babies back-to-back

One pregnancy is challenging enough'—what if another follows hot on its heels?

When my daughter was three months old, I unexpectedly got pregnant again. Soon I was experiencing first hand the physical and psychological challenges typical of back-to-back pregnancies—unrelenting fatigue and back pain, fear of dealing with two babies at once and uncertainties about breastfeeding and pregnancy weight gain. Close spacing of your babies shouldn’t harm your second child, but it can feel daunting to be pregnant within a year or so of having given birth. Here’s some important pre- and postnatal information for your health and peace of mind:

Breastfeeding is not a contraceptive. If you don’t want a quick second pregnancy, be sure to use birth control as soon as your doctor gives you the OK to resume having intercourse. (If you’re breastfeeding, use barrier methods, an IUD or condom—not the Pill.) Breastfeeding may suppress menstruation, but conception before your first postdelivery period is still possible. Jody Moss, a Los Angeles mother of three who reconceived six weeks after her first delivery, says, “My postpartum checkup after my son was born was the prenatal check for my daughter! I never had a period between them.” If you rely on a diaphragm, it should be refitted at your five- or six-week postpartum checkup (you might have gotten larger after giving birth).

Get prenatal care as soon as possible.

Fortunately, Moss received immediate prenatal care for her second child, but since the signs of a rapid repeat pregnancy can be hard to read (you’re still carrying extra weight and not menstruating), that isn’t always the case. Pay attention to nausea (it could be morning sickness) as well as more subtle signs (Moss noted that her hair was thinning, as it had during her first pregnancy), and if you think you could be pregnant, immediately see your caregiver.

You may decide to wean your first baby while carrying the next. New York mom Tracy Calvan did: “I lost weight and felt tired because I was nursing while pregnant, so I slowly weaned my son,” she says. The authors of What To Expect When You’re Expecting (Workman Publishing, 1991), Arlene Eisenberg, Heidi E. Murkoff and Sandee E. Hathaway, B.S.N., suggest that “trying to rally the nutritional forces for both nursing and pregnancy can be a losing battle for all concerned.”

Other women are quite comfortable nursing while pregnant; doing so does not necessarily increase your fatigue, adversely affect your preg-nancy nor leave your in utero baby malnourished, insists Kathleen Huggins, R.N., M.S., and Linda Ziedrich in The Nursing Mother’s Guide to Weaning (The Harvard Common Press, 1994). Discuss the decision with your physician and, if you do continue nursing, be sure to drink plenty of liquids.

Don’t be afraid to gain weight. It’s common to take extra weight into the second pregnancy—I took an extra 20 pounds. You’ll still want to gain weight during the second pregnancy, although perhaps a bit less than the usual recommendation of 20 to 30 pounds. “If you’re 20 percent or more over your ideal body mass, you already have the necessary fat stores,” says John Botti, M.D., professor of obstetrics and gynecology and director of maternal-fetal medicine at Pennsylvania State University’s Hershey Medical Center in Hershey. “Discuss it with your physician, but you can probably gain somewhat less than the usual number of pounds.”

Watch your diet. A short interval between pregnancies means your body may be at a nutritional disadvantage—so you’ll need to be vigilant about eating properly. “Certain nutrients such as calcium and iron must be replenished after delivery, and that takes about six months,” Botti explains. “In a short-order pregnancy, those mineral levels may be less than ideal.” He suggests eating a diet rich in calcium and iron (the RDA for pregnant women is 1,200 milligrams of calcium and 30 to 60 milligrams of elemental iron) and paying careful attention to taking prenatal vitamins. Consult with your caregiver about other nutritional supplements you might need.

Expect to feel extra exhausted. “I had one baby on the outside and one on the inside, and I felt like I couldn’t move,” remembers Moss. Because the second pregnancy progresses in a different environment—there’s now a demanding newcomer to consider—you have to carve out adequate rest time. At the least, sleep whenever your older baby does. If possible, arrange child care or household aid (at-home assistance helped allay my predelivery fears about handling two babies). Also, don’t be shy about asking your mate, family and friends for their assistance.

Don’t stop exercising. Moderate exercise helped alleviate fatigue during Calvan’s second pregnancy. “I’d be exhausted due to sleep deprivation and working full-time, but I always felt better after going to my prenatal exercise class,” she says. All I could handle after my second pregnancy was taking walks with my two babies in their stroller—but at least it was something. It’s important to focus on your health, though, not your figure. “If you didn’t lose weight between pregnancies,” says Botti, “don’t try to work it off now.”

Careful how you carry while you’re carrying. Carrying a nonwalking baby while I was pregnant caused painful muscle spasms in my neck. Other mothers suffer lower-back problems. “My back was very fragile because of holding my first child,” Calvan recalls. Exercises that reestablish abdominal-wall tone should help relieve back stress. Other strategies: Enlist child-care help, eliminate unnecessary lifting and always lift with proper form, making sure to bend at the knees.

Keep those bugs away. Since you’re already physically worn down, try to avoid any person or situation that might give you an infection. Many women find that back-to-back pregnancies deplete their immune system, making them more susceptible to colds, flu and other illnesses. Eating right and getting a lot of rest is your best preventive strategy.

Take it easy. “A close second preg-nancy wreaks havoc on your body—but taking breaks will help you to cope,” says Moss. Above all, don’t try to be perfect. Remember that first-pregnancy lesson: Every challenging phase passes.

Get back in shape. Back-to-back moms agree: Postpartum exercise is crucial to your recovery from a hot-on-the-heels second delivery. “Make the time to do it as soon as you get your doctor’s OK,” says Wendy Weant, a New York City dancer/actress with three closely spaced children—ages 4, 2 1/2 and 16 months. Weant also suggests you make time for Dad as well as his kids. “A happy mom,” she says, “makes for happy children.”

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