The Health Issue Usha Vance Struggled With During Her First Three Pregnancies

Vice president JD Vance and second lady Usha Vance already have three kids, and now they're going to have a fourth. Usha confirmed the news on social media, which also included an approximate due date (July) as well as a gender (male). Usha's pregnancy could explain why she has was out of the spotlight throughout January. There can be all kinds of challenges that come along with being pregnant, and in Usha's case, it could be that she's having a repeat of the anemia that she had with her first kids.

Usha spoke about her earlier pregnancies on the YouTube show "Citizen McCain with Meghan McCain" in June 2025. She said: "I was prone to anemia, which just makes you so tired, and you're already kind of tired and especially when we were having our third child." With that third pregnancy, she confirmed that she "was completely exhausted," so we wouldn't be surprised if Usha continued to keep a low profile.

Anemia can be a common issue when you're pregnant. Your body has more blood in it when you're pregnant, and if you don't have enough iron in your system for that increased burden, then you can become anemic, according to the American Society of Hematology. It happens most often in the second and third trimesters, and it can be treated by upping your consumption of iron-rich foods and/or taking iron supplements (advisably while under a doctor's supervision).

In her conversation with Meghan McCain, Usha Vance also spoke about how, at that moment, she was happy with having three kids. She did note, "Sometimes [JD Vance] thinks he might like to have a fourth, but we — we'll see where that leads." Sounds like not long after this interview, the two of them got on board with having the fourth kid.

Usha turned 40 on January 6, 2026, so she is considered to be of "advanced maternal age," which is used to describe anyone who is 35 or older and pregnant. This comes with some slightly elevated health risks and chances for complications. Usha was in the same situation for her third child; their daughter Mirabel is just three years old. So, it sounds like she knows what she's in for with the potential for developing anemia again in her fourth pregnancy, and we're sure that she and her doctor have discussed her medical history and made plans for whatever might happen as the pregnancy progresses.

Usha and JD are going to be making history, as no other vice president has had a child while in office. Theirs is yet another high-profile pregnancy during Donald Trump's second term. Press secretary Karoline Leavitt announced that she was pregnant in December while Stephen Miller and his wife Katie Miller are expecting their fourth child.