I mostly enthusiastically agree with this, as a mom of 2, but if you will permit me to go on a tangent:
I want to point out that the “no childcare” thing is an artificial problem. If clinicians did home visits - like most doctors used to, and like homebirth midwives do - this would not be a barrier to care.
Like: these pregnant women did not erupt a barrier to their own care. They are not “lacking” in childcare. The clinician is “lacking” in the will and ability to provide an appropriate, patient-centered care model that improves outcomes and has high feasibility and acceptability. Yes, I understand that the current model maximizes profit and maximizes convenience, but it does not serve the client.
As someone who has skipped several prenatals and a postpartum visit and had a VBAC (I skipped mostly due to transportation/work/childcare issues): I have to say, I never regretted it. I went into labor shortly after I skipped my 38w appointment because I’d had pinkeye and didn’t want to leave the house. I was feeling SO relaxed and peaceful, precisely when the surveillance picks up and the pressure to dilate switches on.
For these slightly higher-risk women (I was stage 1 hypertension, had a scar, family history of pre-e and diabetes, overweight) prenatals function as a kind of nocebo effect. You leave feeling really crappy about yourself and just genuinely discouraged. You get yelled at about your stats. You aren’t treated as a whole person. I saw a CNM/OB team and actually the OB was nicer to me, which was a surprise, but my sense was that they couldn’t help themselves: if a pathology existed, by GOD they were going to find it, they were going to exhaust every measure to find the pathologies in the haystack, and that was what they honestly believed constituted “care.”
Sorry they made you feel that way! Women shouldn't be made to feel like "problems."
Regarding in home care, it's an option for prenatal care probably, but would require a huge "scaling up" as far as the number of providers, as we'd only be able to see about half of what we see now (making time to drive around to houses). I personally just try to be as friendly as possible to moms when they bring their kids, involving them in the care and things like that. That way the kids feel welcomed and the moms feel more comfortable bringing them.
And certain treatments like magnesium for preeclampsia or iron infusions can really only happen in the hospital with skilled care.
I remember loading up my newborn into the car for a doctor’s appointment and just going, “Why the F should I have to leave my house right now.” Tiny fragile little baby going 60 mph in the hwy. Felt so wrong in every way.
Yes! Or allow children at the practice. My midwives allow children and have little tables with books and toys in each exam room. Even my MFM (I’m “geriatric”) allowed children for my anatomy scan.
We do some of this at my clinic too! However, the hospital is very unwelcoming to children. No kids under 16 in the birth room. I hate it because on a few occasions it's left a mom laboring without her partner because he had to stay behind to watch the kids. 😔
Oh no! That is horrible! Pre-Covid, our hospital allowed any and all children for the birth. I’m not sure after Covid. I’ve never wanted them there (would feel pulled in two directions), but I know that afterwards, for recovery, only children over 6 were allowed to visit because of flu season. :/
I have mixed feelings about this essay. The risks are real, but many people don’t see the risks or exhaustion as a reason to avoid a pregnancy. It just feels like yet another medical professional being critical of our life choices and attempting to scare us.
I know that is not where your essay is coming from, but it’s been my experience. Most of my children have been born 2-3 years apart. I am currently pregnant with number 8. We exclusively breastfeed and co-op sleep (both usually are needed to keep fertility away) for the first year of the baby’s life, but this is not normal for the U. S. It has allowed us to have decent gaps between children.
I feel like what might help women( and men for that matter) to space children more is rather than talk exclusively about risks, is the conversation about holistic health. For example, how long it actually takes to rebuild vitamin levels in your body after pregnancy (4 years!), how are you planning on caring for your other children because exhaustion is real, what about your mental and physical health, how this can take a toll on the family. All this can help a woman realize that if she wants another child, she needs to be healthy for the best outcomes for herself, baby, and family.
Most of us having large families tend to do it because of religious convictions. Children are gifts, tough but worth it. And we don’t regret bringing a beautiful and unique person into the world. Until the medical profession can recognize this as part of the conversation, the risks seem paltry.
Thanks for bringing this up, Suzanne. I am from a Catholic family and while I don't currently practice Catholicism (I'm Lutheran now), my sister (who is my best friend) is still practicing and she is the mother of 7! She exclusively breastfed, never used birth control, and only once had pregnancies spaced less than 24 months apart.
I think you're right that the focus should be on health, but we need to be honest about how difficult it can be to maintain health with back to back pregnancies. Not impossible! Just difficult.
Anyway I appreciate your attention to this because women who choose to have large families face a lot of shaming on our society--even more than people who have no children, I would argue--and I definitely don't want to be one of the people participating in that shaming. I just see that some of these moms' health is really being compromised, and as a midwife, sometimes it scares me.
It doesn’t really matter, but I was irrationally irritated by the medical records on my second pregnancy saying “high risk because of close spacing” because it started 17 months after the end of the previous one. I was like, I can tell when my body is ready, for God’s sake, don’t patronize me. I might well go for a closer spacing next time if I feel up to it. I know I’m lucky to have a body that has so far handled pregnancy so well (and a great co-parent and all the other nice things) and I don’t need doctors moaning at me about taking advantage of my luck.
Yeah, I typically don’t put that risk factor in someone’s chart unless I think it’s pertinent (like <6 mo between pregnancies and facing nutritional deficiencies). As you point out, it can be really hurtful to moms.
Currently BF my almost-1yo with no period in sight, wondering how the heck so many women seem to have 2 under 2 😂
It does feel like a tricky balancing act, as someone who had their first baby via CS at 35 after multiple losses - but at the moment the breastfeeding is making the decision for me!
A man (who isn’t medically qualified) casually dismissing these risks to women and babies is MAJOR ick. I take it he’s never suffered pregnancy, birth or breastfeeding complications 😂
Fascinating! I wish there were more studies on lactational amenorrhea. Like everything else, the number of months a mom gets must be highly variable. But only once in my career have I met a mom who swore she was exclusively breastfeeding, and got pregnant at 4 months postpartum. 🤷♀️
My son had a high palate at birth and lots of difficulty latching, which led to me exclusively pumping for several weeks after birth until we were able to figure things out. My birth was uncomplicated, and my milk came in almost immediately. I responded well to the pump and easily pumped more than my baby took, veering into oversupply at times. We never once used formula; I pumped so much breast milk I ended up donating it. Nevertheless, my period was back six weeks post-partum.
Obviously, this could have just been new mother anxiety about breastfeeding that wasn't going well, but I had frequent nightmares about my newborn starving, despite a fridge overflowing with milk and the knowledge that formula, if necessary, was just down the road. I was constantly anxious about it. It was like my body *knew* that pump wasn't the baby. I've wondered if that early pumping somehow short-circuited some biological feedback loop that said, "yes, baby's here, he's drinking, we're all good".
Hmm, interesting! I really don’t know. My understanding is that, biologically, the act of removing the breastmilk from the breast is what stimulates prolactin and keeps you lactating. And honestly 6 months of lactational amenorrhea is pretty average. Lots of other factors (like diet) probably also influence a return to menstruation and fertility. I imagine just being pretty healthy in general would promote a quick return to fertility (for better or worse!)
She said 6 *weeks*, not months! This is an interesting tangent. I've wondered, too, if there's something missing in the cues your body is receiving when you're just pumping and not nursing directly. We know that the contents of your milk responds to your baby's saliva, so there's something happening there and maybe it could be acting through a mechanism we don't understand yet. But realistically, I think it's probably because pumping women are a lot more likely to be removing milk less frequently compared to nursing on demand.
This reminded me of my own experience with pumping! I nursed on demand every day until I started teaching my university classes again when my baby was about 7 months old. My period started again very shortly after I went back to teaching. I was only away for two afternoons a week, and I pumped twice during that time (I would have nursed more frequently, most likely). Could be a coincidence! But weirdly, when school ended for summer and I went back to full time nursing on demand, my period also went away again! It didn't come back until school started again in the fall.
Still exclusively breastfeeding my 6th baby and she's almost 2. Most of my kids nursed till 3 and I got my period back by 12 weeks like clockwork. And I agree with most of this. After large gaps in my kids and very healthy pregnancies and home births my youngest 2 are 15 months apart. It was the hardest pregnancy and I got sudden onset pre-eclampsia and they nearly lost me. I prefer nearly 3 years in between babies. I have 2 grandbabies from my 2 adult children and I warn them of all the reasons to be careful with spacing. My midwives didn't need to put babies too close together in my chart I knew already.
Isn’t it interesting how everyone’s bodies respond differently? We had three under two even though I nursed our oldest until the day I delivered babies 2 and 3. I got pregnant with twins when my oldest was 13 months old and she was obviously eating food by then but was also nursing on demand throughout the day and several times at night still. Now about to finish weaning these twins who are three today!! Amazing journey.
I was in the same boat! I was so thrown off by it I weaned at 18 months as I was worried I hadn’t gotten it back. I got it the next month, then took 6 months to get back to “normal” and another pregnancy. Such a spread amongst my friends as well- our bodies are amazing!
age plays into fertility too, of course— yours may be staying away for longer because you’re not in your 20s, or maybe not, of course i don’t know but info suggests fertility is a bit of a use it or lose it scenario (to be succinct)
i’ve had three kids at 21 (my cycle returned 27mo postpartum after that child; i was a single mom not living with a ‘suitor’), at 27 (cycle back around 4mo pp but always knew it would different bc i’d be living with the father of my child), and at 32 (cycle returned at 15mo pp) ~~ i also have to say that SO SO many women breastfeed and expect that to be enough to keep fertility at bay. it’s not just that, it’s also: meeting all suckling needs at the breast (nutritive and non-nutritive, so no pacifiers or bottles and ideally baby doesn’t suck his/her fingers), nursing on demand through the night and sleeping with baby at night, not leaving baby even for ‘short appointments’ etc — def not saying any one mother is or isn’t doing these things but there is a very common misconception that breastfeeding alone is what curbs fertility and it is not the whole picture
Agree about BF being a spectrum - we don’t do bottles/dummies/thumb sucking, I’m with baby 24/7 and feed on demand while bedsharing, all that jazz. She’s interested in solid food but really doesn’t eat that much - I’m guessing once her intake of solids goes up, she’ll need less milk and things might start to shift.
Interested what you mean by “use it or lose it” in terms of fertility?
This is largely what the Boomers’ parents did in that prosperous postwar/pre birth control era - kid after kid, sometimes for years. Was this a good thing? Maybe for some, not for others. One of my grandmothers had what was then called a nervous breakdown after having one kid per year for 4 years. My other grandmother died in her 30s, following compounding health issues from many pregnancies in a row (also multiple kids in short time period). Likely other issues were present but I don’t think the constant pregnancy and birthing helped.
Every woman should be able to make an informed choice about this, and ideally it isn’t driven by some kind of larger agenda.
My mom is one of those babies--the fourth of nine in a large Irish Catholic family. I have mixed feelings about it. My mom clearly faced neglect. She often didn't get enough to eat. But, she is a lovely person and if she weren't here, I wouldn't be either 🤷♀️ Her diverging behavior choice was to breastfeed her kids and make sure we "had her own babyhood" and I'm really grateful. She had four kids and spaced us 2-3 years apart!
Of course! I don’t wish anyone wasn’t there (do wish to have met my maternal grandmother) and what happened has happened. I myself wouldn’t be here if not for some terrible events, which is probably true of a lot of us. I did notice that in the next generation, those who had larger families, or just more than one kid, spread out the pregnancies by 2-3 years.
My parents are also from large Catholic families and were surrounded by large Catholic families, some of whom had kids in the double digits. There was definitely neglect in some families and older kids taking on too much responsibility. On the other hand, parenting expectations were refreshingly low compared to today. For instance, my great aunt and uncle had 9 children. Their car simply did not fit 9 plus a parent so they just couldn’t all ride in the car at once. Whoever didn’t get to go to the store or whatever last time got to go next time. Today this does not fit parenting expectations, to say the least.
Most of the points here seem to come back to the idea that mothers don't have support networks. E.g. with the no childcare thing - this isn't really a point to me on why you shouldn't have children spaced close together, but more of an indicator that society doesn't currently support women who have closely spaced children. My first and second were 19 months apart, and it was very very intentional on my part, but I also have a community around me who were there with the meal trains and the check ins and the 'yes drop your child off while you go to that appointment' attitude, and also post-natally we have home visits from midwives and health visitors here (UK), all of which definitely help alleviate the 'no childcare' burden. That this is not a normal circumstance for women is to my view a tragedy.
The use of the word 'risk' is strange to me. I prefer more neutral language like 'chance', because I find that certain healthcare professionals just don't like the idea of women having more than 2 children, so they ramp up the conversation about 'risk this' and 'risk that' as a means of trying to scare women out of being up for more children. Yes, sometimes there are medical issues that need resolving or paying close attention to, but women are fully capable of running that cost-benefit analysis for themselves and deciding that another child is really worth it for them. I think many medical professionals don't think women are capable of making those decisions, or they don't like it that women can know the chances of something and make a different choice to what the doctor/midwife would personally prefer, which comes across as infantilising.
Completely agree that lack of support is one of the issues. It's why people have to weigh this question for themselves. In my case, even 3 years did not feel like enough between kids because we had no family in town and no close friends who weren't also parents of young children.
Regarding health and risk, as a midwife, I really do think of pregnancy as a state of health. I just also work with a fairly high risk population, and I'm not sure moms always appreciate that as empathetic people, it is hard for us too when our patients have bad outcomes. Obviously, it's their risk, or chance as you say, to take, but we just want them to do it with eyes wide open. Does that make sense?
Yes it does make sense re wanting the best for your patients - just as context for where I'm coming from with this, my husband is a doctor who has done rotations in Obs&Gynae, and I do believe that by and large medical staff are very caring towards their patients and want the best for them! But I also have experienced healthcare staff thinking that their own opinion about what's 'best' being entirely unmedical and down to their own biases against women having large families. That's where my main dislike of the use of 'risks' comes from!
I can really see both sides to this, as an O&G doctor who is always trying to inform, discuss but not needlessly scare! I can fully imagine how annoying it is to have a barrage of “risks” spewed at you at every appointment.
The flip side seems to be that people are so used to all “risks” being mitigated in our extremely over-cautious health and safety focused world, that even when we do talk of risk, it often seems like water off a duck’s back! A 1 in 100 risk - “well, there are risks to everything aren’t there, I know you have to tell me” - OK, but what that means is that in a big maternity unit, we expect to see that happen more than once a week! Real women, real problems, all who thought it wouldn’t happen to them or that whatever happens, there’ll be some helicopter to get everyone out safely.
Definitely agree re. attitude of some healthcare staff though, and I don’t put myself on a pedestal there. We’re all capable of being unhelpfully judgemental. But often women are coming back within months of delivery with unplanned pregnancies, looking anaemic and exhausted, and you have to wonder whose choice that really was.
I think the really helpful thing this piece points out is that, when objections are growing towards birth control as unnatural and causing side effects, it is other unnatural and unhealthy aspects of modern life that are often causing such short inter-pregnancy intervals.
Thanks, Tom. Not sure where you practice but it is also my experience that on a busy unit, you will see some pretty significant bad outcomes play out on a weekly basis. It's a balance between acknowledging that many risks are worth taking (because people do want to grow their families after all!) while others seem unnecessary.
My mother had 4 chidren. We were separated by 14,21 and 21 months
My paternal grandmother had 5 children in 6 years, of which two were twins.
My maternal grandmother had 4 children in 6 years.
My wife's maternal grandmother had 11 chidren in 20 years.
All different characters, but never heard a complaint about how hard it was. No signs of maladjustment, breakdowns, psychological suffering, etc. All physically strong, healthy women. What changed?
Great question! I would say a lot has changed, actually. First of all, the expectations of mothers (and parents in general) are much higher. Secondly, childhood deaths and accidents are way down!
Again, not to say having kids two kids in a row will always be a disaster, but there are some pitfalls for some people!
That's true, but I doubt that the motivation for having more kids was about potential accidents. I'm sure this thought never crossed my parents' minds.
My personal take is that:
a) there was much less hedonism back then. Parents didn't have the constant anxiety that they were giving up good things in life because of parenthood, and
b) there were many less stressors and demands to "perform", both socially and economically.
Cultural norms are massively different! My uncle for instance was parked in a baby carriage outside for several hours each day by his 50s housewife mom so she could get work done. He just lay there!
He was pretty free range and as a result almost drowned as a kid; got trapped in a junkyard and had to scream for help for hours; his parents were completely MIA and believed "parenting" meant food and a bed at night.
Contrast that with today when the cops get called when a kid crosses the street alone. Parents get arrested for this stuff. Routinely. I am personally not willing to risk it.
That's true, but what your uncle went through sounds pretty extreme. My understanding from my family tales and other sources is that until 3/4 years, children were kept at very close range by their moms or other family members (often, older siblings); at 5 they could explore under supervision the immediate surroundings of the home, and at 6 they could walk to school on their own.
I dunno. I think it's easy to idolize the past! My mom was the 4th of 9 kids. She often went without food. She describes being left alone with her siblings for hours at a time in unsafe places (like a ditch where they cut themselves on glass). She's had a rocking habit her whole life that is reminiscent of children in orphanages. 😔 But she was a great mom to me, which constantly impresses me given her role models!
the past, I was just highlighting that I have several examples of mothers who could handle many children without any visible impact on their mental health. On the other hand, there was much less concern about children safety, in particular over six. In the examples I mentioned, no children were malnourished, but for sure they were left mostly unsupervised after six. In the case of my wife's maternal grandmother, children over three were mostly entrusted to the care of their older siblings - mostly to the girls, since the boys were expected to help on the fields after school.
As a side note, my wife's family is interesting also under another perspective: it was a true partriarchal one - and I'm using patriarchy in the actual meaning of the word, not in the contrived feminist sense. Sooner or later I'll write something about that.
Glad to see you address this. Closely spaced pregnancies are not really recognized as risky and they should be — you gotta let your body heal and recover!
I think Elena has pointed out that there may be an increased rate of miscarriage for short interbirth intervals. I had two pregnancies within my son's first 18 months that sadly both ended in miscarriage. Most of the women in my family seem to have miscarriages between successful pregnancies, with no known cause for this despite many tests. But I do think all of the miscarriages happened within 18 months post-birth. Something to think about, at least!
I’m convinced there is a strong familial component to it in my case anyway, one that will probably be discovered decades from now. The good news is everyone appears to have had successful pregnancies following the miscarriages.
This is super fascinating to me. I am one of the lucky few who don’t experience delayed periods during breastfeeding. Man was I disappointed to discover this! I ended up with 4 children in less than 5 years with no twins. After the first two were born 16 months apart we used contraception and I still found myself pregnant before my seconds first birthday. It was a lot on my body so my husband opted for a vasectomy after the fourth. To be clear, I exclusively breastfed on demand around the clock and would still get my period back by 4 months postpartum. I had a huge oversupply so maybe my body wasn’t burdened by just feeding one baby? Who knows.
Wow! You sound super fertile! Some women would love to be you. 😊 Honestly I have very rarely seen this (really good fertility while breastfeeding) but it is fascinating and I wish there were more studies that capture the variation among women.
Yes very thankful for each of my children! We went through a few years of unexplained infertility before getting pregnant on my own. Definitely helped with perspective as I was drowning at some points after my third.
My period comes back at 6 weeks postpartum and I’m always exclusively breastfeeding that whole time. I have four kids very spaced out. The only time I got pregnant soon was when my oldest was 7 months old (I was not exclusively bf by that time). I miscarried that baby, so obviously despite my period my body wasn’t ready.
I think this was a helpful and important article and all your takes in the replies have been so very grounded even tho the line about anti-vaxxers making their own vaccine schedule hurt me a little 😅.
I did delayed/selective vaccines with my kids and I don’t really see what the huge problem is with that. Vaccines can be a modern miracle and still come with risks.
🙏🏻💜! you’re also totally entitled to your opinion of course! Like… I didn’t mean to prompt an apology 🥲💞. I probably worded it poorly but I meant to just conversate about it a tiny bit bc yanno.
I understand wanting to see all the vaccines happen on schedule!! But as far as I can tell vaccine injuries, though rare, are real? No? So it seemed reasonable to spread them out and see how my babies did with them one or two at a time 🙈
Vaccine injuries are not as rare as you think. Perhaps catastrophic/immediate vaccine injuries are rare, but most autoimmune conditions, allergies and ADD/ADHD are also vaccine injuries disguised as "unknown cause" or "genetic".
Or from the Standard American Diet, poison in the water, air, toiletries, cleaning products, furniture, clothing and just about everything else in modern society. What did I miss? None of this is genetic. Parents loaded with toxins raise kids loaded with toxins - that isn't genes, it's environment.
If that’s all it was, everyone would have adhd. I was diagnosed with adhd when I was 10 years old - back in the 90’s when no one was diagnosing girls 😅. I have raging adhd because my dad, a boomer, also has raging adhd 😂😂. I inherited it directly from him. Believe me - it’s genetic lmao.
I’ll grant you a “genetics load the gun + environment pulls the trigger” but only to a degree 🥲
I find that whenever a man pontificates on women’s bodies and reproductive choices, he literally talks out of his behind. Thank you for spending so much time and energy to rebut this nonsense. I wish we could all collectively laugh him and his ilk all the way back to the cave they came from.
😆 he's a smart guy and I don't begrudge him that perspective but agree it's a little easier to tell others what to do than to put your own body (and ultimately children) on the line
This was a refreshing take. Most of my friends with two under two are drowning. After my c section I went from being fearful of waiting to wanting to wait a full 18 months before trying to conceive again and a lot of people in my community (mainly evangelical Christians) didn’t seem supportive of my choice. But I’m so thankful I’ve given my body time and space to heal from my traumatic birth.
I am so, so glad I waited to conceive after my cesarean. I had a lovely, easy VBAC. My daughter was 3.5 when my son was born - old enough to understand I needed to take care of him, not be jealous, but be happy. And - they can play together just fine now.
Also: children deserve healthy mothers. I was raised as 1 of 5 in a Christian community where having 6+ was normative. Many of those young women, my friends, have grown up to be loudly proudly childfree. They saw their exhausted, frequently depressed mothers with zero support and decided “absolutely not.” The quiverfull movement has yielded very rotten fruit. I’m pretty much the only one who’s still religious and has kids.
Your line, “maternal energy is finite” — hit me like a tonne of bricks (as I lay exhausted on the couch next to my 2year old who has finally decided to take a nap). I really enjoyed this post, and your perspectives, thank you Ann!
I appreciate you giving the caveat of women who struggle to get pregnant or women who met their partners later in life. Currently 34y old and 18w with my fifth pregnancy in 2 years - no living children. I don’t pass POC without surgical intervention, so have had 6 hysteroscopies/d&cs during that time. It’s been a ride, and whenever people comment that having kids close together other isn’t ideal (and I’m a PA, so I understand the medical recs more than most) my first thought is, wow, what a place of privilege you are speaking from. If my first pregnancy has not become a missed miscarriage 2y ago, I would have the luxury of family planning at my leisure - not so anymore. Honestly I’m currently in the opposite camp - really wanting to EBF but also wanting to get pregnant again asap! I think going into that potentiality on purpose as opposed to from lack of BC/etc makes a difference too- not on the physical or medical load, but on the emotional one.
Anyway, thank you for qualifying what you said - truly appreciate it. It takes the sting out of things for people like me who have fewer options.
You make great points here! Everyone's fertility is so different, but yes, it is very true that not everyone can assume they'll get pregnant right when they start trying and sometimes that needs to be taken into account. Good luck! I hope you get just the family you want.
Two under two here (16 months apart). My mom also had her first two 14 months apart. Can corroborate every single thing you said was my experience. My husband and I had expectations of a rather large family. Now we are doggedly determined to only ever have 1 child under three years old at a time, which, my own mom (with military husband) had one 3 years later, and then 5 years later. Now I understand why.
It was just such an awful experience, I was so depressed, weighed under 120 lb as a 5’9” woman, sleep deprived because my 16 month old reacted to the baby by refusing to sleep for a year, plus my husband travels for work so I was mostly alone. They are nearing 4.5 and 3 now, so we are feeling out of the woods, but I just tell all of my friends THERE IS NO RUSH. even if you’re 36 years old or whatever. I can’t even remember what my oldest was like in her cute 2 year old stage because I seriously blacked it all out. My children are worth any sacrifice to me but I would never deliberately undergo that again nor recommend it. I am a practicing Catholic and I do pretty rigorous NFP using a Mira monitor to accomplish this, because the lactational amenorrhea religious women idolize as “proper child spacing” didn’t work for me (16 month age gap?) and exclusively breastfeeding made my ppd worse.
I have a piece coming out that is tangentially about this soon so I’ll return and restack with a link. Thanks for writing this, more women need to know.
Yes, please share your piece with me when you're done! What you're describing sounds like a very rough experience with two so closely spaced! So glad you're starting to see the light at the end of the tunnel.
I have also dabbled in NFP found it difficult (for example, got pregnant on the 26th day of my cycle after thinking I had already ovulated 🤷♀️) I think it's cool how closely those methods teach you to know your cycle and fertility, but of course they aren't perfect either! But maybe you know some secrets!
I admit I prickled a bit when reading the title of this! This, because my second and third children were 16 months apart and I feel very happy with how it all turned out. But then I remembered that when I found out I was pregnant at 7 months postpartum, I cried. I was sad for weeks. I did not feel ready, I felt guilty. Mainly because breastfeeding is really important to me and I knew this new pregnancy would have implications on my son’s breastfeeding experience. He had to be supplemented for a few months in between the end of my pregnancy and giving birth, and then I tandem nursed and was able to get rid of the supplementation. My third baby was not SGA but she was definitely my littlest baby and borderline. So, I felt the consequences, and yes, my energy is and was finite. Thank you for speaking to that fact (and it is a fact!). I do think that short interval pregnancies can work out just fine for some women sometimes, but that conversation really needs to focus on self responsibility, nutrition/self care, genetics, etc.
I also know Myrtle (laughing at her name 😆) and has seen the scenarios you describe here play out many a time, the childcare situation being the most difficult thing to witness in my opinion. Pronatalism is great (and I do consider myself to be a pronatalist) until you see a woman who had a c-section 6 hours prior left alone in her hospital room with her newborn, 13 month old and toddler.
I also want to point out what I said above, breastfeeding is important to me. The idea of it being just fine to nurse a baby for less time simply because the formula industry has impacted human evolution in reference to lactose tolerance (I need to read more about this) doesn’t track to me. Sure, formula makes short interval pregnancies more feasible. But is that good for any other reason than more babies, more quickly? I don’t actually think so. I saw in another comment that Lyman said he is part of the formula industry (in what capacity I do not know)….which leads me to question his position there, as if this is the case there is some bias at play.
Thanks for your always very valuable perspective, Emily! In retrospect, I wish I’d come up with a title that was a little less bristly. I definitely don’t want to hurt moms’ feelings, and like you I know a lot of moms who have been in this boat of closely spaced kids and wouldn’t have it any other way! Thanks for being honest about some of the consequences, though, too. Whatever moms choose, they should do it with eyes wide open!
It’s interesting to hear about your closely spaced pregnancies even though you were still breastfeeding! We clearly need more research on this, because the duration of lactational amenorrhea is so variable. It makes me wonder what other aspects of the breastfeeding experience are influencing the return of fertility.
I think the title is good because it gets people’s attention and brings it to this important topic! Eyes wide open is a good policy!
I agree about the second point here as well, I think my experience is unique but not that unique, as I know many women who get their cycles back earlier despite adhering to the tenants of “biological nurturing”. I suspect it does have something to do with both genetics and nutrition.
I mostly enthusiastically agree with this, as a mom of 2, but if you will permit me to go on a tangent:
I want to point out that the “no childcare” thing is an artificial problem. If clinicians did home visits - like most doctors used to, and like homebirth midwives do - this would not be a barrier to care.
Like: these pregnant women did not erupt a barrier to their own care. They are not “lacking” in childcare. The clinician is “lacking” in the will and ability to provide an appropriate, patient-centered care model that improves outcomes and has high feasibility and acceptability. Yes, I understand that the current model maximizes profit and maximizes convenience, but it does not serve the client.
As someone who has skipped several prenatals and a postpartum visit and had a VBAC (I skipped mostly due to transportation/work/childcare issues): I have to say, I never regretted it. I went into labor shortly after I skipped my 38w appointment because I’d had pinkeye and didn’t want to leave the house. I was feeling SO relaxed and peaceful, precisely when the surveillance picks up and the pressure to dilate switches on.
For these slightly higher-risk women (I was stage 1 hypertension, had a scar, family history of pre-e and diabetes, overweight) prenatals function as a kind of nocebo effect. You leave feeling really crappy about yourself and just genuinely discouraged. You get yelled at about your stats. You aren’t treated as a whole person. I saw a CNM/OB team and actually the OB was nicer to me, which was a surprise, but my sense was that they couldn’t help themselves: if a pathology existed, by GOD they were going to find it, they were going to exhaust every measure to find the pathologies in the haystack, and that was what they honestly believed constituted “care.”
Sorry they made you feel that way! Women shouldn't be made to feel like "problems."
Regarding in home care, it's an option for prenatal care probably, but would require a huge "scaling up" as far as the number of providers, as we'd only be able to see about half of what we see now (making time to drive around to houses). I personally just try to be as friendly as possible to moms when they bring their kids, involving them in the care and things like that. That way the kids feel welcomed and the moms feel more comfortable bringing them.
And certain treatments like magnesium for preeclampsia or iron infusions can really only happen in the hospital with skilled care.
I remember loading up my newborn into the car for a doctor’s appointment and just going, “Why the F should I have to leave my house right now.” Tiny fragile little baby going 60 mph in the hwy. Felt so wrong in every way.
Agree postpartum home visits are a must
Yes! Or allow children at the practice. My midwives allow children and have little tables with books and toys in each exam room. Even my MFM (I’m “geriatric”) allowed children for my anatomy scan.
We do some of this at my clinic too! However, the hospital is very unwelcoming to children. No kids under 16 in the birth room. I hate it because on a few occasions it's left a mom laboring without her partner because he had to stay behind to watch the kids. 😔
Oh no! That is horrible! Pre-Covid, our hospital allowed any and all children for the birth. I’m not sure after Covid. I’ve never wanted them there (would feel pulled in two directions), but I know that afterwards, for recovery, only children over 6 were allowed to visit because of flu season. :/
Your experience is precisely why more women are opting out of the system and choosing homebirth with a CPM or wild pregnancies and freebirth.
👏👏👏👏👏
I have mixed feelings about this essay. The risks are real, but many people don’t see the risks or exhaustion as a reason to avoid a pregnancy. It just feels like yet another medical professional being critical of our life choices and attempting to scare us.
I know that is not where your essay is coming from, but it’s been my experience. Most of my children have been born 2-3 years apart. I am currently pregnant with number 8. We exclusively breastfeed and co-op sleep (both usually are needed to keep fertility away) for the first year of the baby’s life, but this is not normal for the U. S. It has allowed us to have decent gaps between children.
I feel like what might help women( and men for that matter) to space children more is rather than talk exclusively about risks, is the conversation about holistic health. For example, how long it actually takes to rebuild vitamin levels in your body after pregnancy (4 years!), how are you planning on caring for your other children because exhaustion is real, what about your mental and physical health, how this can take a toll on the family. All this can help a woman realize that if she wants another child, she needs to be healthy for the best outcomes for herself, baby, and family.
Most of us having large families tend to do it because of religious convictions. Children are gifts, tough but worth it. And we don’t regret bringing a beautiful and unique person into the world. Until the medical profession can recognize this as part of the conversation, the risks seem paltry.
Thanks for bringing this up, Suzanne. I am from a Catholic family and while I don't currently practice Catholicism (I'm Lutheran now), my sister (who is my best friend) is still practicing and she is the mother of 7! She exclusively breastfed, never used birth control, and only once had pregnancies spaced less than 24 months apart.
I think you're right that the focus should be on health, but we need to be honest about how difficult it can be to maintain health with back to back pregnancies. Not impossible! Just difficult.
Anyway I appreciate your attention to this because women who choose to have large families face a lot of shaming on our society--even more than people who have no children, I would argue--and I definitely don't want to be one of the people participating in that shaming. I just see that some of these moms' health is really being compromised, and as a midwife, sometimes it scares me.
It doesn’t really matter, but I was irrationally irritated by the medical records on my second pregnancy saying “high risk because of close spacing” because it started 17 months after the end of the previous one. I was like, I can tell when my body is ready, for God’s sake, don’t patronize me. I might well go for a closer spacing next time if I feel up to it. I know I’m lucky to have a body that has so far handled pregnancy so well (and a great co-parent and all the other nice things) and I don’t need doctors moaning at me about taking advantage of my luck.
Yeah, I typically don’t put that risk factor in someone’s chart unless I think it’s pertinent (like <6 mo between pregnancies and facing nutritional deficiencies). As you point out, it can be really hurtful to moms.
Currently BF my almost-1yo with no period in sight, wondering how the heck so many women seem to have 2 under 2 😂
It does feel like a tricky balancing act, as someone who had their first baby via CS at 35 after multiple losses - but at the moment the breastfeeding is making the decision for me!
A man (who isn’t medically qualified) casually dismissing these risks to women and babies is MAJOR ick. I take it he’s never suffered pregnancy, birth or breastfeeding complications 😂
Fascinating! I wish there were more studies on lactational amenorrhea. Like everything else, the number of months a mom gets must be highly variable. But only once in my career have I met a mom who swore she was exclusively breastfeeding, and got pregnant at 4 months postpartum. 🤷♀️
I wonder what effect pumping has on it.
My son had a high palate at birth and lots of difficulty latching, which led to me exclusively pumping for several weeks after birth until we were able to figure things out. My birth was uncomplicated, and my milk came in almost immediately. I responded well to the pump and easily pumped more than my baby took, veering into oversupply at times. We never once used formula; I pumped so much breast milk I ended up donating it. Nevertheless, my period was back six weeks post-partum.
Obviously, this could have just been new mother anxiety about breastfeeding that wasn't going well, but I had frequent nightmares about my newborn starving, despite a fridge overflowing with milk and the knowledge that formula, if necessary, was just down the road. I was constantly anxious about it. It was like my body *knew* that pump wasn't the baby. I've wondered if that early pumping somehow short-circuited some biological feedback loop that said, "yes, baby's here, he's drinking, we're all good".
Hmm, interesting! I really don’t know. My understanding is that, biologically, the act of removing the breastmilk from the breast is what stimulates prolactin and keeps you lactating. And honestly 6 months of lactational amenorrhea is pretty average. Lots of other factors (like diet) probably also influence a return to menstruation and fertility. I imagine just being pretty healthy in general would promote a quick return to fertility (for better or worse!)
She said 6 *weeks*, not months! This is an interesting tangent. I've wondered, too, if there's something missing in the cues your body is receiving when you're just pumping and not nursing directly. We know that the contents of your milk responds to your baby's saliva, so there's something happening there and maybe it could be acting through a mechanism we don't understand yet. But realistically, I think it's probably because pumping women are a lot more likely to be removing milk less frequently compared to nursing on demand.
This reminded me of my own experience with pumping! I nursed on demand every day until I started teaching my university classes again when my baby was about 7 months old. My period started again very shortly after I went back to teaching. I was only away for two afternoons a week, and I pumped twice during that time (I would have nursed more frequently, most likely). Could be a coincidence! But weirdly, when school ended for summer and I went back to full time nursing on demand, my period also went away again! It didn't come back until school started again in the fall.
Still exclusively breastfeeding my 6th baby and she's almost 2. Most of my kids nursed till 3 and I got my period back by 12 weeks like clockwork. And I agree with most of this. After large gaps in my kids and very healthy pregnancies and home births my youngest 2 are 15 months apart. It was the hardest pregnancy and I got sudden onset pre-eclampsia and they nearly lost me. I prefer nearly 3 years in between babies. I have 2 grandbabies from my 2 adult children and I warn them of all the reasons to be careful with spacing. My midwives didn't need to put babies too close together in my chart I knew already.
Isn’t it interesting how everyone’s bodies respond differently? We had three under two even though I nursed our oldest until the day I delivered babies 2 and 3. I got pregnant with twins when my oldest was 13 months old and she was obviously eating food by then but was also nursing on demand throughout the day and several times at night still. Now about to finish weaning these twins who are three today!! Amazing journey.
I'm glad you're ok! Thanks for reading. Appreciate your take as an experienced mom.
I was in the same boat! I was so thrown off by it I weaned at 18 months as I was worried I hadn’t gotten it back. I got it the next month, then took 6 months to get back to “normal” and another pregnancy. Such a spread amongst my friends as well- our bodies are amazing!
age plays into fertility too, of course— yours may be staying away for longer because you’re not in your 20s, or maybe not, of course i don’t know but info suggests fertility is a bit of a use it or lose it scenario (to be succinct)
i’ve had three kids at 21 (my cycle returned 27mo postpartum after that child; i was a single mom not living with a ‘suitor’), at 27 (cycle back around 4mo pp but always knew it would different bc i’d be living with the father of my child), and at 32 (cycle returned at 15mo pp) ~~ i also have to say that SO SO many women breastfeed and expect that to be enough to keep fertility at bay. it’s not just that, it’s also: meeting all suckling needs at the breast (nutritive and non-nutritive, so no pacifiers or bottles and ideally baby doesn’t suck his/her fingers), nursing on demand through the night and sleeping with baby at night, not leaving baby even for ‘short appointments’ etc — def not saying any one mother is or isn’t doing these things but there is a very common misconception that breastfeeding alone is what curbs fertility and it is not the whole picture
Oof, feeling old 😂
Agree about BF being a spectrum - we don’t do bottles/dummies/thumb sucking, I’m with baby 24/7 and feed on demand while bedsharing, all that jazz. She’s interested in solid food but really doesn’t eat that much - I’m guessing once her intake of solids goes up, she’ll need less milk and things might start to shift.
Interested what you mean by “use it or lose it” in terms of fertility?
This is largely what the Boomers’ parents did in that prosperous postwar/pre birth control era - kid after kid, sometimes for years. Was this a good thing? Maybe for some, not for others. One of my grandmothers had what was then called a nervous breakdown after having one kid per year for 4 years. My other grandmother died in her 30s, following compounding health issues from many pregnancies in a row (also multiple kids in short time period). Likely other issues were present but I don’t think the constant pregnancy and birthing helped.
Every woman should be able to make an informed choice about this, and ideally it isn’t driven by some kind of larger agenda.
My mom is one of those babies--the fourth of nine in a large Irish Catholic family. I have mixed feelings about it. My mom clearly faced neglect. She often didn't get enough to eat. But, she is a lovely person and if she weren't here, I wouldn't be either 🤷♀️ Her diverging behavior choice was to breastfeed her kids and make sure we "had her own babyhood" and I'm really grateful. She had four kids and spaced us 2-3 years apart!
Of course! I don’t wish anyone wasn’t there (do wish to have met my maternal grandmother) and what happened has happened. I myself wouldn’t be here if not for some terrible events, which is probably true of a lot of us. I did notice that in the next generation, those who had larger families, or just more than one kid, spread out the pregnancies by 2-3 years.
My parents are also from large Catholic families and were surrounded by large Catholic families, some of whom had kids in the double digits. There was definitely neglect in some families and older kids taking on too much responsibility. On the other hand, parenting expectations were refreshingly low compared to today. For instance, my great aunt and uncle had 9 children. Their car simply did not fit 9 plus a parent so they just couldn’t all ride in the car at once. Whoever didn’t get to go to the store or whatever last time got to go next time. Today this does not fit parenting expectations, to say the least.
Most of the points here seem to come back to the idea that mothers don't have support networks. E.g. with the no childcare thing - this isn't really a point to me on why you shouldn't have children spaced close together, but more of an indicator that society doesn't currently support women who have closely spaced children. My first and second were 19 months apart, and it was very very intentional on my part, but I also have a community around me who were there with the meal trains and the check ins and the 'yes drop your child off while you go to that appointment' attitude, and also post-natally we have home visits from midwives and health visitors here (UK), all of which definitely help alleviate the 'no childcare' burden. That this is not a normal circumstance for women is to my view a tragedy.
The use of the word 'risk' is strange to me. I prefer more neutral language like 'chance', because I find that certain healthcare professionals just don't like the idea of women having more than 2 children, so they ramp up the conversation about 'risk this' and 'risk that' as a means of trying to scare women out of being up for more children. Yes, sometimes there are medical issues that need resolving or paying close attention to, but women are fully capable of running that cost-benefit analysis for themselves and deciding that another child is really worth it for them. I think many medical professionals don't think women are capable of making those decisions, or they don't like it that women can know the chances of something and make a different choice to what the doctor/midwife would personally prefer, which comes across as infantilising.
Completely agree that lack of support is one of the issues. It's why people have to weigh this question for themselves. In my case, even 3 years did not feel like enough between kids because we had no family in town and no close friends who weren't also parents of young children.
Regarding health and risk, as a midwife, I really do think of pregnancy as a state of health. I just also work with a fairly high risk population, and I'm not sure moms always appreciate that as empathetic people, it is hard for us too when our patients have bad outcomes. Obviously, it's their risk, or chance as you say, to take, but we just want them to do it with eyes wide open. Does that make sense?
Yes it does make sense re wanting the best for your patients - just as context for where I'm coming from with this, my husband is a doctor who has done rotations in Obs&Gynae, and I do believe that by and large medical staff are very caring towards their patients and want the best for them! But I also have experienced healthcare staff thinking that their own opinion about what's 'best' being entirely unmedical and down to their own biases against women having large families. That's where my main dislike of the use of 'risks' comes from!
I can really see both sides to this, as an O&G doctor who is always trying to inform, discuss but not needlessly scare! I can fully imagine how annoying it is to have a barrage of “risks” spewed at you at every appointment.
The flip side seems to be that people are so used to all “risks” being mitigated in our extremely over-cautious health and safety focused world, that even when we do talk of risk, it often seems like water off a duck’s back! A 1 in 100 risk - “well, there are risks to everything aren’t there, I know you have to tell me” - OK, but what that means is that in a big maternity unit, we expect to see that happen more than once a week! Real women, real problems, all who thought it wouldn’t happen to them or that whatever happens, there’ll be some helicopter to get everyone out safely.
Definitely agree re. attitude of some healthcare staff though, and I don’t put myself on a pedestal there. We’re all capable of being unhelpfully judgemental. But often women are coming back within months of delivery with unplanned pregnancies, looking anaemic and exhausted, and you have to wonder whose choice that really was.
I think the really helpful thing this piece points out is that, when objections are growing towards birth control as unnatural and causing side effects, it is other unnatural and unhealthy aspects of modern life that are often causing such short inter-pregnancy intervals.
Thanks, Tom. Not sure where you practice but it is also my experience that on a busy unit, you will see some pretty significant bad outcomes play out on a weekly basis. It's a balance between acknowledging that many risks are worth taking (because people do want to grow their families after all!) while others seem unnecessary.
I'm a bit perplexed.
My mother had 4 chidren. We were separated by 14,21 and 21 months
My paternal grandmother had 5 children in 6 years, of which two were twins.
My maternal grandmother had 4 children in 6 years.
My wife's maternal grandmother had 11 chidren in 20 years.
All different characters, but never heard a complaint about how hard it was. No signs of maladjustment, breakdowns, psychological suffering, etc. All physically strong, healthy women. What changed?
(we have two separated by 21 months, by the way)
Great question! I would say a lot has changed, actually. First of all, the expectations of mothers (and parents in general) are much higher. Secondly, childhood deaths and accidents are way down!
Again, not to say having kids two kids in a row will always be a disaster, but there are some pitfalls for some people!
That's true, but I doubt that the motivation for having more kids was about potential accidents. I'm sure this thought never crossed my parents' minds.
My personal take is that:
a) there was much less hedonism back then. Parents didn't have the constant anxiety that they were giving up good things in life because of parenthood, and
b) there were many less stressors and demands to "perform", both socially and economically.
Cultural norms are massively different! My uncle for instance was parked in a baby carriage outside for several hours each day by his 50s housewife mom so she could get work done. He just lay there!
He was pretty free range and as a result almost drowned as a kid; got trapped in a junkyard and had to scream for help for hours; his parents were completely MIA and believed "parenting" meant food and a bed at night.
Contrast that with today when the cops get called when a kid crosses the street alone. Parents get arrested for this stuff. Routinely. I am personally not willing to risk it.
That's true, but what your uncle went through sounds pretty extreme. My understanding from my family tales and other sources is that until 3/4 years, children were kept at very close range by their moms or other family members (often, older siblings); at 5 they could explore under supervision the immediate surroundings of the home, and at 6 they could walk to school on their own.
I dunno. I think it's easy to idolize the past! My mom was the 4th of 9 kids. She often went without food. She describes being left alone with her siblings for hours at a time in unsafe places (like a ditch where they cut themselves on glass). She's had a rocking habit her whole life that is reminiscent of children in orphanages. 😔 But she was a great mom to me, which constantly impresses me given her role models!
Of course we shouldn't idolize
the past, I was just highlighting that I have several examples of mothers who could handle many children without any visible impact on their mental health. On the other hand, there was much less concern about children safety, in particular over six. In the examples I mentioned, no children were malnourished, but for sure they were left mostly unsupervised after six. In the case of my wife's maternal grandmother, children over three were mostly entrusted to the care of their older siblings - mostly to the girls, since the boys were expected to help on the fields after school.
As a side note, my wife's family is interesting also under another perspective: it was a true partriarchal one - and I'm using patriarchy in the actual meaning of the word, not in the contrived feminist sense. Sooner or later I'll write something about that.
Glad to see you address this. Closely spaced pregnancies are not really recognized as risky and they should be — you gotta let your body heal and recover!
I think Elena has pointed out that there may be an increased rate of miscarriage for short interbirth intervals. I had two pregnancies within my son's first 18 months that sadly both ended in miscarriage. Most of the women in my family seem to have miscarriages between successful pregnancies, with no known cause for this despite many tests. But I do think all of the miscarriages happened within 18 months post-birth. Something to think about, at least!
Hmm interesting. I hadn't heard that stat exactly, but I feel like I have witnessed it a bit among patients I work with .
I’m convinced there is a strong familial component to it in my case anyway, one that will probably be discovered decades from now. The good news is everyone appears to have had successful pregnancies following the miscarriages.
This is super fascinating to me. I am one of the lucky few who don’t experience delayed periods during breastfeeding. Man was I disappointed to discover this! I ended up with 4 children in less than 5 years with no twins. After the first two were born 16 months apart we used contraception and I still found myself pregnant before my seconds first birthday. It was a lot on my body so my husband opted for a vasectomy after the fourth. To be clear, I exclusively breastfed on demand around the clock and would still get my period back by 4 months postpartum. I had a huge oversupply so maybe my body wasn’t burdened by just feeding one baby? Who knows.
Wow! You sound super fertile! Some women would love to be you. 😊 Honestly I have very rarely seen this (really good fertility while breastfeeding) but it is fascinating and I wish there were more studies that capture the variation among women.
Yes very thankful for each of my children! We went through a few years of unexplained infertility before getting pregnant on my own. Definitely helped with perspective as I was drowning at some points after my third.
My period comes back at 6 weeks postpartum and I’m always exclusively breastfeeding that whole time. I have four kids very spaced out. The only time I got pregnant soon was when my oldest was 7 months old (I was not exclusively bf by that time). I miscarried that baby, so obviously despite my period my body wasn’t ready.
I think this was a helpful and important article and all your takes in the replies have been so very grounded even tho the line about anti-vaxxers making their own vaccine schedule hurt me a little 😅.
I did delayed/selective vaccines with my kids and I don’t really see what the huge problem is with that. Vaccines can be a modern miracle and still come with risks.
Sorry about that! Delaying vaccines a bit bothers me way less than just not getting them at all!
🙏🏻💜! you’re also totally entitled to your opinion of course! Like… I didn’t mean to prompt an apology 🥲💞. I probably worded it poorly but I meant to just conversate about it a tiny bit bc yanno.
I understand wanting to see all the vaccines happen on schedule!! But as far as I can tell vaccine injuries, though rare, are real? No? So it seemed reasonable to spread them out and see how my babies did with them one or two at a time 🙈
Vaccine injuries are not as rare as you think. Perhaps catastrophic/immediate vaccine injuries are rare, but most autoimmune conditions, allergies and ADD/ADHD are also vaccine injuries disguised as "unknown cause" or "genetic".
ADHD might be exacerbated by vaccines (maaaaaybe) but it’s also definitely genetic!
Or from the Standard American Diet, poison in the water, air, toiletries, cleaning products, furniture, clothing and just about everything else in modern society. What did I miss? None of this is genetic. Parents loaded with toxins raise kids loaded with toxins - that isn't genes, it's environment.
If that’s all it was, everyone would have adhd. I was diagnosed with adhd when I was 10 years old - back in the 90’s when no one was diagnosing girls 😅. I have raging adhd because my dad, a boomer, also has raging adhd 😂😂. I inherited it directly from him. Believe me - it’s genetic lmao.
I’ll grant you a “genetics load the gun + environment pulls the trigger” but only to a degree 🥲
I’m with you. If we space out vaccines for our kids —-we are by definition _not_ anti vaxers. Because we are giving our kids vaccines!
I find that whenever a man pontificates on women’s bodies and reproductive choices, he literally talks out of his behind. Thank you for spending so much time and energy to rebut this nonsense. I wish we could all collectively laugh him and his ilk all the way back to the cave they came from.
😆 he's a smart guy and I don't begrudge him that perspective but agree it's a little easier to tell others what to do than to put your own body (and ultimately children) on the line
This was a refreshing take. Most of my friends with two under two are drowning. After my c section I went from being fearful of waiting to wanting to wait a full 18 months before trying to conceive again and a lot of people in my community (mainly evangelical Christians) didn’t seem supportive of my choice. But I’m so thankful I’ve given my body time and space to heal from my traumatic birth.
It will probably have benefited not just yourself but your future children too! Glad you're happy with your choice.
Thank you! With all that we’ve learned about attachment I think a bigger age gap is nice for that too for the kids sake!
I am so, so glad I waited to conceive after my cesarean. I had a lovely, easy VBAC. My daughter was 3.5 when my son was born - old enough to understand I needed to take care of him, not be jealous, but be happy. And - they can play together just fine now.
Also: children deserve healthy mothers. I was raised as 1 of 5 in a Christian community where having 6+ was normative. Many of those young women, my friends, have grown up to be loudly proudly childfree. They saw their exhausted, frequently depressed mothers with zero support and decided “absolutely not.” The quiverfull movement has yielded very rotten fruit. I’m pretty much the only one who’s still religious and has kids.
Your line, “maternal energy is finite” — hit me like a tonne of bricks (as I lay exhausted on the couch next to my 2year old who has finally decided to take a nap). I really enjoyed this post, and your perspectives, thank you Ann!
Thanks for reading! Those early years are so exhausting. Wishing you the best. You can do it!
I appreciate you giving the caveat of women who struggle to get pregnant or women who met their partners later in life. Currently 34y old and 18w with my fifth pregnancy in 2 years - no living children. I don’t pass POC without surgical intervention, so have had 6 hysteroscopies/d&cs during that time. It’s been a ride, and whenever people comment that having kids close together other isn’t ideal (and I’m a PA, so I understand the medical recs more than most) my first thought is, wow, what a place of privilege you are speaking from. If my first pregnancy has not become a missed miscarriage 2y ago, I would have the luxury of family planning at my leisure - not so anymore. Honestly I’m currently in the opposite camp - really wanting to EBF but also wanting to get pregnant again asap! I think going into that potentiality on purpose as opposed to from lack of BC/etc makes a difference too- not on the physical or medical load, but on the emotional one.
Anyway, thank you for qualifying what you said - truly appreciate it. It takes the sting out of things for people like me who have fewer options.
You make great points here! Everyone's fertility is so different, but yes, it is very true that not everyone can assume they'll get pregnant right when they start trying and sometimes that needs to be taken into account. Good luck! I hope you get just the family you want.
Two under two here (16 months apart). My mom also had her first two 14 months apart. Can corroborate every single thing you said was my experience. My husband and I had expectations of a rather large family. Now we are doggedly determined to only ever have 1 child under three years old at a time, which, my own mom (with military husband) had one 3 years later, and then 5 years later. Now I understand why.
It was just such an awful experience, I was so depressed, weighed under 120 lb as a 5’9” woman, sleep deprived because my 16 month old reacted to the baby by refusing to sleep for a year, plus my husband travels for work so I was mostly alone. They are nearing 4.5 and 3 now, so we are feeling out of the woods, but I just tell all of my friends THERE IS NO RUSH. even if you’re 36 years old or whatever. I can’t even remember what my oldest was like in her cute 2 year old stage because I seriously blacked it all out. My children are worth any sacrifice to me but I would never deliberately undergo that again nor recommend it. I am a practicing Catholic and I do pretty rigorous NFP using a Mira monitor to accomplish this, because the lactational amenorrhea religious women idolize as “proper child spacing” didn’t work for me (16 month age gap?) and exclusively breastfeeding made my ppd worse.
I have a piece coming out that is tangentially about this soon so I’ll return and restack with a link. Thanks for writing this, more women need to know.
Yes, please share your piece with me when you're done! What you're describing sounds like a very rough experience with two so closely spaced! So glad you're starting to see the light at the end of the tunnel.
I have also dabbled in NFP found it difficult (for example, got pregnant on the 26th day of my cycle after thinking I had already ovulated 🤷♀️) I think it's cool how closely those methods teach you to know your cycle and fertility, but of course they aren't perfect either! But maybe you know some secrets!
I admit I prickled a bit when reading the title of this! This, because my second and third children were 16 months apart and I feel very happy with how it all turned out. But then I remembered that when I found out I was pregnant at 7 months postpartum, I cried. I was sad for weeks. I did not feel ready, I felt guilty. Mainly because breastfeeding is really important to me and I knew this new pregnancy would have implications on my son’s breastfeeding experience. He had to be supplemented for a few months in between the end of my pregnancy and giving birth, and then I tandem nursed and was able to get rid of the supplementation. My third baby was not SGA but she was definitely my littlest baby and borderline. So, I felt the consequences, and yes, my energy is and was finite. Thank you for speaking to that fact (and it is a fact!). I do think that short interval pregnancies can work out just fine for some women sometimes, but that conversation really needs to focus on self responsibility, nutrition/self care, genetics, etc.
I also know Myrtle (laughing at her name 😆) and has seen the scenarios you describe here play out many a time, the childcare situation being the most difficult thing to witness in my opinion. Pronatalism is great (and I do consider myself to be a pronatalist) until you see a woman who had a c-section 6 hours prior left alone in her hospital room with her newborn, 13 month old and toddler.
I also want to point out what I said above, breastfeeding is important to me. The idea of it being just fine to nurse a baby for less time simply because the formula industry has impacted human evolution in reference to lactose tolerance (I need to read more about this) doesn’t track to me. Sure, formula makes short interval pregnancies more feasible. But is that good for any other reason than more babies, more quickly? I don’t actually think so. I saw in another comment that Lyman said he is part of the formula industry (in what capacity I do not know)….which leads me to question his position there, as if this is the case there is some bias at play.
Thanks for your always very valuable perspective, Emily! In retrospect, I wish I’d come up with a title that was a little less bristly. I definitely don’t want to hurt moms’ feelings, and like you I know a lot of moms who have been in this boat of closely spaced kids and wouldn’t have it any other way! Thanks for being honest about some of the consequences, though, too. Whatever moms choose, they should do it with eyes wide open!
It’s interesting to hear about your closely spaced pregnancies even though you were still breastfeeding! We clearly need more research on this, because the duration of lactational amenorrhea is so variable. It makes me wonder what other aspects of the breastfeeding experience are influencing the return of fertility.
I think the title is good because it gets people’s attention and brings it to this important topic! Eyes wide open is a good policy!
I agree about the second point here as well, I think my experience is unique but not that unique, as I know many women who get their cycles back earlier despite adhering to the tenants of “biological nurturing”. I suspect it does have something to do with both genetics and nutrition.