Your fourth pregnancy

For many women, the fourth pregnancy is like riding a bike — after experiencing the ins and outs three times before, both your body and your mind are intimately familiar with the changes pregnancy brings.

While every pregnancy is unique and different, the general mechanics will be the same. Still, there will likely be a few differences between pregnancy number one and pregnancy number four. Here’s what to expect.

Physical changes

Women experiencing pregnancy for the first time typically show later than they do in subsequent pregnancies. Blame it on the first baby — your uterus and abdominal muscles were much tighter before they stretched to accommodate a growing passenger.

As your uterus grew, it expanded out of the pelvis into the abdomen, stretching your abdominals and eventually becoming that baby bump.

The result? Many women will show earlier during their fourth pregnancy than they did with subsequent pregnancies. And for a fourth-time mom, early can mean somewhere around the 10th week.

During a first pregnancy, many women notice breast changes. With those changes comes extreme tenderness, which can be an early indication of pregnancy.

For second-, third-, or fourth-time moms, your breasts might not be quite as tender. They might not change in size as significantly as they did the first time.

Pregnancy symptoms

That “feeling” about pregnancy that experienced moms have comes from, well, experience! Women who have been through a previous pregnancy tend to notice signs and symptoms that they might have missed the first time around.

It can be easy to mistake breast tenderness for an impending menstrual cycle, or morning sickness for a stomach bug. But fourth-time moms are more likely to recognize pregnancy symptoms than first-timers.

Other parts of pregnancy are more recognizable, too. Many women experiencing pregnancy for the first time mistake the movements of their tiny baby for something like gas. Moms on their second, third, or fourth pregnancies are far more likely to recognize those little flutters for what they are.

You might notice that you’re much more tired during a subsequent pregnancy. It’s no wonder — you will probably have at least one other small child to look after. This probably means less opportunity to rest, something you likely did during your first pregnancy.

Your partner might not pamper you quite as much, either, thinking that you’re a pro by now. If you’re on your fourth pregnancy, you’re at least five years older, too. The age difference alone can make you feel more tired.

The age difference is one of the biggest contrasts between first and fourth pregnancies. Having a baby when you’re older means you have a greater likelihood of twins. This is because hormonal changes as you age increase the chance that more than one egg is released during ovulation.

Being an older mom also means a greater risk of having a baby with a chromosomal defect. Doctors are more likely to recommend genetic testing in a fourth pregnancy than they might with a first.

Labor and delivery

One of the benefits of subsequent pregnancies is a shorter labor. For many women, labor is faster the second, third, or fourth time. On the flip side, you may notice that Braxton-Hicks contractions begin earlier in your pregnancy, and that you have more of them.

It’s a common misconception that your first delivery experience will dictate any deliveries that follow. Just like every baby is different, so is every pregnancy.


If you had complications with a previous pregnancy, including gestational diabetes, preeclampsia, hypertension, or premature birth, you could be at an increased risk for these issues.

If you had a cesarean delivery in the past, you are also at a higher risk for complications. It’s important to speak with your doctor about previous pregnancies, so you know what to look for going forward. Women with a previous cesarean delivery can still have a vaginal delivery on a subsequent pregnancy.

Other experiences that can worsen with subsequent pregnancies include back pain and varicose veins. While a sore back is a common pregnancy woe, it can be even more painful if you’re carrying around young children.

Varicose and spider veins also tend to get worse from one pregnancy to the next. If you suffer from vein issues, try wearing support hose from the beginning. Also remember to elevate your feet and legs when you can.

If you had hemorrhoids, constipation, or incontinence during a previous pregnancy, try being proactive to avoid the same problems this time. Make sure to eat lots of fiber, drink plenty of water, and get regular exercise.

Don’t forget daily Kegel exercises, either. While you might not be able to prevent these symptoms, you may be able to keep them to a minimum.

The takeaway

For many women, one of the biggest advantages to a fourth pregnancy is experience. First-time moms can have a lot of emotional stress from the unknown and the many changes to come.

Second-, third-, and fourth-time moms already know what to expect from pregnancy, labor, recovery, and beyond. That knowledge can make you feel more secure as you begin another pregnancy.

Will labor be the same as my previous pregnancies? Not necessarily. A baby’s size and placement in your uterus will have the biggest effect on your labor experience, no matter what number pregnancy this is.