, whose sole job is to tend to your needs.

• Let your child know what to expect at the birth. Tell her what labor and birth are like (long and boring, yet exciting at times). Prepare her for the sights and sounds (such as the presence of blood and your groans, grunts, and cries). Suggest things that she can do during labor, such as bring you juice or a cool cloth, walk with you, play music, take photos with a disposable camera, be quiet when asked, and so on. Prepare her for the baby’s appearance and behavior immediately after the birth (see Chapter 17). If you plan to breastfeed the baby, explain the process to your child in terms she can understand. If your child is also breastfeeding, see page 429 for information on tandem nursing.

Children’s books or DVDs on birth also can help prepare your child for the event. During the birth, your child’s support person can refer to them to help explain what’s happening. For example, he or she may say, “Your mommy’s working hard to push the baby out. She’s making noises just like those we heard on the DVD!”

• Avoid making promises about the birth that you might not be able to keep. For example, don’t say, “You will be there to see your new brother being born.” Instead, say, “We hope you can be with us when our baby is born.”

• Let your child know what will happen if circumstances prevent her from attending the birth (for example, she’s at school, asleep, or ill), if she changes her mind about attending, or if complications develop in your pregnancy or during labor or birth. See page 445 for more information.

• Expect that your child will behave as usual during your labor. Don’t expect the experience to change her character or suddenly make her more mature. She’ll still fuss at times, need to be taken to the restroom, say no to requests, and want you to cuddle her.

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IF YOUR CHILD WON’T BE AT THE BIRTH

The following guidelines will help you plan for your child’s care while you’re away and prepare him to meet his new sibling.

• During the last weeks of your pregnancy, let your child know you’ll be leaving when it’s time to have the baby. Unless you’re having a scheduled induction or cesarean, explain that the exact time will be a surprise—it may happen during the night or day. Tell your child whether he’ll be at home or stay at another person’s home while you’re away. Let him know who’ll care for him. Your child will be less anxious if he knows and trusts this person.

• If your child will be staying at someone’s home, help him pack a bag with his favorite clothes, toys, and comfort items. If you like, have him help you pack your suitcase or the baby’s bag to involve him in the birth preparations.

• When labor begins, tell your child when you’ll be leaving and where you’ll be going. Let him know that you may leave while he’s asleep so he’ll be prepared for your absence when he awakens.

• Prepare for the possibility of separation anxiety if you’ll be giving birth in a hospital. A one- or two-day stay after a vaginal birth is typical, as is a three- or four-day stay following a cesarean birth. During that time, your child’s ability to tolerate the separation will depend on his age, how often he’s been separated from you before, how long this separation will last, how comfortable he is with the person caring for him, how comfortable he is with the place of care (if not cared for at home), and how well he understands what’s happening. Separation anxiety may lead to fretting, crying, sadness, clinging, irritability, sleeping difficulties, and tantrums. Let the person who’ll care for your child know about these normal reactions.

• Plan to have your child visit you and the new baby. Birth centers and most hospitals allow children to visit after the birth.

• Have realistic expectations when your child visits. Seeing you and the baby will probably reassure him and let him respond in a positive way. But it’s possible that he may ignore you and the baby, cling excessively, or cry uncontrollably when it’s time to leave. If he responds in this manner, you may feel that it’d have been easier to avoid the visit entirely. However, it’s healthier for your child to see you briefly than to be separated from you for a longer period.

• Consider having a gift for your child to open when he visits you or when you phone him to announce the baby’s arrival. Tell him the gift is from the baby.

• If your hospital stay lasts longer than expected or if your child can’t visit, try to talk to him by phone. You also may want to connect with him by providing photos of you and the new baby.

Books for Children about Babies and Siblings

I’m a Big Brother and I’m a Big Sister by Joanna Cole and Maxie Chambliss (1997). For ages two to six, these books talk about the importance of a family. Except for the sex of the main character, the stories are identical.

My New Baby by Annie Kubler (2000). This board book uses only pictures to tell the story of a family in which the mother breastfeeds and the father helps with housework and baby care. It’s for preschoolers and younger children.

The New Baby by Mercer Mayer (2001). For ages one to five, this story uses simple language to explain what it’s like to have a new baby and ways a sibling can play with the baby.

The New Baby by Fred Rogers (1996). This book talks about a new baby joining the family.

Helping Your Child Adjust to the New Baby

After the arrival of a new sibling, your child may have mixed feelings. Sometimes she may show fondness for the baby. Other times, she may express jealousy and resentment toward this tiny person who requires almost constant care, especially if your child had your undivided attention for several years.

If your child is angry and distressed by the baby’s arrival, she may react by having tantrums, seeking attention, becoming excessively preoccupied with the baby, withdrawing, showing aggression toward you or the baby (hitting, biting, throwing things, and so on), changing her eating and sleeping patterns, or reverting to outgrown behavior such as thumb sucking, wanting a pacifier, feeding from bottle or breast, or wetting herself. This behavior will typically be new for your child and may catch you by surprise.

How and when your child expresses this negative behavior (if she does) depends on her age. A child younger than three tends not to fully resent a new arrival’s presence until the baby begins crawling and interfering in her play. A child who’s at least three years old often immediately recognizes the impact a new baby has on her relationship with her parents, and she typically has little difficulty showing her displeasure. Even preteens can feel resentment toward a new sibling, although they usually feel guilty about it and may successfully hide their feelings from their parents.

What can you do if your child isn’t adjusting well to her new position in your family? Because it’s difficult to avoid your child’s feelings of displacement, focus instead on helping her deal with the stress. Try to accept her behavior as a normal reaction to the changes in her life.

The following are tips to ease your child’s adjustment:

• Give your child a doll so she has a “baby” to care for, too.

• Have a party to celebrate both the birth of the baby and the “birth” of a big sister or brother. Provide a cake or treats and give a gift to your child. Encourage her to make a gift for the baby or choose one to buy. When visitors bring gifts for the baby, let your child open them for the baby, or delay opening the gifts until she’s not around.

• Before the birth, have your partner provide more of your child’s daily care, such as giving her a bath or reading her a bedtime story, to help establish a routine that won’t be disrupted by the baby’s arrival.

• Schedule time to be alone with your child and let her decide what you’ll be doing together.

• Respond to your child’s requests, comments, and actions. Ignoring her when you’re busy may upset her at this vulnerable time. If you can’t respond right away, try not to blame the baby. Don’t say, “We can’t go to the park now because the baby is eating.” Instead, say, “We’ll go to the park later, because I think it will be sunnier then.”

• Correct negative behavior as you always have. Familiar rules and routines reassure young children. If you suddenly become permissive, the change may confuse your child.

• Help your child express her feelings by saying what you think she’s feeling. For example, you may say, “New babies make a lot of noise” or “Sometimes it’s hard to have a tiny baby around.” Reading books about new siblings with your child may help her find words to describe her emotions. (See page 446.)

• If your child wants to avoid the baby, let her. If she wants to help with baby care, include her in age-appropriate tasks. If she’s older, she can hold the baby and help with diapering, dressing, or burping. Children of all ages can entertain the baby by smiling, singing, talking, and making funny faces. Teach your child how to recognize engagement cues that show the baby wants to play and disengagement cues that show the baby is overwhelmed. (See pages 377–378.)

• Use the time when you’re feeding the baby to read, talk, or share a snack with your child. Consider providing special toys, books, or snacks that are just for feeding times.

• Think of stimulating activities that you and your child will enjoy doing together, such as planting seeds, blowing bubbles, or making cookies. Working together on useful tasks (even small ones) may help remind her that she’s still important to you.

• While your older child is listening, talk about her to the baby. For example, say, “Lily, today we’re going to the zoo with your big sister, and she’s going to show you all her favorite animals.” Also, praise your child within her hearing. You may say something such as, “Grandma, did you see how Adelyn smiles when Kate talks to her? Kate is such a big help when she plays with her baby sister.”

Although adjusting to a new baby may be difficult for your child, it’s an opportunity for her to learn healthy ways of handling stress. With time and guidance, your child will adapt to the new family structure and eventually develop a lasting bond with her sibling.

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Key Points to Remember

• Physical changes occur earlier when your body has gone through pregnancy before.

• After you’ve told your child that you’re pregnant, use the time until the birth to help him develop realistic expectations about the baby and to include him in the preparations.

• The decision to include your child at the birth is one that’s best made by you, your partner, and your child.

• Whether your child attends the birth or stays with someone else, preparing him for the event will help him understand and accept the new addition to your family.

• The arrival of a baby will forever change your child’s life. Help him adjust by accepting any negative reactions to the change and helping him find new, positive coping skills.