Hellobee

This post has been co-written by Mrs. Train, mama to twin boys, and Mrs. Blue, currently pregnant with twin boys.

~~~

Multiples are a thing of natural curiosity, so mamas of twins get lots of questions about their pregnancy, their babies, and how they manage to raise two at the same time.  Here’s a little peek into a few of the differences between carrying one baby and carrying two.

Mrs. Train:  I think the good part about a twin pregnancy is that at the end you get two beautiful babies.  It’s twice the work and twice as scary, but it such a joy as well.  The anticipation of meeting two new babies is just incredible.  The worst part for me was the high risk pregnancy issues. I was constantly worried if baby B would still be alive the next week.  It’s a horrible pressure to have to endure each week.  Also all the aches, pains and nausea are all twice as bad.

Mrs. Blue:  The best thing is definitely all the babies you get!  I also really love thinking not only about what each one will be like, but also about what their relationship will be like, what they’ll do together, the tricks they’ll play on people, etc.  It’s twice the kids to dream about and look forward to mothering.  The worst things have been (1) all the constant worry about something going wrong, and (2) the discomfort and exhaustion.  Because our pregnancy has been high risk, I’ve lived in constant fear of the next ultrasound showing a problem. Now, at 32 weeks, I feel more at ease, though I still worry.  The last couple of weeks, I’ve gotten to the point of being super, duper uncomfortable.  It’s hard to sleep, to move, to get through my day at work.  I’m measuring 40 weeks now, and I can’t imagine how I’m going to waddle my way through another 4-5 weeks!

Mrs. Train:  The fact that more than one infant will be coming home with you from the hospital can be alarming. The need for more accommodations can be daunting.  We had a nursery set up for our oldest son.  Now all of a sudden we were going to have to figure out where to put two more cribs.  I think, especially in the case of new moms who don’t know what to expect from infancy, being thrown into it with two can be difficult.    Nothing can truly prepare you for motherhood, and certainly not for mothering multiples.

I think there is a lot more worry about bringing home two or more babies.  There is a lot more worry about their care and well being.  Some are born premature and have other health issues that need to be addressed; others are fine and come home in a few days.  All of these things are possible with a singleton but they just aren’t as common.

Of course there is also the concern of how you will get home.  Do two backwards facing car seats fit in my car?  How about three?  Off to the car dealership we went. Three car seats, room for three strollers, room for stuff for three babies.  The car was a big deal for us.

Mrs. Blue:  It’s been challenging to try to figure out how to fit two infants into our lives, and it’s something I suspect we’ll have to keep working on long after they arrive.  Physically, finding a way to fit two cribs into our nursery was enough of a challenge, plus trying to find places for swings, bouncy chairs, rock ‘n plays, and all those other baby “musts.”  We’ve had to really consider what items we need two of, what would be nice to have two of, and what we think one is sufficient.  Financially, we’ve had to rework some areas of our budget, and we’ll definitely have to cut down on most of our non-necessity spending.  We had a budget all worked out for how to have one baby and still have a comfortable lifestyle on our current salaries, which are lower than average because we work for the government for the next 1 1/2 years.  Adding the cost of another infant definitely makes our finances tighter than we expected.  Last, on the practical side, I’ve spent a lot more time trying to figure out the answers to questions like, “How do I take two infants to the grocery store since two carriers in a basket doesn’t leave room for groceries?”  (FYI, I hear the answer is wear one and put the other in the basket.)  It’s been challenging to try to figure out the practical logistics of raising two babies, and I’m sure that will be an on-going learning process.

Mrs. Train:  Mine was very different. With my twins I was monitored weekly from week 12 to 32. This was due to our Twin to Twin Transfer issues. The doctor never seemed confident enough to let me go two weeks in between visits. At 32 weeks I started having heart monitoring twice a week at my OB’s office, plus my ultrasound at the perinatologist. That brought my doctors’ visits up to three times a week. It was insanity. At 35 weeks my perinatologists looked at me and laughed and said “OK, I can recommend to your OB that you are ready when she is to deliver. I never thought you would make it this far. I really thought we were going to have to take you into surgery before week 20.” I stared blankly and said “Well I’m sure glad you didn’t tell me that 20 weeks ago.” I was also hospitalized three times for extra monitoring during my last few weeks of pregnancy. Each time I thought they were going to do my c-section and each time they sent me home. Finally at 37 weeks my preeclampsia got bad enough that they did a c section and my boys were born.

With my single daughter things were so different. I went in once a month, had two ultrasounds the whole time, never had any concerns at all and went on to have a calm scheduled c-section at 39.5 weeks. It seemed like a breeze. There were some weeks when I had to go back and do the math to figure out how many weeks along I was, whereas the twins I was counting the days to viability.

Mrs. Blue:  This is largely variable depending on the type of twins you have and the approach of your OB.  If you are having di/di twins, there’s a good chance the early part of your pregnancy won’t be treated drastically different, unless you have some other complications.  With mo/di and mo/mo, expect more frequent ultrasounds and seeing a Maternal Fetal Medicine specialist (MFM).  With all twin types, you probably see your OB more frequently earlier than with a singleton pregnancy.  I got bumped to every 2 week visits with the OB at around 26 weeks, and starting this week (32 weeks), I’ll go every week.  Add to that the every other week ultrasounds, and I miss a lot of work for appointments (though not as many appointments as Mrs. Train had!).

Mrs. Train:  So this is going to be a pretty embarrassing thing to admit. I gained 90 pounds with my twins. Although before the last month it was at about 55. I gained almost 35 pounds in the span of a few weeks. It was all water retention due to the preeclampsia I had developed. It resulted in huge stretch marks everywhere on my body starting at my arms and going all the way down the back of my legs. I was doing pretty well with the 50 pounds but that last month absolutely killed me. The good thing about water weight is it comes off quick. I had come down 50 pounds before my 2 week postpartum visit. My mom called me the incredible shrinking woman. With my single pregnancy I gained 45. It is still higher than recommended, but I really tried not to gain much and it still happened.

Mrs. Blue:  As a general rule, moms of multiples will measure further along than the gestational age of their babies.  For example at 12 weeks, I measured 14 weeks pregnant.  At 29 weeks, I measured at 36 weeks pregnant.  At 32 weeks, I’m clocking in at over 40 weeks pregnant.  According to my OB, this can change from week to week depending on the position of our babies.  If they are more side-by-side, your fundal height won’t be as big, whereas if they are more on top of each other, your fundal height will be increased quite a bit.  If you’re expecting multiples, definitely buy stretchy maternity clothes because by the end you are likely to be measuring quite a bit over 40 weeks pregnant.  Since I’m not at the end of my pregnancy I can’t say exactly what my total weight gain will be, but right now I’m up 33 pounds all of which seem to be centered in my tummy.  This means my maternity shirts now barely cover the bottom of the bump, and some will definitely have to be retired before these boys arrive.  At my practice, they generally recommend gaining 25-35 lbs for a single baby and 35-45 for twins.

Mrs. Train:  There are so many increased risks. My biggest concerns were gestational diabetes and preeclampsia. Luckily I never developed GD put preeclampsia showed its ugly face around 32 weeks. I kept them in for several more weeks but it was getting increasingly difficult to deal with the pregnancy. I also had a weird problem with my hips that has never fully recovered. I had such severe hip pain I was unable to lay on my sides anymore.  I slept in the recliners on our couch. Even now my hips are a little wonky and I have pain if I have walked a lot during the day. The best I can describe it is that my hips don’t always feel like they are fitting together correctly. My OB said it was due to baby growth and there wasn’t much we could do. So I have beautiful babies and wiggly hips and now my blood pressure is back to its normal low self.

Mrs. Blue:  The biggest across the board increased risk is probably preterm labor.  It doesn’t matter what kind of twins you are having, this is always a concern.  I have worried quite a bit about that, although after hitting 32 weeks I feel more comfortable with the babies’ prognosis if they do come early.  There is also a higher risk of developing preecalmpsia or gestational diabetes.  I’ve passed the lovely gestational diabetes test, which was such a relief.  Now, I just have to hope my borderline blood pressure & swelling doesn’t ever turn into pre-e.

Mrs. Train: In general twins have a much higher rate of c-section delivery. In either vaginal or c-section there will be double the amount of people in the room because each baby will have a set of staff specifically for them. My OB recommended a c-section because my twins shared a placenta. She said “You can try a vaginal but if it were my children or my body, I wouldn’t risk Baby B.” I trusted her completely and decided to have a c-section. I had so many scares along the way with Baby B I was terrified to have any more risks. In my c-section operating room there was my OB and another to assist, an anesthesiologist, my nurse and a set of two nurses for each baby. That was 8 hospital staff in that tiny room waiting for my babies to be born. It was also considered an emergency c -ection because my blood pressure had gone up so high, they had to take me the evening of my doctor’s appointment to have it done. It wasn’t as rushed as a real emergency, but people were in a hurry and they were delivered at 8:00pm. Because of some of the complications during pregnancy I didn’t react to the procedure very well. My blood pressure tanked and they had to pump me full of drugs. I was in recovery for 4 hours before I saw my babies again. To be honest I didn’t mind I was really out of it and it felt like minutes not hours.

With my singleton I decided to go with a scheduled c-section. I went in early in the morning, everyone was relaxed and it was a simple procedure. There was my OB and her assistant, two nurses and an anesthesiologist. My OB was 9 months pregnant so she had another OB do most of the procedure, but she delivered my girl then sat down and let him stitch me up. She sat and talked to me about the kids and how excited she was to be a mom. It was kind of funny to be having a relaxed conversation when my insides were all exposed but it really just showed how different the feel of the day was. I had no bad reactions and I was reunited with my baby girl in 20 minutes or so, which was the time it took the OB to finish the procedure. She was nursing like a champ within the hour.

Mrs. Blue: While giving birth to any number of children can take a variety of paths, there are a few ways that delivering twins is specifically different.  Doctors vary greatly on whether they will allow you to try a vaginal birth with twins.  Personally, my OB, MFM, and hospital are open to allowing me to try a vaginal delivery as long as Baby A (the one closest to the cervix) is head down.  They feel comfortable reaching in to turn Baby B if he is breech (OUCH!) or delivering breech if necessary.  If you are going to try for a vaginal birth, you have to come to terms with the idea that you might end up birthing Baby A and then having to have a c-section for Baby B if something happens during Baby B’s birth.  I would like to try for a vaginal delivery, but currently both my boys are breech, so unless Baby A turns, it will be a c-section.  At this point, I’m mostly just ready to have them out of me and don’t care too much how it happens as long as everyone is safe!

Many hospitals, including mine, require you actually deliver in the Operating Room, even if you are trying for a vaginal delivery.  Because of the increased risk that something could go wrong, they have a policy that all twin births (regardless of twin type) must be done in the OR to minimize the prep time if surgery has to be performed suddenly.  At my hospital, you are allowed to labor in the regular labor and delivery room, and it is only right before you are about to deliver that you are taken to the OR.  It won’t be the same atmosphere, but honestly I feel better about delivering that way in the long run.  As my doctor explained, if I were in a L&D room, they can prep the OR and have the babies delivered quickly, but if we’re already in the OR and set up, the babies could be delivered within 2-3 minutes.  Sometimes, those few extra minutes make a difference, so I feel really good about this policy.

Mrs. Train:  Besides my husband it was all hospital staff. Like I said above, there will be a lot more nurses on hand because each baby gets a full delivery team. It didn’t matter to me much. By the time I was 37 weeks with twins I didn’t care who saw what or how many people there were I just wanted to meet my boys.

Mrs. Blue:  My OB warned me already that delivering twins is not quite as intimate or warm as a singleton delivery based on the number of people present (in addition to being in the OR for a vaginal delivery).  Even in the OR, my hospital will allow me to have my spouse and another support person present.  I plan on it just being Mr. Blue and maybe our doula.  But, in addition to the people I choose, there will be a host of other people staring at my business.  In my delivery, it sounds like the plan will be to have my OB, MFM, and regular medical team for delivery, but then there will also be a medical team for each baby.  Best case scenario, our babies will be born 3-4 weeks early, so each baby will need a separate team to quickly assess their health and jump into action if necessary.  Point being, it will be a bit crowded in there!

Mrs. Train:  I wish I could have been able to relax more. With three infants I stressed about everything. Breastfeeding was a killer and their sleep schedules were off and I just felt like I was failing at everything. I really should not have felt that way. I was doing the best I could and it was absolutely good enough. I would say have confidence in yourself as a mother. They may have to cry a bit before you can get them to calm down because you have more than one, but it doesn’t mean they are crying because you are not doing your job. They are crying because that’s what babies do and you will manage and you will survive. There is life after the first year!

If I could give advice to family members it would be to try to look for signals from the new parents. Look to see if it seems like they need help. Offer help when you think it’s needed. Don’t just offer to watch the babies, offer to cook and clean for them. Offer to watch other children if there are any. Be supportive of parenting decisions being made instead of questioning the new parents. Do not compare it to when you had kids or other kids you know unless they are multiples, because everything changes when there is more than one. Just make sure you are there to love and support the new parents.

Mrs. Blue:  For those pregnant with twins,  I would say to just take it one day at a time and don’t compare yourself to people who are pregnant with one baby.  Just keep doing whatever you can and be good to yourself.  Try to let the multitude of twin comments and advice roll off your shoulders because most people have no idea what carrying or raising twins is like for the parents.  Know that even though there are increased risks, you might very well have a “perfect” twin pregnancy.  I’m so miserable right now, my body hurts, and I just want the kiddos to come out, but to date, everything has been about as picture perfect as it could be with two.  Being pregnant with twins doesn’t automatically mean your babies will have some kind of problems during pregnancy, you’ll end up on bed rest, you’ll go into early pre-term labor, or you’ll develop other complications.  I’ve spent most of my pregnancy just waiting for the ax to fall, but I’m getting so close to the end without any major problems cropping up.  I wish I would have been able to relax a tiny bit more.

For friends and family of women who are pregnant with twins, I would say to be cautious of what you say and try to really listen both to what they say and don’t say.  It is really unhelpful to just talk about how they will never sleep again, how they are sure to end up on bed rest, how you’re glad it’s them and not you, etc.  And for the sake of everything that’s good in the world, please don’t tell your friend who is 7 or 8 months pregnant with multiples any variation of this statement, “You think you’re miserable now, but just wait until your 9 months pregnant.  I was soooo miserable and uncomfortable then.”

There’s a good chance she’s already bigger than most people were at the end of their pregnancy and knows she has several weeks to keep going, and you just might get stabbed with a spork or whatever is available.  :)  Also, it’s really hard to admit to people in real life how difficult a twin pregnancy can be, especially if you’re the type who is normally independent and self-sufficient, so listen carefully and try to read between the lines of what she is saying.  If you are so inclined, see if there’s some way you can help her pick up the slack she probably feels like she’s dropped along the way.  Just the normal things like making dinner, cleaning house, getting the nursery and baby items ready started wearing me out months ago.  Now, I only have a few weeks to go, and I’m super stressed about my house being a disaster and the babies’ stuff not all being bought,  but it takes me a really long time to get anything done and I have contractions and feel like garbage if I push myself too hard.

Do you have any questions about how having twins is different than having one baby?  Do you think you would want to have twins or more?