After 19th Baby, Michelle Duggar or Any Woman Faces Risks

Dec. 15, 2009— -- Michelle Duggar, star of the TLC reality TV show "18 Kids and Counting," astounded America last week with the announcement of the birth of her 19th child -- Josie Brooklyn Duggar.

For now all eyes are on "micro-preemie" Josie Brooklyn in the neonatal intensive care unit, but doctors point out that the Duggar family tradition of back-to-back pregnancies may be slowly adding to the health risks for Michelle and future Duggars.

"I am not aware of this couple's reasoning on the matter of contraception," said Dr. John B. Coppes of the Austin Medical Center-Mayo Health System in Austin, Minn. "However, I hope they are aware of the risks for Down syndrome, uterine rupture, future C-sections, pre-eclampsia."

TLC continues to report that mother and baby are doing fine at the University of Arkansas for Medical Sciences in Little Rock.

All pregnancy carries risk, but some doctors say any woman, even with Duggar's stamina, increases her chances for health problems with numerous pregnancies.

Dr. Katharine Wenstrom, director of Maternal Fetal Medicine at Vanderbilt Children's Hospital in Nashville, Tenn., rattled off a list of complications, including life-threatening bleeding during birth, risk of heart attack or stroke -- all exacerbated by multiple pregnancies.

"She has an increased risk of uterine atony, or failure, of the uterus to contract after delivery, which can cause life-threatening blood loss and may require hysterectomy," said Wenstrom, who added that women who have multiple pregnancies are at risk for a condition called placenta previa. In such cases, she said, "the placenta implants over the cervix -- also associated with life threatening bleeding."

Although it seems only time is limiting the number of children that families like the Duggars can have, doctors say each pregnancy actually scars the walls of the womb, leaving limited real estate for a new pregnancy.

"Every time you have a pregnancy, the placenta implants in the uterus and that implantation site cannot be used again because it's scarred," said Dr. Diane Harper of the University of Missouri in Kansas City.