9 Characteristics of a Twin (Multiple) Pregnancy

Congratulations! You’re Expecting TWINS!

This news can either be elating or devastating to you as the receiving parent-to-be, but either way, happy or traumatized, this news triggers the reality that life will from now on be very different!

Chances are that if you’re reading this article, you’ve recently seen an image resembling the one on the right show up on an ultrasound  machine that you were attached to (and no, this is not one of my scan photos). Oftentimes, this news comes as a complete shock because there is no family history (that you know of) of twins “running in the family” as they say … (‘course they run all over my house). But lately, especially with Assisted Reproductive Technologies (ARTs) so prevalent today, more and more couples are half-expecting to learn that twins, even triplets or more, are ON THE WAY!

I’m not here, however, to discuss how this came to be. It’s a FACT, and when your head stops spinning, the crying eases, and you can finally see straight again, you and your husband need to know what you may expect and need to prepare for, from here on in your pregnancy.

If you’ve already been pregnant and delivered a single baby (aka singleton), you’ll note some similarities but also some differences.

What you may possibly experience while pregnant with twins

1. Prenatal Care: You’ll be advised to seek the care of a Board Certified Obstetrician as opposed to a General Practitioner. You can also expect more visits with your OB/GYN for careful monitoring of your pregnancy progression, especially if a complication develops. You can also expect more screening tests (i.e., blood glucose levels, and ultrasounds).

2. Pregnancy Nutrition: You’ll be asked to increase your intake of iron and folic acid, along with your daily prenatal multivitamin. As with any pregnancy, you should eat foods rich in calcium, iron, and protein. It’s also very important that you drink at least two quarts of water each day to prevent dehydration, which can quickly lead to preterm labor.

3. Morning Sickness: Pregnancy nausea is caused by the levels of the hormone human chorionic gonadotropin (HCG). It’s a fact that this hormone is higher with a multiple pregnancies, so the probability of or higher degree of morning sickness will exist. The good news is that this usually subsides between weeks 12-14. (But when you’re as sick as a dog at 7 weeks, you don’t think week 12 will EVER arrive!)

4. Spotting: Light to moderate spotting can occur in a multiple pregnancy, often due to multiple uterine wall embryonic implantation (which can cause slight bleeding). Some cases are due to the early miscarriage of or more babies, which doesn’t necessarily mean a miscarriage of every fetus, and the remaining baby(ies) can be carried to full-term. If bleeding, however, is accompanied by cramping and heavy bleeding with clots, it is no longer “spotting”, and could indicate a more serious problem.

5. Weight Gain: Where it’s recommended to woman carrying a single baby to gain between 20-30 lbs., you can expect to gain approximately 35-45 lbs. with a twin pregnancy (and more with triplets and beyond).

6. Gestational Diabetes and Preeclampsia: The risk for these conditions to develop is higher in a multiple pregnancy. These two conditions (high blood glucose with diabetes, and elevated blood pressure with preeclampsia) can be very dangerous for both mother and baby(ies) if not detected and treated. With careful medical monitoring, both conditions can be managed.

7. Twin to Twin Transfusion Syndrome (TTTS): This is a complication that occurs in primarily identical twins because there is a higher likelihood that the two babies will share a single (monochorionic) placenta. This syndrome occurs when, due to blood vessel malformation and distribution the babies receive an imbalance of nutrients, meaning one twin becomes severely over-nourished, while the other becomes severely under-nourished. Careful monitoring and treatment is required with this condition. Twins possessing his or her own individual placenta (i.e., fraternal twins), will not develop this condition.

8. Preterm Labor: Labor generally comes early for a mother carrying more than one baby naturally due to the fact that the uterus cannot stretch any further toward the end of the gestational period, perhaps arriving between 1-4 weeks before the due date. But also commonly occurring in about 50% of twin pregnancies is much earlier preterm labor that occurs because of the rate of uterine growth, causing uterine irritability which causes cramping and contractions. Higher order multiples have a 100% chance of going into preterm labor, and with preterm labor, often comes the recommendation for bed rest which could be partial or complete, depending upon the degree of symptoms. Careful monitoring and sometimes medication is required to manage this condition.

9. Delivery: Although it is very possible to deliver twins vaginally if the pregnancy is far enough along (I did, for my 2nd set), and the babies are positioned just right, most often than not, twins are delivered via C-Section. It’s safer for both mother and babies if your gestation is 30 weeks or earlier, and probably much less risky from the standpoint of the delivering physician (and offers much lower medical liability).

For further descriptions and explanations, please visit: Pregnancy Help: What to Expect … Twins and Multiple Pregnancies, an article posted on Epigee ™ Women’s Health, and Expecting Twins? 11 Things You Didn’t Know About Twin Pregnancy, an article by Denise Mann, reviewed by Louise Change, MD for WebMD.com.

 

My personal twin pregnancy experiences

… included excellent prenatal care for all three pregnancies; multiple screening ultrasounds (which I came to enjoy once the tech said that everything “looks great”); severe morning sickness for all three (requiring medication during twins 2 and 3), which always ended by week 14 (glorious week 14!); light spotting that lasted a couple of weeks during my last pregnancy, but was of no consequence; the miscarriage of one of my triplets during week 11 of my second pregnancy (but which was not accompanied by any bleeding), and I went to on to deliver my (now-called twins) at 35+ weeks; I gained about 30 lbs with pregnancies 1 and 3, but about 41 lbs with pregnancy 2, because I carried them longer.

I experienced no gestational diabetes nor preeclampsia with any of my pregnancies, nor (because all of my twins are fraternal) did I develop TTTS. I did, however, experience preterm labor with each pregnancy beginning between as early as 18 weeks with my first, and starting as late as 22 weeks with my last. Each led me to 100% bed rest, and although I followed my doctors’ orders, I delivered twins 1 @ 31 weeks, twins 2 @ 35 weeks, and twins 3 @ 31 weeks (to the day as with twins 1!). As far as my deliveries were concerned, you may have heard of the term: V-BAC (standing for a Vaginal Birth After a prior C-section), well, I call my deliveries a “C-V-C”: a C-section, then a vaginal birth, then a C-section. Although my vaginal delivery was no picnic, it was much more rewarding and satisfying an experience, with a much shorter recovery period than either C-section.

If you’re reading this and expecting a set of twins or more, many congratulations to you, with wishes and prayers for a safe, healthy pregnancy, and safe healthy delivery for you!

Blessings ~

Preparing for Twins: What You’ll Need!

The twins will arrives soon, and you know you want to be completely prepared!

Some parents prepare with just the basic needs, and some parents prepare for the arrival of their baby(ies) by purchasing every possible pricey item, gadget, and trendy must-have out there! For most of us in-betweeners, however, who know that the arrival of their twins will mean being sensibly prepared, here are a list of items that I found met all of our needs, three times around.

Obviously, there are many varieties in terms of styles, features and price range, so I’m listing here the items from a general perspective. These aren’t in any particular order, just a checklist to refer to:

Vital Needs (Furniture/Equipment):

2 Cribs — Even if you co-bed your babies when their tiny, you’ll be surprised how soon they’ll need their own space!

1 Clothing bureau or dresser for folded clothing and blankets

2 Infant Car Seat Carriers — My favorite come with the snap in base for easy placement and removal from the car.

Contours Options Tandem Stroller

1 Double Stroller — These come in both front/back and side-by-side styles.

Pros and Cons of each style of stroller:

Front/Back: Advantages— ease in fitting through tight space. Disadvantages—Heavy, bulky, complicated to open and close, small and awkward to reach storage space beneath seats, and children will eventually kick each others’ seat and pull hair. I believe this is true because no one really likes riding in the back or backwards (in the case of the facing each other option in some front/back strollers).

Graco Twin Ipo Double Stroller

Side/Side: Advantages—lightweight, easy to open and close, generous and easy to access

storage spaces under each seat, and babies/toddlers won’t conflict with each other as much side by side as they do front to back. Disadvantages—Oftentimes awkward maneuvering through tight fitting doorways, but most commercial structures have double doors or wide single doorways.

1-2 Baby Swings — In my book, this is a vital need if you plan to maintain your sanity some days.

2 High Chairs (or high chair/booster transition seats) with trays — They will be used as early as 4-5 months when solid foods are introduced. Many allow the seat to recline slightly for the baby who’s not sitting up yet.

2 Portable Cribs — “Pack ‘n Plays” are great for day or overnight trips for naps and night time because they fold down to (a bit heavy) but convenient to carry and pack. They also double as perfect bassinets since most styles feature a bassinet setting option.

2 Snugglies or Baby Slings for ease in baby toting.

1-2 Boppy Pillows for breast feeding or bottle feeding. There is an actual nursing pillow specifically designed for twins!

Not-so-vital furniture/equipment:

Changing table — Where you WILL need changing pads that can be placed on beds, couches, floor, etc., an actual table just for changing is optional. I never owned one, but these could come in handy if they were a combination changing table and dresser. Changing baby in a high place is much more dangerous than on a lower surface, so that may be a factor for you to consider.

Wipe warmer — I thought this would be a wonderful item to have so the wipe wasn’t so cold to baby’s skin. However, as soon as the wipe is removed from the warmer, it hits room temperature in a matter of seconds, and the biggest disadvantage is that the bottom 1/3 of the wipes in the warmer will dry out (and the bottom few actually may turn brown as they slowly “toast”.

Nursery diaper disposer unit — Save your money and just place the dirty diaper in a plastic grocery bag, and get it in the outside garbage can as soon as possible. You really don’t want to keep a dozen dirty/wet diapers piling up in one of those units that are not as odor-free as they claim!

Bouncy seats — Not a must-have, but I actually liked placing my babies in these so they were off the floor and I could move them from room to room. Once baby becomes active, his activity will bounce the seat and he’ll enjoy that!

Infant bath tub — As long as you have a water proof container, you don’t actually need a tub since it’s often easier to bathe baby in a disinfected sink or in the actual bathtub on top of a tub sponge to lay baby on.

Must-Have Accessories and Nursery Items:

Skip Hop Studio Baby Bag

1 Large Diaper Bag — Always-to-carry contents: diapers, wipes, rash cream, little bags for diaper disposal, 1 change of clothing for each baby, bibs/burp cloths, extra bottles for formula if you formula-feed, toys, hand sanitizer … see why it has to be a large diaper bag?

DIAPERS! — If you use disposable or cloth, be prepared to go through 6-8 diapers per baby per day on average. Yes, that’s a LOT of diapers!

Diaper wipes — Again, use disposable (preferably scent-free for baby’s sensitive skin) or soft cloths moistened in water only.

Diaper rash cream — Use this cream to treat rashes and/or to prevent irritation.

Plastic Diaper-Changing Pads

Simethicone Drops for occasional gasiness in baby’s tuummy.

Infant Acetaminophen (Tylenol) for pain and fever reduction.

Manicure Set to keep baby nails trim to avoid scratching herself. Hand Mittens (or socks) help, too.

Baby Wash (many brands are for hair and body)

Crib sheets — (2-3 tight-fitting sheets per crib)

Light Crib Blankets — IMPORTANT: Remember to keep cribs free from clutter such as stuffed animals, pillows, comforter blankets, etc., due to the high risk of smothering/suffacation that can lead to SIDS.

Crib wedges — to place baby in so he will remain on his side or back (never on tummy!), and to also keep co-sleepers separated but still able to hear, feel and smell each other.

Baby Clothing:

6-8 Onsie underwear that snap between the legs per day per child. They will go through these often!

Have LOTS of onesies on hand!

2-3 soft sleepers with feet per day per baby.

15-20 baby clothes hangers

Cotton infant hats

Socks

10-12 Receiving blankets for swaddling

2-3 day outfits per child per day.

Burp cloths

Bath Towels (hooded)

Baby wash cloths

Feeding Care:

Bottle fed babies — bottles, nipples, caps, bottle washer brush, sterilizer rack, formula, and infant cereal from approximately the 4th month on.

Breast fed babies — breast pump, bottles, nipples, caps, bottle washer brush, sterilizer rack.

Breast care — 2-3 nursing bras, lanolin ointment for sore nipples (but breast milk rubbed into sore nipples works very well), hot/cold gel packs (for engorgments and occasional plugged milk ducts), breast pads (cotton or disposable).

When shopping for baby needs, you’ll see every conceivable product (pun-intended!), so enjoy, but be careful not to overspend on the latest and greatest convenience gadgets, because chances are you’ll use them once, twice or not at all!

VERY IMPORTANT PREPARATION:

Nourish Yourself: Remember what YOU eat is what YOUR BABIES will eat

Choosing what you eat and what you don’t eat is so important, before pregnancy, during pregnancy and after pregnancy. You must be mindful of the foods you put in your body. There may have been a time when eating left over pepperoni pizza for breakfast, drinking diet cola or other high-caffeine sodas all day long, and greasy cheeseburgers for dinner worked for you (or so you thought) at one time, but now that you’re a mom, EVERYTHING IS DIFFERENT. You’re completely responsible for the health, wellness and future growth and development of your babies! I’m not saying that an occasional slice of cheese cake or a lean burger now and then isn’t just fine, but NOW IS THE TIME that you learn the importance of proper, complete nutrition, because it’s just about you anymore.

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Proper nutrition, sleep and exercise nourish your body and provides you with physical, spiritual, emotional and mental wellness that radiates into all the aspects of your life and the lives of your family.
 For information on how you can attain optimum health and wellness, please contact me at: franpitre.reliv@gmail.com

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Blessings and Congratulations on the soon arrival of your twins!