By Korin Miller. Photos: Getty Images.
Kim Kardashian made headlines this week when she announced that she wants to try to get pregnant with a third child—despite having difficulties in the past.
"I'm going to try to have one more baby," Kim tells her family in a promo clip for this week’s Keeping Up With the Kardashians. "I want my kids to have siblings, but the doctors don't feel like it's safe for me." Her mom, Kris Jenner, also seemed concerned, saying "I don't want you to do something that would put you in danger.”
Kim has been open about having high-risk pregnancies with both her daughter North and son Saint. While pregnant with North, she developed preeclampsia, a potentially life-threatening complication that causes high blood pressure—North was delivered six weeks early as a result. And, when she gave birth, Kim developed another serious complication known as placenta accreta, a condition in which the placenta doesn’t completely detach from a woman’s uterine wall. Kim later wrote about the experience on her website, calling it “the most painful experience of my life.”
After North was born, Kim had surgery to remove any traces of placenta and scar tissue, but still had difficulty conceiving Saint. Finally, she turned to in-vitro fertilization, but had placenta accreta again during his delivery. Her doctor later warned her on-camera that giving birth to more children could cause a “life or death” situation.
So, it’s understandable that her family would be nervous that Kim would want to have more kids, knowing that her life could be in danger. It seems like there’s an easy solution—just don’t have another pregnancy, or use a surrogate—but experts say that, while rare, this struggle isn’t exclusive to Kim.
“I have patients who are warned not to have another child and have gone on to have other children with both positive and negative results,” says Tamar Gur, M.D., Ph.D., a women's health expert and reproductive psychiatrist at The Ohio State University Wexner Medical Center. Anjali Kaimal, M.D., director of the Maternal Fetal Medicine Fellowship Program and obstetrical director of the Multidisciplinary Fetal Care Group at Massachusetts General Hospital, says there are actually very few conditions in which women are told they shouldn’t become pregnant. “However, there are many situations in which we talk with women about the risks to their health and the health of the pregnancy based on their underlying medical conditions or the complications they have experienced in past pregnancies,” she says. Those can include Type I diabetes, heart conditions, lupus, kidney disease, or a history of organ transplant, she says, but notes that the ultimate decision is “very personal.”
Lauren Streicher, M.D., an associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine, says she sees this “all the time,” but points out that there’s a very big difference between being told that you’ll have a high risk pregnancy vs. saying a pregnancy will be life-threatening. While conditions like preeclampsia can be monitored, placenta accreta is “dangerous,” she says. “This can sometimes result in a significant postpartum hemorrhage and sometimes an emergency hysterectomy is needed,” she says.
Doctors don’t mess around when it comes to telling women they shouldn’t have children or additional children: Kaimal notes that the warning is usually made because there is a “significant risk of death or long-term medical complications” for the woman.
While women typically listen to the advice of their doctor (or get pregnant unintentionally), Streicher says some don’t. She had one patient who had a stroke during her first pregnancy and was advised not to get pregnant again because she was at risk of having another one. “She got pregnant again, had another stroke, and almost died,” Streicher says.
Why do women do this, knowing the danger? Gur says it’s because the urge to be a mom is incredibly strong in some women. “The desire to have a child or more children is, for some women, as strong as the drive to breathe,” she says. “It really becomes an omnipresent force throughout their day and life.” Women typically don’t make the decision lightly and often become stressed out by it, Gur says. “I frequently see regret that they can’t have a normal pregnancy, and they’re plagued with stress and worry about their own health and baby’s health,” she says. “It’s very much, ‘Wow I know I’m doing this against advice—I hope I’m doing the right thing.’”
Like Streicher, Gur agrees that most women tend to follow their doctor’s advice. And, while she admits that she tends to not see the women who made the decision to go against medical advice and did great, she says she’s seen plenty of women who made the decision and struggle with the aftermath, which usually involves a serious health complication.
If you’ve been told by a doctor that having a child or more children could put your life in danger but you want to try anyway, Gur says that it’s crucial to make sure that your support system—your partner, parents, and close family members—are on board with this. “I’ve seen really negative consequences—you’re not the only one who is going to have to deal the repercussions and consequences of your decisions,” she points out. If everyone isn’t on the same page, she recommends taking a beat and talking to a counselor or physician. “This is not something to leap into blindly,” she says. “This is a marathon, not a sprint.”
While Gur says she doesn’t want to minimize the drive to have your own child, she points out that there are other ways of becoming a mom, which might be better if your doctor has advised against carrying a baby. “It is a very stressful, exhausting, challenging thing to become pregnant when you have severe medical indications not to,” she says. “Make sure it’s a choice that you’re fully prepared to accept the consequences—I’ve seen really sad outcomes.”
This story originally appeared on Glamour.
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