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Plot hole: In this episode Kes states that she has to decide now whether to have a child or not because Ocampa women can only get pregnant once and deliver one child. If that was the case they would have died out a long time ago, or never even evolved, as two people only getting one offspring would reduce the population to 50% of the original figure each generation.
The Doctor: Watch your tongue... Or I'll remove it.
Trivia: Rain Robinson has a model of a DY-100 on the window sill in her office. In 1996 (also the year this episode is set), Kahn left Earth in the SS Botany Bay, a DY-100 class starship.
Thirty Days - S5-E9
Question: Was Tom successful in his mission or did the torpedo that was launched by Tuvok from Voyager stop him from succeeding?
Answer: The torpedo stopped him from succeeding.
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Suggested correction: It's also possible that it's simply required of Ocampan women to give birth the first time they go through it, and can then experience it again.
Greg Dwyer
Nothing in the dialogue suggest Ocampa's can have additional children. While we can speculate about fictitious species, it's still a plot hole due to writing. Kes states she's going through the "elogium" which is a time of change where her body prepares for fertilization. She then explicit states the "elogium" only occurs once. While the doctor compares it to puberty, the elogium is both sexual maturity and "heat", that is, the time a female is ready for fertilization.
Bishop73
But it doesn't ever state the normalcy of birthing for Ocompans. Perhaps sextuplets is the norm?
Kes frequently used the word "child." If it was normal to give birth to more than one, she would know this and should say "children."
Bishop73
Do not forget that this is all done through the universal translator. For all you know the Ocompan word for child and children is the same so the translator cannot tell the difference.