What to expect when you're expecting multiples

twin boysDiscovering you are expecting twins, triplets or more is a surprise and shock to most, even if they were aware there was a chance! Most parents feel a sense of bewilderment: "How are we going to cope?" "What do I need?" "How will this affect my pregnancy?" "What are the risks?" "What support is there?"

The prospect of birth can be such a daunting one that many parents find it hard to think beyond that miraculous and improbable event. Try to bear in mind that once your babies are here, you will be very busy. The time before they arrive is a great opportunity to research some of the practical issues ahead of you, reading up on everything", from what happens in a multiple birth to twin/triplet sleep routines.

 

It's a great idea to go along to your local AMBA club while you are still pregnant to attend an expectant parent information session, access support, loan equipment, connect with likeminded people and read multiple birth publications.

There is nothing like meeting other parents who already have multiples for finding out what you really need to know – such as which equipment you will need extra sets of. You may even be able to pick up some useful items second-hand.

AMBA clubs are also a great place to take any older siblings for a visit to get them used to the idea of two or more arriving. Clubs usually go out of their way to make expectant parents feel welcome and, once your babies are here, they will offer a haven of friendly and understanding company. Find your nearest club using AMBA's club finder.

For more on getting ready, you will find the Parenting Twins or Triplets, Twins Feeding Diary and other publications a great resource.

And finally....

It is perfectly natural to be concerned and overwhelmed. Congratulations, you are going to be a multiple birth parent! Multiple birth pregnancies, just like multiple birth parenting, are much more involved and labour-intensive. The type of multiples you are expecting will dictate the type of antenatal treatment you will get and the preparation you will need to do.

Looking after yourself when expecting twins, triplets or more.

Taking care of yourself during a multiple birth pregnancy starts with eating well – except that little research has been done on what that means for a mother carrying multiples.

In the absence of any real science, it's probably best to aim for healthy, balanced meals along the same lines as all pregnant women. You will need to drink plenty of fluids, ideally eight large glasses of water a day as a minimum. It's worth bearing in mind that sugary snacks can give you highs and lows which may be unpleasant. Slow-burning foods such as whole grain breads and crackers, vegetables, beans, oats, brown rice and whole grain pasta will tend to keep your blood sugar more stable and may satisfy you for longer.

You will need more protein, calcium, iron, folic acid and Vitamin B12 than in a singleton pregnancy, so make sure you have a varied diet. Try to eat little and often. Fresh foods are likely to give your body more of what it needs nutritionally than foods that have been processed. Taking a pregnancy supplement is also a good idea.

How big will I get?

Expectant mothers vary in size as in any pregnancy, but you can certainly expect to gain more weight than women carrying a singleton. In addition to the extra baby or babies, multiples mums carry extra placentas, amniotic fluid and maternal body fluid.

As the babies grow, keeping physically comfortable can be a challenge. It's probably best not to plan a huge amount of activity for the last few weeks of pregnancy – getting in and out of cars as well as negotiating seatbelts can become difficult, and you will probably be more tired with all the extra work your body is doing. It can help to swap tips with other pregnant mums in your local AMBA club or AMBA's Forum.

Boring but important, pelvic floor exercises do minimise the risk of a prolapsed uterus later in life, as well as help your pelvic floor return to normal after the babies are born. To do them, tighten the muscles around your vagina and anus (it feels like stopping the flow of urine) and count to five before relaxing the muscles. Do this ten times, repeating the whole routine five times a day. It can help if you put a discreet note somewhere you'll see it regularly (such as inside your purse) reminding you to do a set. No one need know...

Gentle exercise during pregnancy can ease tension and help your muscle tone. Don't do anything where balance is key as your centre of gravity will be changing as your belly grows. Low-impact sports like walking and swimming suit many people. Whatever you choose, start slowly and stop if you feel any cramping, pain or shortness of breath.

Try to look after your emotional wellbeing as well as physical health. The extra hormones can sometimes make you feel emotional and overwhelmed. This is normal, even though it may surprise or upset you when it happens, especially if it isn't how you usually react.

For more information you can also read these great articles:

Types of Multiples

Below is an explanation about the most common types of multiples; for more information check out the Australian Twin Registry's website and read this great article about fraternal twins, identical twins and other types of twins.

Fraternal twins

Fraternal or dizygotic (two zygotes) twins develop when two separate eggs are fertilised and implant in the uterus. The genetic connection is no more or less the same as siblings born at separate times. They may look alike, or they may not. They can be made up of same-sex multiples (boy and boy or girl and girl) or a mixture (boy/girl) of sexes. Likewise, triplets or quadruplets can be trizygotic or quadrizygotic. Fraternal twins are statistically the lowest risk multiples to have. Having their independent nourishment supply (the placenta) and housed in separate amniotic sacs, fraternal twins are like having two pregnancies simultaneously.

With fraternal twins, you will find your antenatal treatment will slightly differ to a singleton pregnancy.  You will undergo a compulsory glucose tolerance test, there will be a growth reference check by way of an ultrasound at 28 weeks and sometimes beyond and the delivery due date will be brought forward to 38 weeks instead of 40 weeks with singleton pregnancies.  For more information see the Australian Twin Registry's website 

Identical twins

Identical or monozygotic (one zygote) twins form when a single fertilised egg splits into two genetically identical parts. The twins share the same DNA, thus they may share many similar attributes. However, since physical appearance is influenced by environmental factors and not just genetics, identical twins can actually look very different. Identical twin pregnancies will have the same basic treatment as fraternal twin pregnancies with some extra ultrasounds to check for Twin-to-Twin-Transfusion Syndrome and cord entanglement. For more information see the Australian Twin Registry's website.

Higher Order Multiples (HOMs) - triplets, quadruplets, quintuplets, sextuplets or more

Triplets and more can be a combination of both identical and fraternal multiples. Triplets are most commonly a combination of monozygotic and dizygotic with a set of identical (2) and a fraternal (1) triplet. Triplets or more require more intense and consultative pregnancy. For more information on higher order multiple pregnancy and support, please visit our HOM page.