Just yesterday, Jim Bob and Michelle Duggar announced that they weren’t done counting quite yet. The famous Duggar family, from the TLC show 19 Kids and Counting, is expecting another addition next April. If you’ve lost track, this will be their twentieth kid. A God-given gift to the couple, however, also sparks controversy and questioning for many.

The couple, best known for their television program, has a reputation for being hardcore Christians. That being said, Jim Bob and Michelle have let God plan their lives out day to day. Popular assumption for the Duggars’ choice to have so many children comes down to their strong opposition of birth control. I respect the family’s religious and nonreligious views and admire their outlook on bringing new lives into this world, but when does a line need to be drawn?

Number 19, Josie, born in December of 2009, was born over three months premature. As a result, she weighed less than two pounds at birth and suffered birth complications including a perforated bowel. This was a cause of Michelle’s pregnancy-caused preeclampsia and gallbladder problems. I’m no expert on pregnancies, but it’s obvious that child bearing at the age of 45 is quite risky. It’s a shame to face the fact that you’re getting older, but with health risks and time against her, Michelle should really face the realities of another pregnancy. Given the difficulties that Josie faced, chances are high that another pregnancy may only provide more serious and detrimental complications.

While one may instantly think, “she doesn’t need anymore kids” or “she can’t take care of all those kids,” the most realistic accusation is that her choice to endure another pregnancy could be considered selfish. I certainly wish the Duggar family the best and hope that Michelle’s pregnancy goes well, but if birth control isn’t an option, figure something out before we make it to 21.