By Diane Mapes, contributing writer
When Arkansas mom and reality TV star Michelle Duggar announced on the Today show Sept. 1 that she was pregnant with her 19th child, millions of Americans expressed joy and amazement.
But others – undoubtedly the queasiest of the bunch – were a bit uneasy. How could one woman – or rather, one uterus – bear so many children? Isn't that, well, stretching things a bit?
Not necessarily, experts say.
"The uterus is a remarkably flexible organ," says Dr. Florence P. Haseltine, ob/gyn and founder of the Society for Women's Health Research in Alexandria, Va. "It can grow rather rapidly and it can recede rather rapidly. It's able to reconstruct itself and reconfigure itself quickly."
|Beth Hall / AP|
|Michelle Duggar is surrounded by her children and husband Jim Bob, third from right, while she holds her newborn daughter, Jennifer Danielle, the couple's 17th child, on Aug. 2, 2007, in Rogers, Ark.|
Haseltine says she understands how people would be amazed that one uterus could carry and deliver so many children – especially in a day and age when the average number of births per female is 2.12 – but it's a misconception to think that giving birth to 18 or 19 children is overtaxing the organ's ability.
"The sense is 'My goodness, I get physically tired just thinking about it, so therefore the uterus would be tired,' but that's not necessarily true," she says. "I don't believe a uterus gets tired. If it had damage as a result of a specific pregnancy, it might cause trouble. But it doesn't make any physiological sense why one should worry about the uterus."
Thanks to the wonders of reality TV – the family has their own show entitled "18 Kids & Counting!" on TLC – keeping track of Michelle Duggars' uterus has become sort of a national pastime. According to the family Web site, the couple married in 1984 and had their first child four years later. Since then, Michelle Duggar has given birth to an additional 17 children, including two sets of twins. Three of the births have been via Caesarean section; the others have been vaginal. She and her husband, Jim Bob, are currently expecting their 19th child (as well as their first grandchild).
While experts say good health plays a major role in any woman's ability to conceive, carry and deliver children, particularly multiple children, good genes are crucial, too.
"Everyone is different in their health, and with some women it takes more of a toll," says Dr. Karen V. Wells, an ob/gyn at the Center for Women's Health at Evergreen Hospital in Kirkland, Wash. "And women have different muscle tone in their uterus. Some people get saggier and baggier earlier on and some people have good tone to their tissue. It has to do with our individual makeup, our collagen, our elastic fibers, our genetics. I know someone who after just two children had to have her bladder resupported. Other people seem to do fine. Obviously Mrs. Duggar is a very healthy woman and her body is handling it well."
Not that there aren't concerns and complications when it comes to multiple pregnancies or "grand multips," as they're known. After delivering five or six children, women are more prone to post-partum bleeding or hemorrhaging. The risk for toxemia and preeclampsia also increases. Anemia can also be a concern.
"There's a continuous leeching of calcium and iron, the supplemental building blocks that babies need," says Dr. Peter Wall of Eastside Maternal Fetal Medicine in Kirkland, Wash. "After having many children, chronic anemia or osteopenia – weak bones – could be a chronic risk. Also carrying children does increase the risk of incontinence, but even women who haven't had children have incontinence."
And having lots of kids has health benefits, too, Wall is quick to point out.
"We know that having many kids protects from breast cancer and ovarian cancer," he says.
Labor, also, becomes shorter the more deliveries a woman has, although it doesn't necessarily become easier.
"The duration of labor is shortened, but that doesn't automatically translate into easier," he says. "You've been down that road before. The ability to cope with labor is probably better when you're naïve and 18."
According to the National Center for Health Statistics, the average number of births per female has gone up and down over the years, from 3.33 in 1917 to 2.17 in 1937 to 3.68 in 1957 to 1.77 in 1975. National averages aside, though, there have always been "supermoms," from Queen Victoria and Rose Kennedy who both had nine children to Mrs. Feodor Vassilyev, a Russian peasant who made the Guinness Book of World Records by giving birth to a total of 69 children, including 16 pairs of twins, seven sets of triplets and four sets of quadruplets.
Today, the average woman has about 2.12 children, although if desired, any woman could try for supermom status. The trick is to avoid contraception, be exceptionally fertile and be up for the challenge, says Wells.
"Having that many children isn't an oddity," she says. "I look back at my own family history and my great-grandmother had 10 children and five survived. The fact is most people don't want that many children today."
Those who do want lots of babies are encouraged to space their pregnancies out by at least 18 months, says Wall. And to keep in mind that some women are simply more adept at baby-making than others.
"This woman has some remarkable capabilities," he says. "I think this is her special talent."