As the Duchess of Cambridge (the erstwhile Kate Middleton) prepares to give birth to her second child, the media storm surrounding the birth seems more like a spring shower than the hurricane of coverage that was the lead up to Prince George’s birth. In fact a good chunk of the media coverage has focused on how the new prince or princess is already falling victim to second child syndrome, that phenomenon wherein less attention, patience and resources are lavished on the second child when compared to the first.

Enough about poor prince or princess #2, what about Kate? What’s likely to be different for her this time around? Is there any science to second pregnancies and labors being different than the first or is it the stuff of old wives tales?

We know that Kate suffered from hyperemesis gravidarum in the first trimester with both pregnancies. While hyperemesis gravidarum is rare, affecting between 0.3-2% of pregnancies, women that experienced hyperemesis gravidarum with a first pregnancy are somewhere in the realm of 70-90% likely to experience it again with subsequent pregnancies. Unfortunately the illness strikes women at the same rate, even if there’s a change in paternity from one pregnancy to the next and is so severe that nearly 40% of women that experience it with one pregnancy refuse to have a second pregnancy out of fear of suffering through it again.

The Duchess of Cambridge leaving the hospital after being treated for hyperemesis gravidarum in 2012. Image c/o Sun News.

The Duchess of Cambridge leaving the hospital after being treated for hyperemesis gravidarum in 2012. Image c/o Sun News.

To help her through her first trimester the Duchess likely had plenty of help (including a devoted OB, nanny and maids), so while hyperemesis gravidarum was likely miserable for her, she likely had it easier than other second time mothers that suffer from the illness and don’t have help. In her second trimester it looked like her hyperemesis gravidarum lifted and she admitted this time around she sometimes forgets she’s pregnant. According to a highly informal poll of my friends this is also common the second time around. With that said, those in my informal poll reported feeling much more tired at the end of the day during their second pregnancies, which at 40+ weeks pregnant, we can fairly confidently speculate that Kate is also experiencing.

Kate’s pregnancy with Prince George went a little late leading to a media circus outside the hospital that ventured into the bizarre. Anyone who has been pregnant likely knows the rage that the question, “haven’t you had that baby yet?” causes in a woman in those last weeks of pregnancy, forget the entire world asking the same question in unison. I don’t think you need a peer-reviewed study to know that by those last few weeks, royalty or not, most women are done being pregnant. And it looks like it’s not an old wives tale that first pregnancies tend to go a little long, and Kate’s pregnancy with Prince George followed that trend, to the chagrin of the media dutifully waiting outside. Also likely to vex the media this time around is that post-term pregnancies tend to recur. Thus, as George was a few weeks late, his sibling is also likely to make a fashionably late appearance.

On the bright side, even though he or she is likely to be late, Kate’s second delivery is likely to be shorter and easier than her first. Interestingly, studies have shown that in first-time mothers, the duration of labor increases with the gestational week in which labor begins (meaning, a woman who gives birth at 39 weeks will likely have a shorter labor than a woman who gives birth at 42 weeks). With that said, labor with second babies tends to be quicker and easier than labor the first time around, to the tune of half the time to the tune of about half the length, in large part due to lost vaginal muscle tone.



Hyperemesis Gravidarum Facts. American Pregnancy Association. Accessed April 27, 2015.


Magtira, A., et al. Psychiatric factors do not affect recurrence risk of hyperemesis gravidarum. The Journal of Obstetrics and Gynaecology Research. Volume 41, Issue 4, pages 512–516, April 2015. Accessed April 27, 2015.


Fejzo, M.S., Ching, C.Y., et al. Change in Paternity and Recurrence of Hyperemesis Gravidarum. The Journal of Maternal-Fetal & Neonatal Medicine 2012 25:8 , 1241-1245. Accessed April 27, 2015.


Fejzo, M.S., et al. Recurrence Risk of Hyperemesis Gravidarum. Journal of Midwifery & Women’s Health. Volume 56, Issue 2, pages 132-136, March/April 2011. Accessed April 27, 2015.


Rachel McRady and Omid Scobie. Kate Middleton: “I Sometimes Forget I’m Pregnant,” I “Chase After” Prince George. Us Weekly Magazine. March 11, 2015. Accessed April 27, 2015.


Norwitz, E.R.. Patient Information: Postterm Pregnancy (Beyond the Basics). Up To Date ( Accessed April 27, 2015.


Lurie, S., et al. Duration of labor by gestational week in nulliparous women. Journal of Maternal-Fetal and Neonatal Medicine. March 2014, Vol. 27, No. 4 , Pages 372-375. Accessed April 27, 2015.


My Doctor Online – Labor and Delivery Information. Kaiser Permanente.



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Categories: Policy, Politics, + Pop Health, Pregnancy, Birth + Family Planning