Carrying a Duo: Joys and Risks of Twin Pregnancies
You have taken the pregnancy test and it is confirmed that you are expecting. You spend the first part of your pregnancy wondering what your little one will look like and counting down the days until you see your new baby. Then one day, your practitioner gives you more happy news. The little bundle you are carrying has a sibling…you are expecting twins!
After the initial surprise is over and you pick the father-to-be up from the floor, there are probably a lot of questions about how this pregnancy will differ from a single birth or “singleton” pregnancy. If this is your first pregnancy, then the entire experience is new so you have nothing to compare it to. However if you have experienced a single birth before, then you will notice differences in the pregnancy, the pre-natal care and the delivery.
The most common and effective way to confirm whether or not a woman is carrying twins is through an ultrasound test. Ultrasound screenings are typically done around the twenty week mark of the pregnancy, however the practitioner may order a test sooner if he or she sees signs in the behaviour of the pregnancy that might be suspicious.
If a blood test is ordered to confirm the pregnancy, some women can see much higher hCG counts than are normal. The hormone, hCG (Human Chorionic Gonadotropin) is produced during pregnancy and is tested to determine if the pregnancy is viable. When hCG is checked, your practitioner will take 2 blood samples 48 hours apart. The level of hCG in the body should double between the blood tests. In some cases during a twin pregnancy the amount of hCG present in the beginning stages could be much higher than normal.
Another possible sign of twins is the woman’s uterus is measuring larger than what is expected. Your practitioner will measure the belly and use established guidelines to determine that the uterus and baby are growing on track.
It is common for expectant mothers to experience pregnancy related symptoms known as “morning sickness” for part or all of their pregnancy. Symptoms related to morning sickness include nausea, fatigue, vomiting, heartburn and insomnia. Morning sickness is not an indicator of how many babies a woman is carrying, but some twin moms-to-be experience stronger symptoms than usual. It is important to note that the severity of illness during pregnancy is unique for each woman. Some women go through the entire pregnancy with very little sickness, while others do have a hard time adjusting to the changing hormones. Luckily for most women, morning sickness eases by the twelfth week of pregnancy, which is the end of the first trimester.
Your practitioner will schedule more appointments and ultrasounds for your twin pregnancy than normal. This is because although twin pregnancies are becoming more common, it is still considered a high risk pregnancy. The body works considerably hard to accommodate the two little people living within your belly and it is important to make sure they are both measuring correctly.
One risk associated with twin pregnancy is the vanishing twin syndrome. This occurs when one of the twins detected during an ultrasound suddenly disappears. There are no known causes for why this occurs.
Since your practitioner will likely schedule multiple ultrasounds toward the end of your pregnancy, he or she will check to ensure that both babies are measuring equally. Another risk during a twin pregnancy is known as twin to twin transfusion in which the placenta is abnormal and transfuses or pours more blood to one fetus than the other. The fetus receiving the additional blood will have too much supply thus making their heart work harder. The fetus losing blood will become anaemic.
Other risks include pre-eclampsia and gestational diabetes. Pre-eclampsia is a pregnancy related disease marked by high blood pressure and protein in the urine. Gestational diabetes is another pregnancy related disease occurring when there is too much sugar in the blood. Both of these diseases can occur in any type of pregnancy, but there is an increased risk in multiple birth pregnancies.
Despite these risks, it is essential for the mother-to-be to not dwell on possible issues, but instead enjoy the little ones that are growing in her tummy. Positive thinking, good nutrition and following your practitioner’s advice will provide your little duo with the best possible outcome. Expectant mothers of twins should eat an additional 500 calories a day and should expect to gain a total of 35 pounds during the pregnancy. Also, drinking at least 2 litres of water daily is optimal for staying hydrated.
Many expectant mothers are advised at some point in the pregnancy to refrain from specific activities. Some practitioners will put their patients on pelvic rest which means to abstain from sex, douching or wearing tampons. In addition, many women are put on bed rest at some point. This practice is a conservative approach to ensure that the growing fetuses receive the optimal amount of calories as possible and that over exertion does not stimulate the body to go into premature labour.
In a singleton pregnancy, it is typical for a woman to go to 40 weeks before delivering. However, there is an increased chance of delivering twins early. A twin pregnancy will typically last between 36 - 38 weeks. However, it is not uncommon for women to go into labour much earlier than this. It is important to discuss this possibility with your practitioner so you are best prepared and know what to expect.
If your practitioner suspects you may deliver prematurely, he or she may give you a steroid shot at some point during the pregnancy. This shot will help the babies’ lungs develop faster and increase their chances of being able to breathe on their own upon delivery. It is common for twins to stay in the hospital even after you are discharged in order to receive the necessary medical care multiples need and to increase their weight. The average birth weight for a twin baby is 5.5 pounds compared to a singleton birth weight of 7 pounds. It is a good idea to prepare for your hospital stay ahead of time by scheduling a tour of the labour & delivery and neonatal intensive care units.
Many women are able to have their twin babies vaginally, but there is an increased chance of a caesarean section (c-section) during delivery. A c-section is a surgery in which an incision is made in the abdomen to deliver the babies. There is a longer recovery time after a c-section than a vaginal delivery, but it may be medically necessary if a vaginal delivery is not possible. Be sure to talk to your practitioner about the different delivery procedures and to be informed about your options.
Carrying twins is special. You will be excited, nervous and curious about what the world will be like after you bring your little ones home. Though there may be some risks to consider, it is best to enjoy your pregnancy and take care of yourself. And when the practitioner tells you to rest and take it easy, be sure to take this advice. There will be little time for rest once your twins are born!
Article by Lori Beeler