Grand multiparity pregnancy?

[seinfeld]

Apparently on your 6th child you are considered grand multiparity which I wasn't aware of until I saw it listed in my chart and then dr Googled and found a laundry list of possible adverse events that can take place.

Anyone else have 6 or more? How did your pregnancies and deliveries go? Did you make it all the way? Any issues with bleeding or after delivery? Vaginal or c section?

For reference I'm 30w5d no issues so far I'm not overweight or diabetic no health conditions and baby is doing good so far just measuring a little large

 

[onetech]

@seinfeld Wait- do they count all pregnancies, or just the ones that result in full term deliveries?

I’ve been pregnant 11 times, but had 7 early losses. My problem is low progesterone, and that’s really only a problem in the first trimester. My three pregnancies that led to me bringing home a baby were all pretty run of the mill, and deliveries weren’t too dramatic. So far, the baby I’m pregnant with has been mostly uneventful too. No ones ever shown much concern for me after 12 weeks

 

[rpggamer]

@seinfeld I delivered my 6th, no multiple pregnancies, just after turning 40. I had no issues. I had pitocin right after delivery to prevent hemorrhaging.....which wasn't my plan, but an aggressive Midwife changed my mind....story for another day. The delivery was vaginal and unmedicated, like all my other births. I about died when I saw the grand multiparity label too. It felt like maybe I'd gone to far over the edge of getting pregnant...lol. I had a subchorionic hemorrhage early in the pregnancy that never resolved. And I think I caused it when I leaned over my other kid's crib rail to kiss him goodnight, and I heard a pop....but who knows. Anyways.....everything was fine and smooth. No gestational diabetes, no crazy weight gain....totally, and thankfully, unremarkable pregnancy in every way. I hope your delivery goes smoothly.

 

[seinfeld]

@rpggamer All of my pregnancies besides 1 were inductions so they were already giving me pitocin, do they give you more after birth? I never noticed and no one ever mentioned anything

 

[rpggamer]

@seinfeld I've never had pitocin while in active labor or at any other time. My Midwife suggested the pitocin after I gave birth to prevent postpartum hemorrhaging. I requested specifically that I'm not be given any pitocin unless it was necessary in the event of an emergency but she was insistent on my having it as a precautionary measure. And since I was nine and a half centimeters dilated when I arrived at Labor and Delivery I wasn't really in the mood to argue with her at that point. And so I only got the pitocin after I gave birth. I'm not sure if they would just keep the pit available for once you deliver or if what you receive during labor would be enough to prevent a hemorrhage afterwards in the event that should happen

 

[marktwaine26]

@seinfeld I’m 41 and due with #8 this month. My pregnancy has been no more complicated than any of my others. All my previous deliveries were vaginal with no issues besides the normal pain and discomfort we all expect to experience.

I have had miscarriages at ages 37 and 40, at 6 and then 7 weeks pregnant. Maybe that was due to poor egg quality. I just haven’t had trouble carrying the healthy embryos.

 

[noahmetoyer]

@seinfeld Oh hey I did some research on this during my education! I also work in womens healthcare providing maternity care.

Nulliparity (first baby) is actually a lot riskier for a lot of outcomes than grand multiparity

It’s also hard to tease out risk factors because grand multips are on average more likely to be older, have an elevated BMI, have a closer spacing between pregnancies and have a lower socioeconomic status compared to the general childbearing populace all of which increase risk factors in pregnancy

Basically there is a small increase in the risk of hemorrhage, risk of malposition (unstable lie or breech), abnormal placentation, and macrosomia (big babies). But there is not a big increase of other risks independently of age or maternal weight or family income level. Most women having a 6th plus pregnancy will have healthy and normal pregnancies if they are otherwise healthy.

 

[seinfeld]

@noahmetoyer Having to have a c section is what I'm most afraid of! Just because I have so many other kids at home to take care of. But ultimately I know the goal is to get baby here healthy and mom not to die in the process. All other births have been vaginal and relatively short so just keeping my fingers crossed this one's the same!!

He is measuring a week ahead but there were some questions about my due date at the beginning. Supposed to have a growth scan in 2 weeks but my biggest baby thus far was 7lb7oz

 

[jeanxon]

@seinfeld I practice in women’s health in a community with relatively high rate of grand multips. Risk of hemorrhage and abnormal placentation is higher but there are many other more impactful risk factors - I would not be worried about this. Statistical significance and clinical significance aren’t the same thing.

 

[seinfeld]

@jeanxon What are some other risk factors?

 

[jeanxon]

@seinfeld Lots of oxytocin use esp beyond typical amounts, prolonged labor, big baby, twins, excess amniotic fluid, magnesium sulfate use, history of bleeding, atypically located placenta, all can be associated with higher bleeding risk. History of Cesarean especially multiple Cesareans are far more associated with abnormal placental invasion than parity alone.

 

[katma]

@seinfeld I'm 36 and just had my 7th (all 7 were vaginal). Nothing out of the "normal" (for me) realm of complications happened with this one.

I did have a partial placental abruption at the inset of labor.. but i had the same thing with my 3rd and 6th as well.

She was born a month early.. but so was my 2nd and i have a history of preterm labor with my first (stopped with turbutaline twice until I hit term)

Some things that were done differently with this pregnancy... I had an extra ultrasound done and saw a Marernal Fetal Medicine specialist for that. But thay was because I am considered "elderly" or "geriatric" since I am over 35. Because of the abruptions, I am given pitocin after I deliver to help my uterus contract to slow the bleeding.

 

[airamerica]

@seinfeld It's great that you bring this up because it's something that I continue to look for factual medical research on and I'm not finding much helpful information. Most of the studies that indicate high risk for multiparity pregnancy are talking about women in third world countries where I would assume their health and stress level would also play a role in negative outcomes. I too would like to have six kids one day but with each pregnancy I worry about leaving the others without their mother I feel like I can't get any good information to make an informed decision on the risk benefit of analysis of continuing to get pregnant

 

[seinfeld]

@airamerica I'm not even seeing a high risk OB so I guess they don't consider me so. I'm 33 so not yet in the 35 age group where it's considered geriatric pregnancy either

 

[airamerica]

@seinfeld Well congratulations on your beautiful big family I look forward to reading more people's experiences thanks for the Post.

 

[kathyparkar1]

@seinfeld I think it’s important be aware of what might go wrong, because pregnancy and age both take a toll on the body. That being said, I personally didn’t have any serious issues. I gave birth to 12 babies, the last at age 45. I did have gestational diabetes for the last 3, and the last one I was beginning to show signs of pre-eclampsia, but delivered naturally before it became an issue. They did administer pitocin after delivery, probably the last 3 or 4 times, to help the uterus contract down, but I don’t think I was showing any issues; they just did it. I did have 2 c-sections, once for baby #8 and once for baby #11, both because the placenta was failing and baby was in distress; I had VBACs between and after. I don’t know if anyone could say those issues happened solely or even mostly because of my age or the number of pregnancies I’d had. For deliveries, I’d say #1 and #5 were my longest, and those two plus #9 (first vbac) were my scariest/hardest vaginal deliveries. Babies 4, 7, and 10 were my easiest deliveries. 2 & 12 got there before the doctor.

 

[marke2]

@seinfeld My #7 is seven months old.

All my births were unmedicated (never even had an IV), and #5, 6, and 7 were homebirths. #6 and #7 were the only times I needed Pitocin post-birth, and I'm honestly not really sure I needed it after #6 (didn't get along with that particular midwife from the practice and I felt manipulated into getting it). #7 was one of my shortest and easiest labors, despite him being posterior.

Baby #6 was my only complicated pregnancy and even that was mild - he had a PRUV which is 80% comorbid with Downs', Edward's, or congenital heart issues. His fetal echocardio came back normal and he passed all his growth scans. My midwives considered it a normal delivery as long as I made it past 36 weeks. He was born 3 days early (and is a perfectly normal and healthy 2-year-old now).

For what it's worth, I'm one of nine siblings and the only one my mother had complications with was #8, plus a late-ish miscarriage between #8 and #9.

 

[allenemarie]

@seinfeld I had a hemorrhage after my 7th was born. Up until that one, no issues.

I will say, everyone kept feeling my uterus and they kept saying it was odd because it was doing a great job contracting on its own. So it wasn't like a uterine atony issue. There also wasn't any retained placenta or anything. Their best guess at the time was my bladder was too full, which didn't allow my uterus to move down properly. I'm honestly still not really sure what happened.

 

[fastedandprayed]

@seinfeld I just had #6 a month ago, it was my second easiest pregnancy, my worst labor, but my best delivery and easiest recovery. (I had 3 babies in 27 months, so that was most of my obs concern)

With #4, 2 years after my 3rd, I had no problems besides 1 high blood pressure reading after birth.
With #5, I got pregnant 9w pp, I had placenta previa which moved by 30w, and early labor at 29 weeks, which caused me to have constant contractions until I delivered at 39w.

Ultimately, I had no major problems that would prevent me from having another though.

 

[seinfeld]

@fastedandprayed Did you deliver at 40 weeks with number 6? I've been having frequent contractions but no changes I didn't know you could go that long having them! How long was your last labor?

This is my worst pregnancy. My youngest is 2 and into everything and I work full time idk how I'm gonna make it to 40 I'm so miserable