Jul 032012
 
About twin pregnancies

Pregnant with Twins (Flickr: chrismar)

A pregnancy with twins is an exciting time, and one undoubtedly filled with lots of questions. Compared to our first child (a daughter), the twin pregnancy was similar in some ways, but different in many.
Contents
Detecting Twins
Pregnancy Symptoms with Twins
Medical Care for Twin Pregnancies

Detecting Twins

When you’re pregnant with twins or multiples, you have twice (or more) the amount of hormones that a normal pregnancy brings. And that’s a lot. This, and the fact that multiple babies are growing inside of you, can give some hints of what’s going on before it’s official. The raging hormones can have a more dramatic effect, especially if you’ve given birth to a single child before and know what that’s like.   Sometimes a multiple pregnancy can give rise to higher-than-expected levels of hCG (the pregnancy hormone).

The official diagnosis, however, will be made by ultrasound. Multiples are often diagnosed at the same time that your pregnancy is confirmed, or at 12 weeks when a better picture is possible. Here’s the thing, though: twin pregnancies can be missed. I know this because it happened to us. They didn’t notice it in the first ultrasound. They didn’t notice at 16 weeks when we went in after a fall. It was at 20 weeks, during a routine ultrasound, when we reminded the technician that we didn’t want to know the gender and she casually remarked, “You might get one of each.”

“What?” we asked. We thought perhaps she was referring to our daughter who was wandering around the room poking at expensive medical equipment.

“It’s twins,” she said, as if stating the obvious.

I didn’t believe her until I saw both heartbeats for myself. And let me tell you, that was a special moment.

Pregnancy Symptoms with Twins

Given that the odds of having twins are around 3%, we certainly didn’t expect it. Compared to our first, the twin pregnancy was different for us in a number of ways. First, the morning sickness was worse, which isn’t surprising given that there’s twice the amount of nausea-inducing hormone in play. This time around, the OB/GYN prescribed an anti-nausea medication that, although it brought other side effects, seemed to help with the morning sickness. Even so, the other symptoms we noticed were right out of the book What to Expect When You’re Expecting, which has a great section on carrying multiples.

  1. Appetite and cravings. A ravenous around-the-clock appetite isn’t surprising, because your body knows that there are multiple little ones to feed. The cravings can be different, too, and more pressing. With the twins, the cravings were for sweets and junk food. With our daughter, it was all vegetables and cheese.
  2. Sensitivity to smells. Any woman who’s been pregnant can tell you that the smells are one of the worst parts of it. Things that you normally love – like onions – are suddenly enough to make you want to throw up. Cleaning agents and food smells seemed to be the worst offenders.
  3. Fatigue. Carrying around multiple growing babies is hard work! The reasons are obvious late in pregnancy, when you’re dealing with all kinds of extra weight, but even in the first and second trimesters, the increased fatigue was really noticeable for us.
  4. Weight gain. Speaking of which, there will be extra weight gain. Experts say that a woman carrying twins should gain 35-45 pounds. For triplets, it’s 50 pounds! So go ahead, have another cookie. You’re eating for 3 now!

Medical Care for Twin Pregnancies

Not all twin pregnancies are high-risk, but if you’re expecting multiples then you can plan on some extra medical care. Depending on the type of twins you’re having and how far you’re along, you might expect:

  • Extra OB/GYN visits. You’ll probably go in for extra visits for checks and monitoring. Towards the end, we were going in once a week, usually just to get hooked up to the monitors. One benefit of this is that you tend to get lots of ultrasound pictures for sharing with friends and future baby books.
  • Longer OB/GYN visits. Yes, here’s one that they don’t really warn you about: expect all of your visits to take almost twice as long, because each twin gets the same.
  • Bed rest. The possible risks of carrying twins make it more likely that you’ll be assigned to bed rest at some point, especially late in your pregnancy. And by the way, “bed rest” doesn’t mean that you try to lay down a bit more while you’re at home. It means that, except for using the bathroom, you lay in the bed! This minimizes the toll on your body and the time you spend upright.
  • Early arrivals. Everything I’ve read suggests that, on average, twins are delivered at 34 to 35 weeks. Ours came at 33 and a half weeks, a bit earlier than our doctors wanted (and relegating us to a couple of weeks in the NICU). So you should have your bag packed and the nursery ready extra early! If your water breaks or you get bed rest, you’re officially out of time.
  • Delivery options. Our first daughter was born naturally. Usually that means you’ll be encouraged to deliver future babies the same way, because you have a “proven pelvix.” For our twins, though, we had the option of choosing cesarean even if there was no medical need. It was nice to have that choice.

There’s good medical science behind all of these things, and the ultimate goal is to do what’s best for your little ones.

 

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