Why are there MISCONCEPTIONS about Multiple Pregnancies?

“Wow, are all those twins yours? Were they all natural or ‘were they fertility’?”

That’s the way it’s always worded, seriously, and I still cannot get over how very intrusive, rude and indignant that second question (that invariably follows the first) is each time it is asked. I also could never imagine myself asking that question of any other mother!

And in considering this rude question, it begs another: Are only those sets of twins or multiples that occur without medical assistance considered “natural”?  Yes, they would be considered “naturally- or spontaneously-occurring”, but should the many twin pregnancies and twin babies resulting from medical intervention through, for instance, fertility medications or office procedures/surgeries be perceived as artificial in some way? If so, how does this perception affect the parents of babies who resulted from medically-assisted pregnancy attempts? No parents wants to think (or have anyone else think) of their precious children as somehow artificially-created.

Identical twins are not usually products of infertility treatments since they result from the spontaneous splitting of a single embryo, and are not the result of more than one ovum (egg) released during one given cycle. Fertility treatments, for the most part, intend to elevate a woman’s chance of conceiving by increasing the number of egg-containing ovarian follicles in one monthly cycle. Pregnancy odds are increased with this treatment alone, or when combined with a procedure such as assisted insemination (aka artificial insemination), or with one of the procedures under the heading of InVitro Fertilization (IVF). IVF offers the highest percentage of pregnancy success in the infertility industry today. It is a process by which more than one embryo, which were products of in-laboratory fertilization, are transferred to the uterus in the hopes that one or more will implant and result in pregnancy of a single baby or of fraternal twins (or more).

Many fraternal twins, however, occur spontaneously. In other words, these twins are products of the woman spontaneously ovulating more than one egg (hyperovulation) in one cycle, and each becoming fertilized. Personally speaking, I must have ovulated two eggs the month that I became pregnant with my last set of twins! My first two sets, however, were first-attempt G.I.F.T. babies. G.I.F.T (Gamete Intrafallopian Transfer) is a procedure where the egg and sperm are retrieved, then individually placed into the open end of a woman’s fallopian tube. When that procedure is complete, all fingers are crossed and prayers are said in the hopes that fertilization would naturally occur now that the gametes were placed in close proximity, and that the resulting embryos would implant and cause a pregnancy. In our case, the lack of sperm motility (swim-ability) was the infertility issue, so once we took that factor out of the equation, I became pregnant and stayed pregnant quite successfully.

Not all procedures are appropriate for every couple. Many factors (including situation-appropriateness, philosophical and religious beliefs) must be considered and discussed with each couple’s physician before any infertility treatment should be considered and pursued.

More and more couples experiencing infertility problems are becoming parents with medical assistance, and the number of couples seeking fertility assistance rises each year because they are waiting too long before starting a family. Publicity and journalistic reporting on the commonality of fertility treatments and the resulting births has contributed to the public’s perception that most twin or multiple pregnancies are the result of “artificial infertility treatments”, which further feeds public opinion that children are being artificially created.

As parents of our multiples (and multiple multiples), we know better. We know that our children are our children. They are the products of our love, whether they were conceived with or without assistance. Lastly, and most importantly, God has the last say in whether or not a child comes into the world, and there’s simply nothing artificial about that!

9 Tips for Surviving Pregnancy Bed Rest!

Whether you developed a complication early, midway or later in your pregnancy, being placed on 100% pregnancy bed rest by your physician can sound kinda nice to begin with, but believe me (and I’m preaching from lots of experience) … it gets pretty old pretty quickly! But this prescription, if you will, has a very important indication: to keep pressure off the cervix so it does not shorten (or continue to shorten) or dilate, as well as to keep your uterus quiet and contraction-free.

So, once you accept the fact that this is your life for the next few weeks or even months, the best way to survive this situation with all its aches, pains and other challenges, is ATTITUDE. My best advice would be to approach each day as a new gift, another day that you’re still pregnant, and that the baby(ies) are still safely inside where they should be. With this thankful attitude, it’s much easier to face each day.

 

Here are some ways that I found to make the best of bed rest:

1- Switch it up. If your bedroom and a living room/family room are on the same floor of your home, then alternate your scenery by setting up camp on a sofa, and keep the bed for sleeping. You’ll appreciate not having to look at the same four walls day after day. I would NOT recommend however, traveling up and down stairs, so stay on one level.

2- Creature comforts. Surround yourself with your favorite things: favorite pillows, family pictures and other items that comfort you, especially if you’re placed on hospital bed rest.

3- Catch up with friends. Have friends come over and bring lunch! Just because you’re activities are limited, doesn’t mean that everyone else’s are. Chatting and visiting on the phone is another great way to relax and enjoy the company of others. With facebook, and other social media, mommy blogs and forum discussion access today, you can stay connected with (and not feel so isolated from) the world so much easier than even a few years ago!

4- READ! If you enjoy reading like I do, here’s your chance to do all the reading you want! If you’re not a big reader, now would be a good time to rethink that! 🙂

5- Fun with light activities. Movies, board games with friends and family, crochet (I know that sounds so cliché), cross-stitch, and some light craft work while you stay on your side gives you a chance to do something productive.

6- Discomfort solutions. I highly advise that your bed or couch be equipped with some memory foam, and (at the least), the egg crate foam for better comfort on those painful pressure points, such as the hips, shoulders and buttocks. I also recommend a body pillow (or two). These are great for relieving pelvic stress by keeping your top leg resting on the pillow. It also serves as a great book rest! Luckily, when bed pressure pain becomes uncomfortable, your doctor will allow you to take acetomeniphen (Tylenol) which can greatly take the edges off. Stuffy nose and congestion can often be an issue, especially with your lack of circulation, your head not being as elevated as usual, and your increased blood volume expanding your nasal blood vessels. The adhesive strips that you place on the bridge of your nose (Breathe-Right nasal strips) worked wonders for me! Constipation (which occurs naturally with pregnancy) is exacerbated by your lack of activity because activity encourages an efficient metabolism. On top of that, let’s add the constipation-causing IRON supplements that your doctor may subscribe if you’re anemic or have low iron. Solution: eat lots of fiber, along with all your other nutritious foods, cut back on cheeses and other known-constipating foods, and stay hydrated.

7- DRINK! (lots of water, that is). As I stress in my article on preterm labor: DRINK, DRINK and then DRINK some more. Bathroom trips are allowed and very welcomed. The little bit of walking does wonders for your comfort and also helps to avoid developing blood clots due to lack of circulation. Frequent urination also helps to keep the uterus quiet and less irritable. Uterine contractions often accompany a bladder in spasm. Don’t hold your bladder at all because a bladder infection could result, and this type of infection often leads to preterm labor.

8- Eat several light meals a day. Yes, your nutrition is vital to a healthy you, a healthy pregnancy and healthy babies. Bed rest, however, is not the time to eat large, heavy meals. You’ll be asking for heartburn, indigestion and increased constipation problems. Eat 6-7 light meals a day and be sure to include a variety of fresh fruits, vegetables, lean meats and fish, fresh dairy and lots of whole grain. Remember to take your multi-vitamin (either in pill or powder/shake form) in order to fill in the gaps in your body’s nutritional needs.

9- Older children. Having older children can be both a blessing and a difficulty. If they are very young and need constant care, you may need to recruit some live-in help, such as your mom, an aunt, or a very generous friend. If this isn’t possible, you could (as I did for a few weeks) hire a mommy’s helper to assist you with simple tasks under your watchful direction until your husband returns home from work. If your children are school-aged, helping with homework is still very doable. They just have to bring their books and materials to you so you all can work at a coffee table. Remember that your older kids want to help you, so let them refill your water bottle, bring you snacks or pillows, or put in a new DVD! At one point I called my couch my “Central Command Post” from which I could delegate chores, plan activities, plan meal menus a week at a time, create grocery shopping lists for my husband or other aide, and encourage the older kids to help with their younger siblings. I also could see and hear what was going on with everyone, too.

Bottom line: bed rest is manageable. In spite of all its challenges and the many times you just want to get up and go … anywhere, you can always rest assured that you are doing everything possible to keep your baby(ies) from being born too early. Being continually grateful for all the help and care you receive, and meals friends and neighbors bring, will keep you centered and humble. You’ll simply have to give up some control and know that this will end. And when all is said and done, isn’t that worth this temporary condition?

For other tips on coping with prolonged bed rest, visit: Inhabitots.com.

My personal pregnancy bed rest experience …

… I began bed rest at 18 weeks with my first set which lasted until they were born at nearly 31 weeks. I began bed rest with my second set at approximately 20 weeks which lasted a grueling 15 weeks! My third set pregnancy bed rest began around 20 weeks as well, and lasted until I reached nearly 31 weeks, when my sons just couldn’t wait any longer to see the world! And we all made it through it all with lots of support, love, prayer and care!

 

Blessings ~

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 one 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 faster 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 twin set 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 ~