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Maternal Depression in Second Pregnancies: The Untold Story

toddler with newborn sibling

Pregnancy is one of the most life-changing events a woman can experience. A number of physiological and psychological changes occur as the body prepares to nurture and grow new life. However, people often hype the first-time pregnancy experience, while the second and subsequent ones are seen as less important.

The second pregnancy is treated more like a sequel than a blockbuster debut – people know it’s going to get louder and sometimes more expensive, but for the most part, it’s viewed as a familiar and less stressful experience. The irony is that the opposite is often true.

Second pregnancies carry with them unique challenges for the mother and her partner. Many of those challenges remain untold, putting undue pressure on families.

How Second Pregnancies Differ from the First

The National Library of Medicine conducted a survey to understand the psychological status of women during second pregnancies. One-hundred and sixty-two second-time mothers participated in the study. These were all formerly mentally healthy women without any history of pregnancy complications or cognitive dysfunction.

The women rated their adverse emotions on a Self-Rating Anxiety Scale (SAS) and a Self-Rating Depression Scale (SDS). Though anxiety and depression rates varied among the test subjects, they were still higher for second pregnancies than for the first. But what could be so difficult about doing something all over again?

Let’s understand how a second pregnancy is different from the first.

1. Half the Time, But Double the Pressure

The first pregnancy and delivery are always the most special because it is a seismic and life-altering event. As for the second, you already have a fair idea of what to expect. Just as the thrill of welcoming another tiny human kicks in, it’s time to look after two small, helpless people.

Add to that the postpartum hormonal changes and mood swings, and feeling frustrated is natural. The Conversation discussed this topic, stating that a second child adds no new role to the parents’ lives. Instead, it increases the demands of their previous role.

The family finances take a hit, chores double up, and the house is often a mess. If these strains affect the couple’s relationship, the mother may experience intense anxiety and depression.

2. Higher Pregnancy Fatigue

Right when the mother feels like a pregnancy pro, her body succumbs to the constant need for rest. Many women report feeling higher levels of exhaustion during their second pregnancy. This has to do with the added demands of the first child, especially if a toddler.

If adequate support is unavailable, the mother may experience physical and mental exhaustion or feel defeated and paralyzed.

3. Worse Postpartum Cramps

This is another problem that worsens after the first birthing experience. During the second pregnancy, the uterus loses some of its toned muscles. As a result, it becomes more aggressive in clamping down to avoid internal bleeding.

Hence, the postpartum contractions that bring the uterus back to its normal size are worse.

4. Slower Postpartum Recovery

One reason it’s harder to recover after a second baby is that a woman’s abdominal muscles grow much weaker. So, they need longer to heal when compared to the first pregnancy.

The situation is much worse for mothers who do not have the time to rest or exercise due to the demands of life (i.e., the first child).

Rebounding from a Traumatic First Birth Experience

According to the Birth Trauma Association, traumatic first-time pregnancies can make subsequent ones (especially the second) much more mentally challenging for the mother. Some women have second thoughts about having another child, whereas some do not even experience postpartum stress symptoms until they plan for a second baby.

Some top reasons why a woman may have veteran pregnancy fears (borrowed from their traumatic first experience) include:

  • Preeclampsia
  • Third-degree vaginal tears and poor recovery
  • Severe diastasis recti or abdominal muscle separation
  • Misplaced epidurals
  • An intensely long and painful labor
  • Poor communication with caregivers
  • Fear for the baby’s health (especially if the first was a premature baby)
  • Loss of dignity during childbirth (owing to poor maternity care and mistreatment)
  • Negative relationship changes with one’s partner after delivery

Children’s National Hospital found that high stress levels during pregnancy can affect the baby’s brain development, impacting cognitive function. The child may also showcase dysregulation behaviors later in life. This makes it extremely important to rebound from a traumatic first-time birth experience before planning a second.

Other crucial measures that may help make the second-time pregnancy more comfortable include –

  • Choose a certified primary care family nurse practitioner to assist you through every step of the pregnancy. Nurses certified through an online ABSN have the skills and expertise needed to care for people of all age groups, from infancy to advanced years. This is beneficial because a second-time pregnancy is taxing for not just the mother but also her loved ones (not to mention confusing for the first child).
  • If your first-time birthing trauma is associated with the healthcare center, choose a midwife or doula for a relaxing home-birth experience.
  • If you choose to give birth at a hospital or nursing facility, entrust your first child to the care of a family nurse. Often, mothers do not have the energy and mood to take care of their firstborn actively, and the pregnancy can be a stressful and isolating experience for the child. According to Holy Family University, these nurses are trained in evidence-based practices to support and restore childhood physical and mental health.
  • Sit down with your midwife or nurse and jot down a birth plan together. Let them know the details (even the traumatic bits) of the first pregnancy so they can create a plan accordingly.
  • Discuss the birth plan with your partner and what you both must expect as the months progress. Staying mentally prepared as a couple will help you overcome the second-time challenges better, should they arise. This step is especially crucial if your partner also felt traumatized by your previous pregnancy.

Dealing with Pregnancy Fatigue, the Second Time Around

The truth is that pregnancies are challenging, no matter how familiar you become with the experience. Chances are, even if you did not have a traumatic first-time pregnancy and labor, you will face physical and mental health challenges down the line. Here are some ways to cope with pregnancy fatigue, both physical and mental:

1. Ask for Help without Hesitation

Suppose you had a mild to moderately uncomfortable first birth experience, but the second one seems off due to frequent nausea, intense pelvic pain, etc. Do not simply dismiss them because friends and family say it’s normal.

Every woman and every birth experience is unique. Ask for professional help from a pelvic floor physical therapist or a massage expert trained to help you with the discomfort you’re feeling.

2. Take Rest and Lots of It

Often, women can enjoy plenty of rest during their first pregnancies as families also take special care to support them. This can be challenging with a young toddler making mischief and giving the mother a hard time.

As mentioned earlier, let close family members or an experienced nurse care for the child as you catch up on the rest and sleep your body desperately needs. Additionally, eat a healthy diet, do mild exercises, and use a maternity support belt to stay fit.

3. Embrace Body Positivity

The body changes significantly during pregnancy, but more so during the second pregnancy, as women may start showing sooner, and the baby may also go a little lower than the previous time. This is naturally accompanied by weight gain and stretch marks.

Some women struggle to accept these changes before the mirror. In moments such as these, you need to admire your body’s beauty for something deeper and more powerful – it is creating and nurturing a new life for the second time! Your body is the safest place for a little human to thrive, and nothing comes close in comparison.

4. Invest in Prenatal Vitamins

Folic acid is an essential vitamin that protects against mood changes that happen during pregnancy. It may also prevent severe postpartum depression and stress.

Prenatal vitamins usually include folic acid and other nutrients such as Vitamin D, iron, and Omega-3 fatty acids that support energy and a healthy mood. Invest in these vitamins beforehand to prevent pregnancy blues.

Final Thoughts

First, second, or tenth, pregnancy is a beautiful yet challenging time. Things only worsen when the overwhelmed mother receives minimal social support and self-compassion. In addition to the abovementioned points, always stay connected with your loved ones (especially your partner). Do not isolate yourself from family and friends.

Find in yourself a kinder inner voice despite the roller-coaster of emotions you may be strapped onto. Seek help as and when needed, and do not compare yourself with other super moms you see out there (and on social media!). The National Health Service (NHS) confirms that every pregnancy is so vastly different from the others that they should never be compared.

Finally, ditch the pressure to cope and take each day as it comes. Give yourself a break when needed and focus on your and your family’s well-being – it’s all that matters!

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialists can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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About the Author: Susan Trager is a seasoned mental health nurse dedicated to promoting mental wellness and providing compassionate care through online ABSN and PMHNP programs at various reputed universities. With a deep understanding of the complexities of mental health, she offers valuable insights and practical advice to empower individuals on their healing journeys. Known for her empathetic approach, Trager strives to destigmatize mental health issues and create a safe space for those in need.

Photo by Victoria Rain: https://www.pexels.com/photo/toddler-and-a-baby-1648389/

The opinions and views expressed in any guest blog post do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in the article or linked to therein. Guest Authors may have affiliations to products mentioned or linked to in their author bios.

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