Twin pregnancies and beyond

More women these days can expect to have twins than in the past.

Over the last 20 years, multiple births have risen sharply, probably due to the rise in use of fertility treatments and the fact that many women are choosing to start families later in life (as women get older, their ovaries are likely to release more than one egg each month).

For many parents, finding out that they’re soon to be parents to two babies is a big shock. Although it’s exciting news, it can also be extremely daunting to contemplate a 2.4 family situation arriving all at once in less than nine months’ time.

Your feelings

Even if this pregnancy isn’t your first, being pregnant with two babies is a completely different experience to a singleton pregnancy. As well as dealing with the physical demands of carrying two babies, you need to factor in the emotional implications. Discovering you’re pregnant with twins can be a huge shock for both yourself and your partner and you shouldn’t underestimate the range of feelings that you may be working through. Try to make time as a couple to explore your feelings on this subject and keep the communication lines open. Remember that your partner may be experiencing the same degree of anxiety as you and try to include him in the pregnancy process as much as possible to help allay his, as well as your own, fears.

Childbirth education classes are an excellent way for you both to learn more about your twin pregnancy and labor and are a good way of preparing couples for the huge changes to come. They also provide a venue to ask questions and meet other expectant couples. It can be really useful to meet other parents of twins before yours arrive, so use gurgle’s groups area to make contact with other members who’ve experienced twin pregnancies.

Your pregnancy

Aside from all the usual symptoms that occur with a pregnancy, twins place extra demands on your body. Morning sickness and heartburn are likely to be worse. Your blood volume with twins is nearly double your pre-pregnant level, which means your heart is going to have to work much harder than normal and you may suffer with fatigue. You’re at more risk of anemia, as your need for iron to make enough red blood cells increases at this time and you’ll likely feel extremely tired as your body fights to work under pressure.

Don’t make too many demands on yourself. If you’re feeling unwell or exhausted speak to your boss to see if you might be able to start work later or even do some work from home. Try to set aside time to rest and do activities that help you to relax, such as pregnancy yoga or swimming.

You won’t be able to keep your pregnancy secret for too long – you’ll get a bigger bump at a much earlier stage. Women who are carrying twins can expect to gain as much as 50 pounds during the course of their pregnancy, but your weight gain may be lower depending on your height, weight and health. Your OB-GYN or nurse-midwife will be able to advise you on what’s appropriate for your body.

Your twin pregnancy will be closely monitored due to the increased risk of medical complications, such as pre-eclampsia and twin-to-twin transfusion syndrome. This can occur when twins are sharing the same placenta – it’s possible their circulation may be connected and there’s a risk that one twin may suffer a decreased blood volume, which can restrict his growth.

Your labor

Be aware that the birth you want may not be possible on the day. Each labor is unique experience and with twins, complications are more likely. It’s important to prepare yourself for the fact that things may not go quite according to your birth plan – for example, you may want a vaginal birth and end up having a cesarean – but these factors don’t mean that you have to lose control over the experience. Write a birth plan, but expect to be flexible.

One of the biggest risks with multiple pregnancies is pre-term labor. Although 37 weeks is regarded as full term for a twin pregnancy, it’s possible your babies may decide to make an appearance sooner. Thanks to huge advances in medical technology, preemies have excellent survival rates. Try not to waste energy now worrying about premature labor – but pack your labor bag early so you’re ready to head for the hospital if the need arises.

The important thing to remember is that if you do need to have a cesarean you’re going to need some extra postpartum support, as you’ll be caring for two babies while recovering from major surgery. Try not to feel disappointed if you were set on having a vaginal delivery – birthing your babies safe and well is all that counts.

The first six months

You may be wondering how on earth you are going to cope with two newborns. The answer is that you just are! Thousands of parents do it every year and you will too. Of course it’ll be challenging at times – but the rewards will be double.

You’re going to need a lot of help and support from family and friends so don’t turn down any offers of help. De-prioritize less important household chores and if you haven’t done so already, discuss with your partner how you’re going to be able to help each other when your babies are born. Some moms recommend getting into a routine as quickly as possible; others advise that you go with the flow and avoid getting hung up about making life manageable. Accept that there’s only one of you and that there will be times when one of your babies needs your attention while you’re busy with the other. Many parents of twins report that their babies are more independent and easier to care for, and develop more stable sleeping patterns early on, because they get used to having to wait a few minutes for the attention they seek.

Take as much time off as you can financially withstand – the Family and Medical Leave Act provides a maximum 12 weeks unpaid leave. If you feel you need more time, negotiate with your boss – it might be possible for you to take a longer leave or do some work from home.

Paying the price

One reality of twins that hits hard is the financial cost. You’ll need to kit yourselves out with two of everything (try auction websites, Goodwill, the local small ads and the forums on twins and multiples websites). If your babies have to spend a long period of time in the neonatal intensive care unit (NICU) medical bills will be high. Once home, you’ll need to provide formula for two if you’re not breastfeeding, plus double the number of diapers. If you’re going back to work, childcare costs can be high.

It can be a struggle, but don’t put too much pressure on yourself and you’ll survive the early days.

Helpful advice

The National Organization of Mothers of Twins Clubs (www.nomotc.org) can put you in touch with other local parents of twins and offers advice on buying gear for twins. It also offers support services to individual families.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

Related Articles

• Mum Health: Colds, flu and stomach bugs during pregnancy
• Mum Health: Heartburn in pregnancy
• Guide To : Pregnancy: Teenage pregnancy
• Guide To : Pregnancy: How pregnancy affects your vision
• Guide To : Pregnancy: Pregnancy amnesia