The payoff of a nine-month pregnancy is profound. The little person you create will bring you immeasurable joy, love, laughter, sleep deprivation, frustration, worry and gratitude. But for many women, childbirth will also bring physical…
The payoff of a nine-month pregnancy is profound. The little person you create will bring you immeasurable joy, love, laughter, sleep deprivation, frustration, worry and gratitude.
But for many women, childbirth will also bring physical side effects later in life. “Every pregnancy stresses the system. The more children you have, the more stress you’re building, like building blocks,” says Dr. Iffath Hoskins, a clinical professor in the department of obstetrics and gynecology at NYU Langone Health.
There are many structural changes that occur in pregnancy. For example, the intestines and stomach are pushed up as the uterus expands. Joints and ligaments loosen to prepare for labor and delivery. And weight increases — a lot. “Carrying a baby is like carrying a 20- to 40-pound backpack for nine months,” Hoskins says.
Most of the structural changes reverse after the baby is born. But the effect of carrying such a heavy load can be lasting. Muscles and ligaments supporting the abdomen can become damaged or stretched, especially those holding up the uterus, vagina and rectum. “Just being pregnant in the third trimester has been shown to change the structure of the supports to the uterus and vaginal area,” Hoskins says.
The forces of pushing a baby through the vagina can also damage the ligaments, muscles and even nerves associated with bladder and bowel control. While they may heal in time, they can still remain weak.
Later in life, the structural changes can lead to:
— Urinary incontinence: the involuntary leakage of urine, such as urge incontinence (the feeling that you have to go) or stress incontinence (leakage that results from pressure on the bladder, such as laughing or coughing).
— Fecal incontinence: the involuntary leakage of feces.
— Pelvic organ prolapse: a sagging bladder, uterus, rectum or small intestine that is no longer held in place by connective tissues. Sometimes organs descend to the point of protruding into the vagina or even outside of it.
Fortunately, all of these conditions are treatable with medications, exercises (like bladder training or pelvic floor strengthening) or surgery.
Pregnancy has long been linked to high blood pressure and diabetes. “The studies are clear that a woman who has hypertension in pregnancy is at risk for having hypertension later in life. If you have gestational diabetes, you may develop Type 2 diabetes,” Hoskins says. But she notes that pregnancy is not the cause of those later life conditions. “The pregnancy is only unmasking what was going to happen anyway. It may hasten the ultimate outcome,” she says.
Pregnancy does appear to influence cancer risk, possibly because of hormones. For example, a woman’s lifetime risk of postmenopausal breast cancer goes down if her first pregnancy occurs before age 30. But waiting to have a baby or never giving birth increases breast cancer risk, according to Dana-Farber Cancer Institute.
Having a full-term pregnancy is also associated with reduced risks for ovarian and endometrial cancers — the more full-term pregnancies, the lower the cancer risks, reports the National Cancer Institute.
Some pregnant women complain of “momnesia” or “pregnancy brain.”Hoskins confirms anecdotally that some of her patients become forgetful during pregnancy. And some studies suggest that there may be memory-related difficulties that sometimes occur in pregnancy and right after childbirth.
But it’s unclear if childbirth has a long-lasting effect on cognition. The studies on the topic are mixed:
— One study of 3,500 elderly women, published in August in Neurology, suggested that giving birth five or more times was associated with a 70 percent higher risk for developing Alzheimer’s disease later in life, compared to giving birth one to four times.
— But the reverse was true in the first-ever large-scale investigation in the U.S. of various aspects of reproductive history and dementia risk, presented at the Alzheimer’s Association’s International Conference in July. Among almost 15,000 women in the study, those with three or more children had a 12 percent lower risk for dementia than women with one child.
Both studies were observational and therefore can’t prove cause and effect. But researchers say the findings warrant further investigation.
Several studies published this year suggest that childbirth may be associated with accelerated aging at the cellular level.
For example, a study published in July in Scientific Reports found that two markers of cellular aging — telomere length and epigenetic age — looked surprisingly older among 800 young women in the Philippines (ages 20 to 22) who had already been pregnant up to five times. “Each additional pregnancy was associated with between 0.5 and two years of age acceleration,” says lead author Calen Ryan, a doctoral candidate in the anthropology department at Northwestern University.
Ryan speculates that the toll of an altered immune system during pregnancy — which must accommodate foreign cells from another human — may be to blame. “The idea is that as the body is putting energy into the immune system, it might have less energy to maintain itself in other ways,” Ryan explains.
“Every time you have a pregnancy, you’re restressing the body, which may be shortening telomeres,” Hoskins says.
Does that mean you’re cutting years off your life by having a baby? Ryan says it’s far too early to tell, especially since unrelated factors may have affected the results of his study, such as the participants’ exposure to disease and environmental pollution.
Plus, other studies have found that having more children may actually be associated with having longer telomeres, the protective caps at the ends of chromosomes. Longer telomeres are associated with a longer life.
Having children creates relationships with people who may wind up taking care of you later in life. That alone may confer better health if there’s someone to accompany you to doctor appointments and make sure you’re eating right and taking your medications.
The social contact your kids can provide in older age can go a long way toward warding off loneliness and isolation, which are associated with a decline in cognition and an increase in chronic disease as well as early death. “They are interacting with their adult children and their families, compared to people who don’t have children. Socialization translates to true tangible results like better cognitive, cardiovascular and overall health,” Hoskins says.
Indeed, a 2017 study published in the Journal of Epidemiology and Community Health found that parents — both men and women — live longer than nonparents, even in the highest ages.
But you’re not having a baby to breed caregivers and companions for older age. You’re growing your family, sharing your love and getting some back. And that, of course, is the best childbirth benefit to think about when a precious new bundle is placed in your arms.