Usha Vance rarely peels back the curtain on her family life and marriage to JD Vance, but that all changed in June 2025, when she agreed to give an in-depth interview about her journey to becoming second lady and her life as a busy mom. The Yale University alumna was working as a full-time attorney when she and the now-vice president discovered they were pregnant with their eldest child, Ewan. As first-time parents, this filled them with joy, but the road to parenthood turned out to be far more complicated than either of them had hoped.

Appearing on “Citizen McCain with Meghan McCain” podcast, where she inadvertently fueled those divorce rumors circling her and JD, Usha revealed that she struggled with anemia during each of her three pregnancies, which left her feeling constantly depleted. “Especially when we were having our third child… I was completely exhausted because I had a trial right before she was born,” Usha recalled. “It was actually a little bit different, because pregnancy was so exhausting that not being anemic was just like, you know, high on life and that really helped.”

Even more difficult was her transition into motherhood while starting her final clerkship at the Supreme Court just seven weeks after Ewan was born (incidentally, not one of the rare times we’ve seen JD and Usha’s children). “The week before I started that job we were still mostly nocturnal, and I wasn’t awake during the day,” Usha said. “I had to kind of switch to being awake and functioning during the day and sleeping at night … so that was a really rough transition for us.” To better understand her struggles, we spoke to Dr. Natalie Crawford, a board-certified OBGYN and reproductive endocrinologist, about the causes and complications caused by anemia during pregnancies.

“Anemia is quite common in pregnancy,” Dr. Natalie Crawford told Nicki Swift exclusively. Anemia occurs when the body lacks enough iron to produce the red blood cells needed to supply oxygen to tissues. However, it can also be triggered by physiological changes caused by pregnancies. Common symptoms of iron deficiency anemia include extreme fatigue, constant headaches, pale skin, and shortness of breath. Left untreated, it can also increase the risk of pregnancy complications such as premature birth or fetal growth restriction. Dr. Crawford recommends taking a daily prenatal supplement with at least 27 milligrams of iron, along with Vitamin C to help the body absorb it properly. She also encouraged incorporating iron-rich foods into the diet, such as lentils, beans, vegetables, and meat.The other thing about anemia is it can be pretty hard to distinguish from symptoms that are usually present during pregnancy. “So it is important for loved ones to help recognize these and support getting medical attention,” the doctor stressed.

Despite her challenging pregnancies, Usha Vance refused to let the hard parts of her journey overshadow the joy of becoming a mother and watching her family grow. She shared in her interview with Meghan McCain how having kids with JD Vance fundamentally changed how she lives her life. “It showed me a little bit about how much time I had been wasting before and how much more efficiently I could run my professional life in a way that would allow me to be the kind of parent I wanted to be,” Usha said. Raising Ewan, Vivek, and Mirabel also totally changed how she views the world. “I spend a lot more time looking at bugs now, like affirmatively hunting out insects and [calling the] kids over, so everything that I see is just different.”