Pregnant again? What to Expect



If your first pregnancy and the following birth are without complications, you will probably be relatively relaxed when you learn that you are pregnant again. If, on the other hand, your first pregnancy was more stressful than you had imagined, you are probably more anxious now than you were the first time. (Viccars 2009: 270)

A second or subsequent pregnancy can be a real challenge, especially if your first child is still very young. This time, you are also more aware of your fatigue because you can not give it away so spontaneously, since you already have a toddler to look after.

It's quite possible that you may feel torn - on the one hand, you feel that you are not taking enough care of your first baby and, on the other hand, you can not focus on pregnancy as much as you would like. But there are some steps you can take to prepare yourself and your toddler for the baby.

How can I prepare for my next baby?

Many mothers find follow-up pregnancies to pass by and suddenly the birth is imminent. They have the feeling that little preparation has taken place, neither emotionally nor practically, as in the first pregnancy.

Take care of yourself. Every pregnancy is unique, both physically and emotionally. And yet, the things you need to do to stay as healthy and fit as possible are the same:

From the moment you put child planning into action, so stop using it, you should use 400 daily μg of folic acid. (NHS 2011) It is important to start with that before the pregnancy starts. Your body needs folic acid to develop the neural tube and close it to prevent an open back (spina bifida). (Blencowe 2010)

Eat as healthy and balanced as possible. These include:

  • Sufficient carbohydrates (bread, pasta and rice, preferably whole wheat).
  • Lots of fruits and vegetables (including leafy, dark green leafy vegetables, such as spinach).
  • proteins (lean meat and fish) or beans and legumes if you are a vegetarian.
  • Low-fat dairy products containing calcium, such as As yogurt or skim milk.
  • Fats and sweet foods only exceptionally, such as cakes, sweets and carbonated sodas. (NICE 2010)

Read how easy it is to eat healthily in our nutritional companion.

You will probably be tired much more often than during the first pregnancy. But do not be overly caffeinated to stay awake. 200 mg of caffeine per day should be the upper limit - that's about two cups of latte or black tea. (NHS 2011)

Excessive caffeine intake may increase the risk of low birth weight or miscarriage (CARE 2008, Matijasevich et al 2005, NHS 2011, Signorello et al 2005, Weng et al 2008). Of course, occasionally increased caffeine intake is no risk. (FSA 2008)

Although you already have a child, you should do some exercise to keep fit despite your pregnancy! (RCOG 2006)

Stay active. If you have a small child, take a pram or stroller daily in the open air or do some simple pregnancy exercises at home and involve the child.

Make every day a conscious thing for your new baby, and when it's just two or three minutes of deep, relaxed breathing, thinking about how it grows in you.

How will my body change?

You may find that, compared to the first pregnancy, your abdomen bulges earlier and you feel the child's movement a few weeks earlier. (Mangesi and Hofmeyr 2007)

In some women, the pregnancy sickness is not as bad as the first time, but unfortunately this is not a generally accepted rule. (Niebyl 2010, PRODIGY 2008, Tidy 2009, Louik et al 2006)

Unfortunately, if you have had extreme pregnancy (hyperemesis gravidarum) in your last pregnancy, it may happen again. (Tidy 2009) It does not mean that it will be like this anyway.

Complaints that you had in your first pregnancy, such as: Varicose veins, hemorrhoids (NCCWCH 2008) or stress incontinence are likely to recur, but at least now you know how to handle them best.

You'll find that your ligaments on the hip can hurt more and earlier than they did in your first pregnancy. (Mogren 2006) Repeated pregnancies put a lot of strain on them, and you now have to be very attentive to your posture.

Get down on your knees when you need to bend down and grab a pillow to support your back when you sit longer.

If there was a medical problem in your first pregnancy, such as For example, diabetes or cholestasis, this could happen again (NCCWCH 2008, RCOG 2011).

Now you know which diet to follow, which medicines you need and which specialist you need to contact. Because of the experiences from the first pregnancy, you and your doctor have a much better starting position.

Your Feeling in Second Pregnancy

You are thinking and remembering problems in your first pregnancy or during orafter birth? (Viccars 2009) Perhaps you have pushed away these unpleasant or bad memories and now they are threatening to overrun you?

Do not try to get by alone without talking to anyone! Ask your gynecologist or gynecologist for a chat or contact a friend or counseling center for pregnant women.

Is the risk of preeclampsia higher this time?

If you did not have pre-eclampsia in your first pregnancy, then you have a 1% chance of getting pre-eclampsia in another pregnancy. (Hernandez-Diaz et al 2009)

However, if you had preeclampsia during your first pregnancy, you are more likely to get it again. (NCCWCH 2008: 218) The likelihood of this is 1: 6. (Hernández-Díaz et al 2009, Brown et al 2007, NHS 2011)

You are more likely to get pre-eclampsia in a second pregnancy if:

  • you have a strong overweight and a body mass index (BMI) of 30 or above (RCOG 2011).
  • you are suffering from chronic high blood pressure or kidney disease.
  • Lying 10 years or more between your pregnancies.
  • Your sister or mother had preeclampsia.
  • You expect twins or multiple births.
  • you are 40 or over. (NCCWCH 2008)

Whether you feel that you belong to the risk group or not, it is important that you go to all checkups regularly to have your blood pressure and urine examined.

If you experience any of the following symptoms in the second half of pregnancy, please contact your doctor immediately:

  • Headache
  • Vision disorders, such as: B. Blurred vision or fibrillation in front of the eyes.
  • Severe pain under the ribs.
  • Vomiting
  • Spontaneous swelling of the face, hands or feet. (NCCWCH 2008)

How many checkups will I have?

If you are healthy and expect a pregnancy without complications, you will have a check-up every 4 weeks, then every 2 weeks in the last two months of pregnancy.

If you feel less alert to your recent pregnancy than the first time you feel left alone, talk to your doctor or midwife. (NCCWCH 2007: 16).

Will I receive the same support as the first time?

Listen, maybe someone in your circle of friends or acquaintances is pregnant too. Meeting women in the same situation can calm and strengthen you. Sharing the symptoms of pregnancy and having the older kids join you at their meetings makes you more confident in the future.

If the time span between your pregnancies is very long and your friends and acquaintances have already completed their family planning, you may feel isolated.Consider (again) attending a birth preparation course. There you meet women or couples who are in the same situation as you.

Or visit our Pregnant group and share with other pregnant women.

If it's been several years since you first had your first child, then you should refresh your knowledge anyway: much has changed in the field of birth preparation over the past decade. Ask your gynecologist or midwife. They will be pleased to inform you how good pregnancy care and birth preparation are going on today. Good luck!


Blencowe H, Cousens S et al. 2010. Folic acid to reduce neonatal mortality from neural tube disorders. Int J Epidemiol 39 (1): 110-21

Brown MA, Mackenzie, C et al. 2007. Can we predict recurrence of pre-eclampsia or gestational hypertension? BJOG. 114 (8): 984-93

CARE. 2008. Maternal caffeine intake during pregnancy and risk of fetal growth restriction: a large prospective observational study. BMJ . 337: a2332

CMACE / RCOG Joint Guideline. 2010. Management of women with obesity in pregnancy .

FSA. 2008. Food Standards Agency publishes new caffeine advice for pregnant women . London: Food Standards Agency.

Hernandez-Diaz S, Toh S, et al. 2009. Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study. BMJ .

Mangesi L, Hofmeyr GJ. 2007. Fetal movement counting for assessment of fetal wellbeing . Cochrane Database of Systematic Reviews. (1): CD004909.

Matijasevich A, Santos IS, Barros FC. 2005. Does caffeine consumption during pregnancy increase the risk of fetal mortality? A literature review. Cad Saude Publica 21: 1676-84.

Mogren IM. 2006. BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy European Spine Journal . 15 (7).

NCCWCH. 2008. Antenatal care: routine care for the healthy pregnant woman. National Collaborating Center for Women's and Children's Health, Clinical Guideline. London: RCOG Press.

NCCWCH. 2007. Intrapartum care: care of healthy women and their babies during childbirth. National Collaborating Center for Women's and Children's Health. London: NICE.

Niebyl JR. 2010. Nausea and Vomiting in Pregnancy. N Eng J Med . 1544-1550.

NHS Choices. 2011. Foods to avoid during pregnancy .

NICE. 2010. Dietary interventions and physical activity interventions for weight management before, during and after pregnancy . National Institute for Health and Clinical Excellence. Public health guidance 27.

PRODIGY. 2008. Nausea and vomiting in pregnancy: clinical topic .

PRODIGY. 2011. Antenatal care - uncomplicated pregnancy: leaflets for patients .

RCOG. 2011. Obstetric Cholestasis .

RCOG. 2006. Exercise in pregnancy .

Signorello LB and McLaughlin JK. 2004. Maternal caffeine consumption and spontaneous abortion: a review of the epidemiologic evidence. Epidemiology 15: 229-39

Tidy C. 2009. Nausea and vomiting in pregnancy - including hyperemesis gravidarum .

Viccars A. 2009. Antenatal care. In: Fraser DM, Cooper MA. eds. Myles Textbook for Midwives . 15th ed. Edinburgh: Churchill Livingstone. 263-287

Weng X, Odouli R, Li D-K. 2008. Maternal caffeine consumption during pregnancy and the risk of miscarriage: a prospective cohort study. At J Obstet Gynecol . 198 (3): 279

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