It’s no secret that Michelle Duggar, star of reality TV show “18 Kids and Counting“, just had her 19th baby, Josie Brooklyn, recently – and doctors are counting the reasons why she shouldn’t have.

All pregnancies carry with them risks, such as fatal bleeding, stroke and cardiac arrest – and all of these are complicated further by multiple pregnancies. Each time a woman undergoes a pregnancy, her uterus is “scarred” in a number of ways that inflict greater risk for herself and her next child. Surgery during labor, such as a c-section, also complicates the mother’s state, rendering her less and less able to undergo another healthy pregnancy.

Repreated pregnancy also stretches the muscles in the uterus. While this means that a woman would be able to undergo labor relatively easier (because her muscles are already used to it), it also means that her muscles have been substantially weakened, and may not be able to support a child sufficiently during labor. In some cases, the uterus may actually fall into a woman’s vagina along with the baby.

It doesn’t end there, however. Doctors and professionals are also warning against the effects of multiple pregnancies, not only for the mother, but also for their children and, in turn, their offspring as well.

“I am not aware of this couple’s reasoning on the matter of contraception,” shares Dr. John Coppes in a report by ABC News. “However, I hope they are aware of the risks for Down syndrome, uterine rupture, future C-sections, pre-eclampsia.”