Although a multiple pregnancy is classified as higher risk, not all birth experiences are traumatic or surrounded in negativity. AMBA will provide you with resources and opportunities to get through these exciting times while maintaining your mental well-being. You need to surround yourself with other families who are going through the same thing so you don't feel like the odd one out with more than one baby to manage.
There are some harsh realities around a multiple birth and things can get hairy and a bit risky. We don't sugar coat it - the Australian Multiple Birth Association addresses them head on with practical resources for you to have better conversations with your health care provider and work towards a positive outcome for your family.
Discovering it's more than one
The confirmation that you are expecting twins, triplets or more can be a surprise and shock, even if there was an increased chance. You might feel anything from happiness to feeling overwhelmed, to being excited and then bewildered. It's all part of the ride - and AMBA is here to help you.
The prospect of birth or starting a family can be daunting and many parents find it hard to think beyond that miraculous and improbable event. The time before the babies arrive is a great opportunity to research some of the practical issues ahead of you and to read up on everything, from what you can expect in your multiple pregnancy, to the birth, to appropriate sleep routines.
Regardless of what symptoms you may be experiencing, the only way to find out for sure whether you’re having twins or multiples is to have an ultrasound scan. Your health professional will be able to see how many fetuses, placentas and amniotic sacs there are at around 10-12 weeks of pregnancy. Most of the time, this information can tell you whether you have identical or fraternal twins, except when they are the same sex. In the traditional model of twinning, the timing of splitting of a monozygotic embryo determines the number of placentas and amniotic sacs. This complexity with egg split timing is why it can be tricky to determine zygosity of twins while they're still in the womb.
- If it's determined that you have 2 placentas and 2 amniotic sacs, then you have DCDA twins
- If the babies are also the same gender, then the fun starts. Same-sex twins with separate placentas can be fraternal or identical
Your antenatal journey
A multiple pregnancy is higher risk than a singleton one. Firstly, there are more babies to care for and secondly, the health risks for both the babies and the mother are increased. Women with a multiple pregnancy are more prone to pregnancy complications, for example anaemia, bleeding, high blood pressure, diabetes and premature labour - they all occur two to three times more frequently in twin pregnancies and even higher in triplet pregnancies.
If you’re pregnant with twins, triplets or more, then you’ll need a higher level of care to monitor you and your babies' progress. That means more appointments and tests during your pregnancy. The usual tests include things like ultrasound, blood, urine and swab tests. When you are carrying multiples, you will most likely have more ultrasounds than a singleton pregnancy.
- If you have multiples with separate placentas (DCDA), the average ultrasound schedule starts at around 12-13 weeks, then 20 weeks, and then possibly every four weeks until your babies are born.
- A pregnancy with babies sharing one placenta (MCDA and MCMA) may be more complicated, and you might find you have ultrasounds every two weeks from 12 weeks.
Many of our affiliated member-clubs offer expectant parent information sessions, with a mix of face-to-face and online delivery options. You will have an opportunity to meet families who are also expecting, hear from local families who have recently given birth to their multiples and engage with the volunteers who deliver services in your local area
A full term pregnancy in the world of multiples is 37-38 weeks unless problems arise or there’s a good reason to delay the delivery of the babies.
Compared to many singleton babies who are born close to 40 weeks, around 60% of multiples are born before 37 weeks with that rate being almost 100% for higher order multiples (triplets and more).
If you know your multiples will be born early, you can get ready for premature birth.
Looking after you
From a holistic family perspective, multiple birth families experience higher levels of financial stress, marital breakdown, exhaustion, depression and social isolation to name but a few. AMBA exists to reduce the impacts of these in multiple birth families. Your local affiliated member-club (or unofficial support group if you are in a regional area) are there to offer face-to-face opportunities for your family to connect with other families who have been there and done it before (or are in it right now!).
It's a great idea to go along to your local AMBA member-club while you are still pregnant to attend an expectant parent information session, access support, loan equipment and connect with like-minded people. 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.
Generally speaking, body changes with a multiple pregnancy are usually more obvious than with a singleton pregnancy.
Some women who are expecting multiples find that they have noticeable and very early pregnancy symptoms, including tiredness, nausea, vomiting, emotional ups and downs, and constipation.
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. A woman that's pregnant with multiples might gain 16-20 kg (compared to 10-15 kg with a single pregnancy). Unfortunately, stretch marks, bloating, varicose veins and haemorrhoids are all more common in a multiple pregnancy.
Your nutrition and eating well
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.
We suggest 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.
As the babies grow, keeping physically comfortable can be a challenge. We recommend to not 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.
Boring but important, pelvic floor exercises will 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.
Preparing for parenting multiples
Hands up if you've ever experienced negativity as a result of someone finding out that you are expecting multiples... Unfortunately, we know that many of you have. We see negativity all the time - on social media, in the shops, at events, and we experience it as parents of multiples ourselves. When you are expecting multiples, it's super important to surround yourself with a support network who will raise you up and help you get through your pregnancy.
Parenting multiples can be very rewarding, and also very challenging at times. Try our checklist for getting ready for your parenting journey with your multiples:
- Join your local Australian Multiple Birth Association (AMBA) affiliated member-club affiliated member-club
- Don't go it alone! There is plenty of information and support networks around (even if you think you aren't one of those club types)
- Keep the lines of communication open with your partner. It's an essential part of continuing a healthy relationship. You might like to read our blog article on a dad's perspective on expecting triplets.
- Nothing is impossible. You can breastfeed your multiples - it’s good for you and your babies. A lactation consultant or your midwife can help if you are struggling or need advice. Some hospitals offer classes specifically for expectant parents of multiples.
- Seek and accept support. As parents of multiples, you and your partner will find that life is very busy, so it will help to have support from family and friends. Parents who seek and accept support are more relaxed and healthier, so get to it!
For more on getting ready, check out our Parenting Twins and Parenting Triplets publications