The Effects of a Mother's Second Pregnancy on the Firstborn Child

EDITORIAL COMMENT: This paper was accepted for publication because it reminded us of how little data are available on such matters of importance. The only comparable obstetric topic that comes to mind is the long‐term effect, on both spouses and their children, of the presence of the male at his partner's confinement. The mother's second pregnancy can indeed profoundly and permanently affect the firstborn child, and in turn the ‘guilty’ parents, who, in retrospect, handled the problem inappropriately. Image the serene, secure 12‐month‐old first baby son, sent away from home and parents to be cared for (expertly) by a stranger during his mother's second confinement; episodes of spurious labour add to the duration of the parting and when the child is collected to return home 4 weeks later he accepts, more or less, the father who collects him, but is deeply saddened and no longer his extroverted happy self. One has only to look at the face of a happy child to appreciate the enormity of the change. They arrive home; the mother greets him with great love, immediately rejected in a storm of tears as his pain is revealed, this being a matter not quickly resolved — this is not an imagined tale but an anecdote from the home of a member of your editorial committee! Of course when the mother goes to hospital the first child should preferably remain in his/her own home, preferably with people he/she knows (father, grandparents) — to be separated from both parents and home when too young to understand the events of the hour is to be avoided at almost any cost. This advice should be given to all expectant mothers during their second pregnancy. Many patients state that their first child's behaviour changes during their second pregnancy are due to changes in their own behaviour to the child, due to fatigue and / or loss of patience. We need more data on this subject, especially since most of what we hear is bad news, unless the first child is no longer a baby and anticipates with pleasure the arrival of a playmate. It is difficult to explain to a baby how things may change but we should try. Most mothers give much attention to anticipation of the first child's needs after the second is born, when she returns home. This paper indicates that there is room for improvement in the antenatal management of this situation and, in the editor's opinion, the care of the firstborn during the mother's absence from home at the time of her confinement. Summary: Mothers in the last trimester of the second pregnancy admit to being less active, more tired and moody than previously. Many were more anxious than usual. Their first child frequently showed behavioural changes. Those surveyed were between 11/2 and 4 years of age and showed more clinging, sleep disturbance and misbehaviour with tantrums than expected. It is presumed that the mother's pregnancy induces anxiety in her child with consequent behavioural changes.