“Are you really ever ready for a second?” – GP Preeya Alexander Asks The Question
The moment our daughter turned two, I felt a certain pressure from friends and society - "so when will you guys have a second?" was frequently asked...

Honestly, it was only until our daughter's two year birthday party I felt like I had my body and elements of my life back; bedtime was a known quantity, so was childcare – I had a resemblance of the old Preeya (my old jeans fit perfectly again!) mixed with the new mama Preeya and I quite liked it. Just when I felt like we had it kind of sorted, the questions about a second child started coming thick and fast. I was nervous because I was very far from considering another pregnancy; in fact, the idea would make me panic. Seeing all my friends in similar boats get pregnant and have another child didn't help; I was the person on the sidelines watching and completely freaking out because I was definitely not ready to run onto the pitch again.

I don't find motherhood easy. I'm sure it has a little something to do with being married to a plastic surgeon who works odd hours and can't guarantee being home for bedtime let alone home at all lots of nights in the week. I'm sure it has something to do with the fact that I'm a perfectionist who likes to excel at things I do and FYI motherhood isn't a thing you can nail 100%, or even 70%, of the time – it took me a good 9 months to learn that lesson and I still struggle with my type A/hard on myself/do it all amazingly attitude on a regular basis. And I'm sure it has something to do with the fact that I really love my job and my career and the truth is that having a child impacts that; not necessarily negatively but it certainly means you have to be a world-class juggler who can tightrope walk at the same time if you "want it all."

As a GP I know you ideally want to plan pregnancies so this was always in the back of my mind and this is some of the stuff my patients often aren't aware of when it comes to family planning. You should ideally see your GP/fertility specialist 6 to 12 months before you try to conceive; we check your bloods; ensure you are immune against conditions like rubella and that you are taking the right supplements like folic acid and iodine. We ensure vaccinations are up to date and that your weight is as close to optimal to reduce the risk of gestational diabetes and blood pressure issues in pregnancy. We also discuss and offer tests like genetic carrier screening, a blood test ideally done before pregnancy (if you choose to do this). Preconception care is about optimising a woman's health before she conceives, and we know it improves pregnancy outcomes for mum and baby. I'm a huge advocate for preconception care and I ending up doing a lot of this as a GP (it's one of my favourite consults because I'm a huge nerd and preventative medicine gets me excited!).

When I would pop into my GP she would subtly throw-in, much like I do with my patients, "come and have a chat when you're ready and six months out from starting to try." I remember telling her I had no inkling, no desire, nothing going on that would even suggest I was ready to have a second child. I started to panic slightly – was something wrong with me? Wasn't it OK to just have one child? I had a traumatic labour with our daughter which ended in an emergency C section – was I really ready to take the gamble all over again? Did I want to add more chaos to this life we were living? Will was a training plastic surgeon (thank goodness training is over, just quietly can I get a wahoo!?) and we were like ships passing in the night most of the time so why would I add more to my plate, our plate with another child?

The World Health Organisation (WHO) recommends that after a live birth a period of two years should ideally pass before attempting another pregnancy in order to reduce the risk of maternal, perinatal and infant outcomes such as low birth weight babies and preterm delivery. Likewise, longer pregnancy intervals (the time between birth and conception) of more than five years are also associated with a higher risk of pre-eclampsia and other complications. Of course, women and families have babies when they're ready when it works for them (and that's how it should be, trust me!) but this is just what the recommendations are. Why tell you all these random medical factors about family spacing, preconception care? Because in my head I had the GP information – the stuff I lecture on and do day-to-day in clinical practice – and the very subtle societal pressures and honestly, my brain completely imploded with the mammoth decision.

The thing with a second child is you KNOW what to expect. You know pregnancy is a minefield – there's the fatigue, then the pelvic twinges which turn into the sensation that there's a bowling bowl hidden deep (deep) inside your vagina. You know that sleep deprivation is real, that infants do wake repeatedly in the night for feeds and don't go straight back down to sleep just because they're full and you've swaddled them like a ninja. You know your nether regions cop a beating and despite the emergency C section, it all feels a bit different afterwards, not bad just different. You know about the post-baby blues when you cry to the point of dehydration for a couple of days after the birth. You know what's coming, and for me that made the decision even more scary and complex.

In hindsight I overthought it all – I tried to pick the perfect time and let's be honest; when it comes to motherhood, children, family – there is never ever a right time.

I think it's OK to admit we're never fully ready for motherhood, for kids, for the drastic changes that occur. I think it's OK to admit some of us love having kids and have six, and some of us, like me, are motherhood lovers but slightly more reserved and cautious in our position. I think it's OK to say we all do motherhood our own way – the family spacing, the numbers of kids we have or don't have, and that whatever we choose it's all OK.

So, to answer the question, "are you ever ready for a second?" I was never going to be the person who was 110% ready. As my mother gently said to me recently "you can't plan everything darling and you won't always be ready for everything good that happens." How right she was. I write this 20 weeks pregnant. I am ready-ish, as ready as someone as type A and overthinking as me can ever be. Honestly, I can't wait to hold this little boy, for him to join our family, for our daughter to bond with her little brother. I'm cautious about the birth – this time we are having a planned C section so as not to repeat any of the events from last time, and I'm nervous about how I will juggle the other passions in my life, career included, with another child on board. Ready, nervous, excited and cautious because I know what is to come; but yes, ready(ish).

Go to www.thewholesomedoctor.com.au | Photo Cocoa Jones Photography


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