1. What Makes a Twin Pregnancy Different?

A twin pregnancy comes with its own unique set of experiences. The most apparent difference is that two babies are growing simultaneously, which means your body has to support both. This can lead to a higher intensity of pregnancy symptoms or some that may present earlier than with a singleton pregnancy.

2. Top Symptoms That May Indicate You’re Pregnant with Twins

a. Excessive Morning Sickness

Morning sickness is a common pregnancy symptom, but it can be more pronounced in twin pregnancies. If you’re experiencing extreme nausea and vomiting, known as hyperemesis gravidarum, it might be one of the early signs of twins. This is often attributed to the elevated levels of the pregnancy hormone human chorionic gonadotropin (hCG), which tends to be higher when you’re carrying more than one baby.

b. Rapid Weight Gain

Gaining weight quickly in the early stages of pregnancy is another possible sign of twins. Since there are two babies developing, your caloric needs and overall body mass tend to increase faster than they would with a single baby. If your healthcare provider notices significant weight gain early on, they may recommend an ultrasound to check for twins.

c. Extreme Fatigue

While fatigue is common in all pregnancies, carrying twins can take an even bigger toll on your energy levels. Your body is working overtime to nourish two babies, which can result in feeling more exhausted than usual. If you’re struggling with extreme tiredness, even after getting plenty of rest, it might be an indicator of a twin pregnancy.

d. Higher hCG Levels

As mentioned earlier, hCG levels tend to be higher when carrying twins. Some women may have an earlier pregnancy test result or a darker positive line on their home pregnancy test. Your healthcare provider may order blood tests to check hCG levels, which could offer another hint of a multiple pregnancy.

e. Bigger Belly Early On

If you’re showing much earlier than expected, it could be due to the extra space needed for two babies. Many women with twin pregnancies report that their bump appeared more noticeable in the first trimester compared to friends expecting just one baby. However, belly size can vary and only an ultrasound can confirm whether you’re expecting twins.

f. Increased Appetite

With two babies growing, your body needs more energy. Some moms-to-be with twins notice a significant increase in appetite, often feeling hungry shortly after meals. This can happen as early as the first trimester and might be accompanied by stronger food cravings or aversions.

3. Medical Indications of a Twin Pregnancy

a. Elevated AFP Levels

Alpha-fetoprotein (AFP) is a protein produced by the fetus, and its levels are checked through a maternal blood test during pregnancy. When carrying twins, AFP levels tend to be higher than normal, which could be a red flag for your healthcare provider to look further into the possibility of twins.

b. Hearing Two Heartbeats

One of the most thrilling moments during a pregnancy is hearing your baby’s heartbeat for the first time. But what if there are two? If your healthcare provider detects two distinct heartbeats, it’s a strong indicator of a twin pregnancy. However, this can sometimes be tricky in the early stages, so it’s often confirmed with an ultrasound.

c. Ultrasound Confirmation

The only way to truly confirm a twin pregnancy is through an ultrasound. Most often, this happens during the first trimester, usually around weeks 10 to 12. In some cases, twins can be spotted even earlier during a routine dating scan. If you’re experiencing more intense symptoms than expected, your provider may suggest scheduling an early ultrasound.

4. Are You More Likely to Have Twins?

Certain factors increase the likelihood of having twins. These include:

• Family History: If twins run in your family, particularly on the mother’s side, your chances are higher.
• Age: Women over 30 are more likely to conceive twins, especially if they are over 35 due to higher levels of follicle-stimulating hormone (FSH).
• Fertility Treatments: Assisted reproductive technologies, such as in vitro fertilization (IVF), often increase the likelihood of twins due to multiple embryos being transferred.
• Previous Pregnancies: If you’ve had multiple pregnancies before, your chance of having twins is higher.

5. When to Consult Your Healthcare Provider

If you suspect you’re pregnant with twins based on any of the signs mentioned above, schedule an appointment with your healthcare provider. They can perform tests and ultrasounds to determine if you’re carrying more than one baby. Early detection is important as twin pregnancies often require closer monitoring due to the increased risks associated with carrying two babies.

6. Caring for a Twin Pregnancy

Once twins are confirmed, it’s important to follow specific advice for managing a multiple pregnancy:

• Regular Check-ups: You’ll likely have more frequent prenatal visits to ensure the health of both babies.
• Balanced Diet: Proper nutrition is crucial, as your body needs extra calories, vitamins, and minerals to support two growing babies.
• Rest: Expect to need more rest throughout your pregnancy, as twin pregnancies can be more physically demanding.
• Monitoring for Complications: Twin pregnancies can carry a higher risk of complications such as preterm labor, gestational diabetes, and preeclampsia, so close monitoring is essential.

Ready to take the quiz?

While experiencing more intense pregnancy symptoms doesn’t always mean you’re having twins, it can be a clue to consider. If you notice any of the signs mentioned above, it’s always best to consult your healthcare provider for an accurate diagnosis. Whether you’re having one baby or two, early care and attention are key to ensuring a healthy pregnancy for you and your little ones.

Note: This quiz is for fun and informational purposes only. It’s not a medical test and should not replace professional medical advice. For accurate pregnancy information, please consult a healthcare provider.”

The post Wondering if you’re pregnant with Twins? Take the Quiz! appeared first on TWINS Magazine.

Calling old friends!  Calling old friends! Come out…Come out, wherever you are! As the mother of two singletons and 1-year-old twin boys, I created this slight “fun” variation on an old children’s game to make a serious point.  You see, I am often home alone with my twins, and fun is a word that I recently had to look up in the dictionary to recall its meaning.

I know just by writing this that I am bordering on self-pity (not to be confused with remorse) over the fact that raising four young children can be tough.  But is that why my old friends are rather invisible these days?  I often ask myself.  Are they afraid that my condition is contagious?

To put it bluntly, I’d like to know where all my friends have gone.  I seem to remember them from the not-too-distant past whooping with joy when hearing about my impending multiple births.  They were the same ones who daily called to get the “twin pregnancy update” and who promised to be that extra pair of hands when the babies arrived.

So, there I was, egotistical old me, feeling very special and flattered by all the attention.  I could not wait to deliver my babies—the only twins, by the way, ever born in the whole world!  Finally my boys entered the world amid much “ooohhing” and “aaaahing” from friends near and far.  They visited; they left; and they didn’t come back… so much for feeling special.

Excuses!  Do I get excuses!  Some of the most popular ones are: “I’ll try to come by!” “I’m so busy!” “You don’t need visitors!” “I don’t want to bother you!”

Please bother me, I think when hearing those comments.  I want to be bothered!  Yes, my hands are full; my home is crazy; and someone is crying or hungry or wet, but I still need my friends to bother me.  Now more than ever, I need the security that friendships give!

Maybe it’s a fear I have that I will never return to my pre-babies state of mind.  Granted, my life has changed, but I haven’t, I hope and I wonder how my friends perceive me?  Their absence is disturbing, if not depressing.

If I thought the fault lay with me, I would readily admit it.  But in talking to other mothers of multiples, I find the same trend.  It distresses them as much as it does me.  For some reason, our old friends consider us off limits now that our families have grown.

I realize that most people fail to understand how I cope with my topsy-turvy life.  24-hours a day of doing double diaper changes, juggling two bottles in two hungry mouths and attending to stereophonic screaming (not to mention the voices of my other children who would also appreciate some of their mother’s attention) is a tough schedule for an outsider to grasp.

I don’t lightly dismiss the fact that many of my friends have similar days with their children.  I’m not trying to outdo them on the misery index, but I have come to believe that nobody can appreciate what two babies the exact same age, running in opposite directions, can do for one’ psyche, unless they have experienced raising multiples.

Had I delivered a single baby, I would probably be a lot more mobile, running to the mall or lunching with a pal, baby in tow.  But I cannot do that comfortably.  The hassle and exhaustion of getting two babies revved up for a fun day spent strapped in a stroller and dressed in parkas when naps and meals have to be considered can be a monumental, if not impossible challenge for me to meet.  Quite honestly, I don’t really know if I can blame some of my friends who have older children for their excusing themselves from joining me on those excursions.  I’d like to stay home, too!

So I stay home often, nursing my wounds, hoping for an impromptu visit or telephone call from a buddy who just wants to get together for old times’ sake.  I love my kids, but I love my friends, too.  It seems that “never the twain shall meet!”

I think that I know what the real problem might be:  My friends are all afraid that I am going to put them to work chasing babies!  Never mind that they volunteered to be that extra pair of hands anytime I needed them.  In fact, I know just the thing that might wake them up.  If they need an invitation, so be it:

Mrs. Kitty Just requests the honor of your presence for coffee, some sympathy and general chit-chat any day of the week including evenings.  Expect several interruptions, but diaper changes unnecessary.

Regrets Only (Running Shoes Optional)!

Kitty Just has twin boys and was an active member of her local parents of multiples club for many years including serving as president.

The post Where Have All My Friendships Gone? appeared first on TWINS Magazine.

Nothing was easy about Desiree Childress’s third pregnancy. Soon after she and her husband, Will, learned they were expecting identical twin boys, she experienced severe nausea. Having trouble holding anything down, she became dehydrated and IV lines for fluids were placed.

At about 18 weeks, preterm labor began and strict at-home bed rest prescribed. With two young daughters at home, Tiffany, 9, and Victoria, 5, Desiree found staying off her feet and reducing stress nearly impossible. Five weeks later, she was hospitalized.

Both nurses, Desiree and Will knew that these early complications and a twin pregnancy increased the likelihood of a premature delivery. Over 50% of multiples are born prematurely (before 37 weeks gestation), or weigh less than five and one-half pounds. Many preemie multiples require weeks of hospitalization and special medical attention.

By getting expert care in the hospital, Desiree hoped her babies would arrive close to term, but she also wanted to be prepared for the unexpected. David and Isaiah were born eight weeks early, each weighing a little over three pounds. “You really can’t prepare for the reality of delivering preemies, but knowing what to expect made it a little less overwhelming,” she says.

Julie Medas, a clinical neonatal nurse specialist at MetroHealth Medical Center in Cleveland, Ohio, agrees. She says that learning about the neonatal intensive care nursery (the NICU) and what a preemie looks like “won’t provide comfort, but it will give parents a sense of familiarity should their babies arrive early and need special care.”

Taking a Tour

Medas recommends that parents experiencing pregnancy complications ask for a tour of the NICU and visit a baby of comparable gestational age. “The perception is that seeing a preemie will overwhelm parents, but sometimes the imagination is far worse,” she says.

A neonatologist or a neonatal nurse can explain some of the medical equipment and common problems of preemies. Your hospital may also offer a video or booklet about the NICU. If information becomes stressful, cut your visit short and come back another day.

“The NICU can seem like a foreign land with an unfamiliar language,” says Medas. Take your time to absorb this new world, and don’t be afraid to ask questions. Some suggestions:

* What are visiting hours, and who can visit?
* Will my babies be placed near each other?
* How can I participate in my babies’ care?
* Does the NICU encourage skin-to-skin contact, music therapy, or infant massage?
* Are multiples co-bedded (placed in the same bed)?
* What resources are available to parents of premature babies and multiples?
* Is there a developmental program (occupational and physical therapy) for preemies?
* Is there a place for parents to spend the night?
* Is CPR training offered?

Researching Resources
On bed rest and with time on her hands, Desiree created a notebook of resources she’d need after the twins’ birth: “I made a list of dependable support systems, those who I could really count on like my church to provide meals and sitters my girls really liked.” She also included important names and phone numbers, such as her insurance provider and pediatrician, and she rented a pager so the NICU could reach her.

To find out what services and help you may need following your babies’ birth, talk with your hospital social worker or a nurse. Also, ask if there are any local preemie parent or mothers of multiples support groups: A parent of preemie multiples can offer first-hand advice. Mothers of Supertwins (631-859-1110) and The Triplet Connection (209-474-0885) offer programs and literature to support expectant mothers of multiples.

Desiree joined a mothers of multiples club in her third trimester. “At first, it was scary because all of the mothers of twins in the group had delivered prematurely,” she says, “but it also gave me hope to see that their children were okay, and they offered great support.”

Breastmilk Basics
When you’re coping with pregnancy complications and the risk of premature babies, thinking about breastfeeding can be daunting, to say the least. But learning about breast milk and how it can help your babies is something important you can do for your babies.

“Some doctors consider breast milk a medicine for preemies,” says Medas. Research shows breastmilk is less stressful on a preemie’s digestive system and kidneys, provides important antibodies that fight infection, and protects against allergies.

Babies who are born very small and very sick will not have the ability to breastfeed during their first days or weeks of life, but they can receive breast milk through a feeding tube placed in their nose or mouth. This means mothers have to pump and store their milk. A lactation consultant with knowledge of a preemie’s special needs can provide instruction. Ask your pediatrician, the hospital staff, or the La Leche League (800-525-3243) for a referral. Many NICUs have lending libraries that include breast-feeding books and videos, too.

“Even if you can’t or choose not to breastfeed, you can still provide your babies with the best nutrition possible,” says Medas. And it’s something only you, a mother, can do.

Preemie Parenthood
“I was prepared for the monitors and technology in the NICU, but it was still overwhelming to see those two tiny little babies,” says Desiree. “I couldn’t see their faces because of the wires and tape. I couldn’t hold them or feed them. I felt like I had really lost out.”

If your babies’ birth can’t be delayed and you become a parent of preemie multiples, like Desiree and Will, you’ll face many emotions: guilt, anger, sadness, and fear, to name a few. Having more than one baby adds to the stress: You may have two sets of medical complications to cope with, maybe even two sets of healthcare providers.

Making arrangements for help before your babies’ birth is a good idea (whether or not you delivery prematurely). You’ll need time to take care of yourself so that you’ll have the energy to take care of your babies and family.

After a difficult pregnancy, you’ll also need time to reflect on your losses. To help you cope with your feelings before and after delivery, consider starting a journal, or find someone who listens well (another parent, a social worker, a mental health expert, an Internet chat room (such as the TWINS Magazine Message Board), or a clergy member).

“Remember, feeling is healthy,” says Mara Stein, a Chicago clinical psychologist who delivered twin girls ten weeks early. “But if your feelings start getting in the way of your life, affecting your marriage or other relationships, or you find yourself constantly feeling sad, you may need professional help,” she says. Consult a trained therapist, such as a psychologist, psychiatrist, social worker, or family counselor.

“Becoming a parent of preemies is the hardest thing you’ll ever have to do,” says Desiree, whose twins are now eight months old. “But when I look at David and Isaiah and see them smile, I know it’s all been worth it.”

Amy E. Tracy is the author of The Pregnancy Bed Rest Book (Berkley Trade, 2001), and the co-author of Your Premature Baby and Child (Berkley Trade, 1999). Visit her Web site at www.pregnancybedrest.com.

Who’s Who in the NICU

Neonatologist: a doctor who is specially trained in the care of premature and sick babies
Registered Nurse: has graduated from an accredited school of nursing; these nurses provide much of the daily care of preemies.

Neonatal Nurse Practitioner: a registered nurse who has advanced training in neonatal care.

Clinical Neonatal Nurse Specialist: a registered nurse who has additional neonatal training in patient and nurse education.

Social Worker: can provide information on nonmedical care, such as insurance coverage, emotional support, and transportation.

Respiratory Therapist: a specialist who provides the respiratory needs of ill babies.

Developmental Therapists: help enhance a baby’s physical development.

Medical Specialists: doctors with further specialized training in such areas as the eyes, heart, lungs, and brain.

NICU Baby Books
NICU Notebook: A Parent’s Journal
Available from:
Mothers of Supertwins
PO Box 951
Brentwood, NY 11717
www.mostonline.org
877-434-MOST (6678)

The post Expecting the Unexpected: Preparing for an Early Delivery appeared first on TWINS Magazine.

Experts think this may be because many of preterm labor’s signs, such as a backache and pelvic pressure, are what women carrying multiples expect to experience. “There’s also so much activity inside their womb, mothers might not recognize contractions,” says Dr. Elliott.

Knowing you’re at risk and not a good monitor of contractions means you should immediately discuss any concerns with your doctor. You may need to wear a belt with electronic sensors that detect contractions around your abdomen. Several times a day, the monitor is hooked to a telephone and relay graphs of uterine activity to a nurse.

Also, ask your doctor about tests to predict preterm labor, including frequent pelvic exams, checking cervical length by ultrasound, and measuring hormones in the saliva, and ways to postpone delivery, including medication. Listen to your body carefully and look for these early labor signs:

• increased uterine contractions that are painful or painless (do not write them off as “Braxton Hicks” (false labor); let your doctor evaluate you)
• menstrual-like cramps (these can come and go or be constant)
• a low, dull backache
• diarrhea
• pelvic pressure (it feels like the babies are pushing down)
• increased frequency of urination a change in color, amount, or consistency of vaginal discharge.

The post Is it Preterm Labor? appeared first on TWINS Magazine.

Sherene Silverberg, a marketing consultant, who lives with her husband, Marc, in Norfolk, Virginia, was thrilled to learn one August that she was pregnant for the first time and carrying twins.

Then the stories started.

“It seemed every person I met insisted on telling me a horror story about twin pregnancy, about someone they knew who had a long bed rest, terrible complications, or a premature delivery,” says Silverberg. “I became very fearful that my babies would end up in the neonatal intensive care nursery.”

In fact, multiples are often born prematurely (before 37 weeks’ gestation). “For every additional baby inside the womb, you can deduct three and a half weeks off of your due date,” says Dr. John Elliott, director of maternal-fetal medicine at Good Samaritan Hospital and a partner with Phoenix Perinatal Associates, in Phoenix, Arizona. Twins typically arrive at 36-1?2 weeks, triplets at 33 weeks.

Babies born prematurely are at risk for medical and developmental problems, but “the majority of babies who are born between 34 and 37 weeks have fewer and milder problems,” Dr. Elliott says.

Besides premature birth, “any complication that can happen with a singleton is two times as likely to happen with twins,” says Dr. Elliott. Of primary concern is preterm labor. Mothers carrying multiples are also at increased risk for preeclampsia (high blood pressure that only occurs during pregnancy). Twins are at higher risk for birth defects, too.

The Power of Positive Thinking

Though these statistics are disheartening for mothers-to-be, like Silverberg, Dr. Elliott and other perinatal health experts say there is much a woman can do to increase her chances of delivering healthy babies. One of the most important of these is having a positive attitude: “If you tell a woman that she is not going to succeed, it can negatively affect the outcome,” says Dr. Elliott. “But if you give a woman confidence that she will succeed, you’ll see better results.”

A case in point is Silverberg’s experience. “Hearing those awful stories and reading books about all the bad things that could happen during my pregnancy really messed up my mind,” she says. At sixteen weeks, Silverberg began experiencing mild contractions, which she believes were caused by all the worry and stress. She began seeing a therapist, who helped her focus on the positive and less on the negative, and the contractions stopped.

Silverberg continues to keep her spirits up throughout her days in waiting by listening to relaxation tapes and meditating several times each day. You can also keep a diary of your pregnancy progress, or a journal of your feelings. To stay upbeat, some women practice saying frequent positive affirmations, such as “My babies will arrive healthy and strong.”

Deciding on a Doctor

Finding the right doctor is critical. “Women carrying multiples need to make sure their pregnancy is being treated as a multiple pregnancy, not a singleton pregnancy, and that their practitioner is aware of the special issues concerning multiples,” says Dr. Gila Leiter, assistant clinical professor at Mt. Sinai School of Medicine, in New York City, and author of Everything You Need to Know to Have a Healthy Twin Pregnancy (Dell, 2000). “It’s a warning flag if your doctor says he or she is not going to treat your twin pregnancy any differently.”

You may choose an obstetrician/gynecologist (look for one with experience in multiples) or a perinatologist, a doctor who primarily focuses on high-risk pregnancies. Midwives typically do not care for twin pregnancies. Ask your doctor or hospital if there are any prematurity prevention programs in your area. Some larger communities offer clinics that specialize in multiple births, too.

When choosing your doctor, consider these questions:

• Is it a solo or group practice? Weigh the pros and cons. You’ll get one-on-one attention in a private practice, but your doctor may cancel appointments during deliveries, or even be on vacation when you go into labor. In a group practice, you probably won’t see your primary doctor at every appointment, but all the physicians who may deliver your babies will know your medical history.

• What access does your doctor have to sonography?

• Twin pregnancies typically require frequent ultrasounds.

• How will your doctor monitor this pregnancy? Ask for specifics regarding frequency and content of appointments, and what tests and procedures may be needed.

• What hospital is your doctor affiliated with? You may need a hospital with a nursery that can handle very premature babies?

• Will you be able to call your doctor with concerns and questions (not just emergency calls)? Make sure your doctor welcomes you as part of your medical team.

A Change of Pace

Experts say reducing the stress in your life can also help you carry your twins longer. “I tell women that if they are going to have successful pregnancies, their first job is to be an incubator; anything else they can fit into their lives is a bonus,” says Dr. Elliott.

One of the first things Jennifer Shearin, an automotive engineer, in Rochester Hills, Michigan, did when she found out she was expecting twins at 19 weeks was reduce her workload and notify her employer that she’d probably be going on temporary disability (which she did at 24 weeks).
“I was concerned about how we’d handle finances when the disability payments ran out, but I also knew I needed to eliminate some stress in my life for my babies,” says Shearin. She and her husband, Will, managed money concerns by eliminating “recreational shopping,” delaying the purchase of a new car, and cutting back on dining out.

When her blood pressure went up late in her pregnancy, Shearin rested more, napped frequently, and avoided anything strenuous, such as grocery shopping. Her babies, Emma and Olivia, were born four and a half weeks before their due date, but without any long-term health problems.

Most doctors do not prescribe bed rest as preventative treatment; however, bed rest at home or in the hospital may be prescribed if you experience complications, such as preterm labor. “A lot of studies say bed rest doesn’t work to prevent preterm birth, but bed rest is useful in high-risk situations in helping to decrease uterine activity and to get pressure off the lower uterine area,” says Dr. Leiter. (For more on bed rest, see What To Do If You’re Sent to Bed.)

Nutritional Needs

Since twins often arrive preterm, it’s important for you to gain weight early in your pregnancy. “It’s been well studied that a mother’s good nutrition and proper weight gain increases the birth weight of a baby, and the higher the weight at birth, the better a baby does,” says Dr. Leiter, who gave birth to twin girls more than a decade ago.

But gaining weight can be a challenge for multiple moms who often experience excessive nausea and vomiting. To reduce nausea, Dr. Leiter suggests consuming products with ginger (ginger ale, ginger tea, and ginger preserves) in small amounts (too much ginger may be harmful). Also, try eating dry crackers and cereal and drinking flat noncaffeinated soda. Consult your doctor about other methods to reduce nausea, including hypnosis, “relief bands” that stimulate acupressure points on the wrists, and medication. To maintain calories, eat frequent small meals throughout the day and stay hydrated by drinking water and juice.

You’ll also need to make sure you get the most nutrition from the food you do consume. Two essentials in your diet should be protein (red meat, rice and beans, nuts, and dairy products) and calcium (four glasses of milk per day or the equivalent). Ask your doctor or a dietitian for nutritional guidelines and if supplements might be needed. “Nutrition is not a minor issue during a multiple pregnancy,” says Dr. Leiter. “Women need to seek the advise of an expert.”

Silverberg knows the importance of eating well for her babies. She avoids soda and artificial sweeteners, and prepares all meals from scratch. “I believe that everything I eat and do impacts these two little souls,” says Silverberg. “It’s such an awesome responsibility, and I plan on doing as good a job as I possibly can.”

Amy E. Tracy is the author of The Pregnancy Bed Rest Book(Berkley Trade, 2001). Visit her Web site at www.pregnancybedrest.com

The post Carrying Twins to Term appeared first on TWINS Magazine.

But that didn’t stop the contractions, and soon 30-year-old Kelli was placed under house arrest—no going to work, no trips to the park with her two-year-old son, not even a drive to the grocery store.

“I tried to stay upbeat, but it was really lonely lying there all day,” says Kelli. “At about three or four in the afternoon, I would start going nuts. I just wanted someone to talk to or a project to do.”

Feelings of isolation and boredom are common among the over 700,000 women who are prescribed bed rest each year for pregnancy complications, including premature labor and multiple babies. A little preparation and planning can help pass those long days in waiting. Based on suggestions from those who have been there, the following guide can help you not only survive but thrive while staying off your feet.

What to Keep on Hand

Resist the temptation to get up by keeping these items within arms’ reach:

• A container of water and a drinking cup (to stay hydrated, try to drink at least eight glasses a day);

• A cooler or dorm-size refrigerator for snacks, meals and drinks;

• Toiletry items in a makeup case or other small bag;

• A tray or table for eating and writing (an ironing board can be lowered and raised to the right level);

• A telephone, personal telephone directory, and a local telephone book;

• Entertainment equipment, such as a radio, television, walkman, or computer;

• A communication device, such as a baby monitor, walkie-talkies, intercom, or bell;

• A storage container, such as a hanging shoe rack with pockets or a three-tiered storage shelf on wheels, to keep craft supplies, reading material, pens and paper, and other necessities nearby.

Bedside Parenting

“When parents and children join forces during mom’s bed rest pregnancy, most children do just fine,” says Dr. Deborah S. Simmons, a licensed marriage and family therapist in St. Paul, Minnesota, who experienced her own bed rest pregnancy. “The key is to keep life as normal as possible, and to reassure your children that you’re still there for them.”

Sticking to a regular schedule, including meals, bedtime, and activities, is important. Also, try to follow the same family rules and rituals.

Giving children the opportunity to help you can also make them feel more in control. Even very young children can talk to the baby, rub your tummy, bring you items, and do some meal preparation.

Explain to your children that you can’t go to the park or play ball outside, but you can spend time together playing games, coloring, and reading. Some good choices: “And Mommy’s on Her Side: A Children’s Book About Bedrest” and “My Mommy Is on Bedrest,” a coloring book (available from A Place to Remember, call 800-631-0973; or order online at APlaceToRemember.com). Or, request the free “Mommy and the Hospital” coloring book by sending a self-addressed 8½ x 11 envelope with three First-Class stamps to: Beth Mosele, 2525 Maconda Lane, Houston, TX 77027 (you may download the PDF version free of charge from Sidelines.org).

Lifting Your Spirits

“Being trapped in your home or the hospital, not doing the tasks you normally do, can make you feel inadequate,” says Kristine Jablonski, a Placentia, California, psychotherapist who was on bed rest herself during two pregnancies. You also have too much time on your hands to worry about your family, household, finances, job, and your babies’ health. “For mothers expecting twins, it’s double jeopardy. You worry about two lives,” says Jablonski.

What can help, she says, is finding ways to gain some control of your situation. Try to keep to a daily routine: take a morning shower and change clothes; eat meals and snacks at regular times; schedule times for naps and visitors. Make to-do lists for helpers, and do small projects from bed that won’t cause added stress, such as folding clothes and organizing files.

Celebrating each day that passes can also help. Write a V for victory on a calendar, or light a candle at the end of the day. When a week goes by, share a movie or massage with a loved one. Try not to focus on the length of your bed rest sentence; a trimester or even a couple of weeks can seem unbearable. Instead, take it one day at a time—and soon, you’ll have those babies in your arms.

Learn Your Limitations

Bed rest orders can range from some activity restrictions and periods of lying down to strict bed rest at home or in the hospital. According to Dr. Judith A. Maloni, a leading researcher on pregnancy bed rest at the Bolton School of Nursing at Cleveland’s Case Western Reserve University, “A woman must understand the reason her doctor is recommending bed rest, and she must get clear guidelines as to what she can and cannot do. A second opinion from a high-risk obstetrician is a good idea, too.”

Some questions to ask:

* Can I continue working full-time or part-time, or will I need to go on temporary disability?

* Can I take care of my children (specify ages and needs), or do I need childcare?

* What household chores can I do, and which ones should I avoid?

* How often and for how long can I get up during daytime hours? (Short walks throughout the day may reduce inactivity’s ill effects, such as muscle and cardiovascular weakening.)

* How often can I take a shower or bath?

* Can I eat meals at the dinner table, sitting up in bed, or should I lie down to eat? (A tablecloth thrown on the bed and a bib can catch those crumbs and drips.)

* Can I drive, or be a passenger in a car?

* In what ways can I be intimate with my partner?

The post Multiples Pregnancy Bed Rest: What to do if you’re sent to bed appeared first on TWINS Magazine.

About a month prior, a positive pregnancy test left me elated with anticipation for our third child. The excitement gave way to gloom and winter stretched on, so I blamed the gray skies. When my belly grew faster than my previous pregnancies, I thought maybe it was something physical. I couldn’t put my finger on it, but I knew something changed in me towards the end of my first trimester. 

Looking back, I understand why I misidentified the heavy feeling. First, during my previous pregnancies, I totally rocked the glow factor. I felt healthy and alive, despite the looming complications created by my freak uterus. Rocky deliveries, however, explained my husband’s hesitant response to the idea of a third pregnancy. 

Eventually, he warmed up to the thought, and voila, the third pregnancy was upon us. Perhaps, I still felt the need to convince him a third pregnancy was a good idea, so I laid low all day and tried my best to look alive in the evenings. 

Going out proved to be exhausting and bedtime never came soon enough! 

Second, “depression” seemed, well, too depressing. Prior to this pregnancy, I never struggled with emotional highs or lows. On the contrary, my husband often called me a “ridiculous optimist.” While I knew friends with depression, identifying depression within me remained foreign. I knew post-partum depression swung with indiscriminate blows, but I never even considered depression an option in those hard prenatal days, I just kept trying to be optimistic thinking tomorrow would be better, but I always woke up with the same dull feeling. 

As my pregnant belly grew, the doctor revealed the baby’s gender, a boy! Adding a son to our family overjoyed my heart. I thought the excitement of replacing all the pink in my storage bins with blue might just shoo away the heavy cloud, but the gloom remained. My belly seemed to grow larger by the day, and I chalked up my heaviness to the physical stress such quick growth might cause. 

At my 20-week doctor’s visit, I wanted answers. I asked about my growing belly and the uncharacteristic movement I was feeling all over the place. What caused such fast growth? Why the lack of energy? And the dull feeling? Unfortunately, the doctor shuffled me through his office quickly explaining, “Pregnancies with boys are different. Expect different feelings during this third pregnancy.” 

After my visit, my heaviness worsened. Now, in addition to the emotional weight, I began feeling physical symptoms. Constant fatigue stole my glow and a mysterious “lump” moved into my throat, one that I was familiar with only from moments in my life when I was on the verge of tears. Except, I never felt like crying. I didn’t feel like anything. The lump in my throat remained a nagging reminder that something was “off.” 

I asked my husband to accompany me to the 24-week visit. Our specialist, known for quickly assessing and sending patients along, intimidated me. I couldn’t muster up the boldness or even maintain consistent perception to ask the questions others asked of me after these visits. My husband also recognized a marked difference with this pregnancy and wanted to ask a few questions of his own. 

In the exam room that day, the doctor pulled out the ultrasound wand for the fifth time to look at our growing son. As a specialist, his quick routine measurements directed our conversations. He lubed up my belly, glanced at the screen, and then surprised himself (and us) by exclaiming, “Oh! We’ve got two babies!” 

And that was my answer, at least for then. 

My pregnancy lasted another ten weeks. It was ten more weeks of the same heavy feeling and the lump in my throat, but twins were double the joy and double the concern, so we spent those ten weeks with the best kind of distraction. The reality of my heaviness remained and even now, when I watch home videos of the pregnancy, I hear the nagging lump in my through the tone of my voice. 

Our world was a whirlwind of diapers and feedings and so much laundry after the birth of our twins. I remember feeling the physical lump in my throat for some time after but kept so busy, I never addressed it with anyone. The feelings of heaviness left before the lump and after the twins’ first birthday, even that disappeared completely. 

Four years later, in a pediatric waiting room, I read an article about “antepartum depression” or “prenatal depression.” The article explained prenatal depression as “baby blues” during pregnancy as opposed to after when postpartum depression sets in. The article cited research about the probability of prenatal depression and listed “mothers of multiples” as one of the factors. 

“AHA!” I remember thinking. What an enlightening personal discovery! I wanted to return to that tired mama, resting on the couch for the umpteenth day in a row, and say: 

•  “It’s going to be okay.” 
• “Don’t feel guilty about missing out on the excitement of growing a human being inside of you. Your body is working overtime and you will enjoy all that life soon enough.” 
• “Take all the time you need and pass your heaviness around. Let people help you and encourage you while you rest.” 
• “Be honest about how you feel. Talk it out with your husband, a trusted friend, and most importantly (and emphatically!) to your physician.” 
• “Eat well and rest plenty, taking good care of yourself so your body can miraculously grow a life, or two, or three – and a legacy whose heart beats with yours.” 

Depression related to pregnancy is real. My twin pregnancy exposed the reality of living with numbness of emotion and lack of desire for anything. Although pregnant women with a history of mental health conditions increase the likelihood of prenatal and post-partum depression, my case shows a twin pregnancy might be the only factor that increases the chance of experiencing prenatal depression. 

And you know what? It was okay. I eventually got off that couch and felt like whistling again. Today, my twins are rocking fourteen years of very full lives thanks to the heavy load I carried and that pesky lump in my throat. This mama’s heart sings in knowing the struggle that gave birth to so much life. 

The post Prenatal Depression: One Mom’s Story appeared first on TWINS Magazine.

Most people realize that there is a percentage of women who experience feelings of sadness after they deliver their baby or babies. The reality is that many people have no idea of the severity and complexity of life with PPD. 

In fact, there are a number of discouraging myths that keep many women from seeking help when they experience the signs of depression after delivery.  

In this article, we will look at what postpartum depression is, why it occurs, debunk some popular myths, and talk about how to get help for you or someone you love.

Postpartum depression does not have to derail your experience as a new mom of multiples. 

What is postpartum depression?

There is not one single underlying cause of PPD. Instead, experts believe that there is a myriad of contributing factors that lead to developing this form of clinical depression. 

Postpartum or perinatal depression affects as many as 1 in 7 women. It is so common that it is the most common complication of childbirth. 

Who is most likely to develop postpartum depression?

PPD can affect any woman. It strikes women who experience easy pregnancies, as well as, those with difficult pregnancies. First-time mothers and mothers who have one or more children can also experience PPD. It doesn’t matter if a new mom is married or single, and things like income, age, ethnicity, culture, and education make little difference in your risk of experiencing depression after birth.

One group of women who are at a higher risk of suffering from postpartum depression are moms of multiples (or MoMs). MoMs are much more likely to develop PPD than moms of singletons. While not all twin moms will experience symptoms, they are at an increased risk. 

What are the risk factors for postpartum depression?

• A change in hormone levels after childbirth 
• Previous experience of depression or anxiety 
• Loneliness, not having close friends and family around
• Family history of depression or mental illness 
• The stress involved in caring for a newborn and managing new life changes
• Having a challenging baby who cries more than usual, is hard to comfort, or whose sleep and hunger needs are irregular and hard to predict
• Having a baby with special needs (premature birth, medical complications, illness) 
• Lack of family support
• The health consequences of childbirth, including urinary incontinence, anemia, blood pressure changes, and alterations in metabolism
• The physical changes during and after pregnancy
• Other emotional stressors, such as the death of a loved one or family problems
• Financial or employment problems 
• Caring for twins, triplets, or higher-order multiples 
• Isolation and lack of social support
• Changes in the sleep cycle 

Difficulties with breastfeeding might also be linked to PPD. New moms who have difficulty breastfeeding in the first 2 weeks after delivering their babies have a higher risk of PPD 2 months later, according to a study at the University of North Carolina in Chapel Hill. 

What is the difference between baby blues and depression?

Many new moms confuse their own postpartum depression with the less serious “baby blues.” Baby blues happen when moms feel more melancholic than is typical for them after delivering their infant. As hormone levels drop, moms can feel moody, sad, tired, and generally “blue.” This is very different from PPD. 

Unlike the baby blues, PPD doesn’t go away on its own. It can impact a mother’s ability to care for her newborn. The symptoms are much more debilitating and longer-lasting. Any mom who is concerned about how she is feeling should talk to their doctor in order to stay aware of what is going on. 

How prevalent is postpartum depression?

Rates of PPD in singleton pregnancies

According to a report and statement issued by the U.S. Preventive Services Task Force, 8.9 percent of all pregnant women and 37 percent of new mothers experience clinical depression in the months before or after giving birth. Less research has been done on new fathers, but some studies suggest that about 10 percent of dads may also experience postpartum depression. For half of the women diagnosed with PPD, this is their first episode of depression. 

Rates of PPD in twin pregnancy

Moms of multiples experience PPD at a higher rate than singleton moms. Researchers have not yet isolated whether these higher rates are due to physical etiology (such as higher levels of hormones) or the additional stress of caring for two newborns. 

A 2009 study, published in the journal Pediatrics found that new MoMs were 43 percent more likely to have postpartum depression than were mothers of singletons. While not all moms of multiples will develop PPD, it is important for these MoM’s and their families to be on the lookout for potential symptoms.  

Recognizing the signs of postpartum depression

In theory, it sounds like it would be fairly simple to identify and treat PPD, right? 

The reality is that after delivering newborn twins, in the sleep-deprived newness of parenting, things can get muddy. MoM’s often think their sadness or anxiety will go away. They often blame their feelings on exhaustion. Understanding the signs of PPD can help to tease apart normal postpartum blues with true depression. 

What are the symptoms of postpartum depression?

The warning signs are different for everyone but may include: 

• A loss of pleasure or interest in things you used to enjoy
• Fear of not being a good mother 
• Eating much more, or much less, than usual
• Anxiety — all or most of the time 
• Fear of being left alone with the baby 
• Racing thoughts 
• Feeling guilty or worthless, including blaming yourself 
• Excessive irritability, anger, or agitation 
• Sadness, crying uncontrollably for very long periods of time 
• Difficulty sleeping, beyond the typical new parent lack of sleep
• Disinterest in the baby, family, and friends 
• Difficulty concentrating, remembering details, or making decisions 
• Thoughts of hurting yourself or the baby (seek help immediately if you experience this symptom).

What to do when you suspect postpartum depression?

If you suspect someone you love may be suffering from any form of postpartum depression, anxiety, or even blues – the first thing to do is talk about it. Many moms don’t even realize what is going on. In many cases, it is the loved ones that first recognize the symptoms. 

However, if you are feeling any of the earlier noted signs of PPD, talk to your doctor right away. There is no need to suffer in silence. PPD is treatable!

Fighting the stigma of postpartum depression

Despite the mountains of research surrounding postpartum depression and dialogue that is opening up, many women still feel a stigma when it comes to PPD. There are a number of myths that keep many people in the dark about the realities surrounding postpartum depression. 

Debunking the myths

Myth #1: Moms who have PPD don’t bond with their babies

Truth: Moms with PPD love their babies just as much as moms who do not have PPD. Depression is in no way a sign that a mom will not bond with her baby and love her twins the same as any other mother.  

Myth #2: You can only get PPD if you had a previous mental illness

Truth: While women with a history of mental illness (specifically a mood disorder) are slightly more likely to develop postpartum depression, any new mom can experience it regardless of health history. What’s more is that MoM’s who have experienced a mental illness in the past, are not necessarily going to develop PPD.  

Myth #3: Symptoms show up right after birth

Truth: In many cases, moms will not experience the symptoms of PPD for weeks (or even months) after giving birth. In some cases, women can display signs during the last stage of pregnancy and some won’t develop until as much as a year after delivery. Typically, the condition develops within 4 to 6 weeks after giving birth, but it can sometimes take several months to appear.

Myth #4: PPD will go away on its own

Truth: PPD is a serious condition that requires treatment. It often will not subside on its own and may require a combination of therapy and medication to alleviate the symptoms. Many new moms wait in hopes that the symptoms will retreat on their own, but inevitably prolong their negative feelings. 

Myth #5: Moms with PPD cry nonstop

Truth: Postpartum depression can take many forms. While some moms of multiples will be tearful, others will experience PPD as isolation, anxiety, or withdrawal. A woman does not have to cry around the clock to be experiencing PPD.  

Seeking help for postpartum depression

If you experience these symptoms during pregnancy or after delivering your babies you should talk to your doctor. Also, if you recognize any of these signs in someone you love, encourage them to talk to a medical professional. Many women delay seeking treatment for PPD and suffer in silence for much longer than is necessary. 

Too few women seek help for postpartum depression

In a survey published in the Journal of Psychiatric Practice, parents of twins or other multiples reported experiencing the most difficulty during the first three months of their babies’ lives. The study included 244 parents of twins and other multiples (including 197 mothers and 44 spouses or partners), asking about parents’ mental health during the postpartum period. 

They found that, although 48 percent of the study participants had struggled emotionally after their babies were born, very few got help. Many parents reported that with caring for multiple babies at once, finding childcare, and the financial stress of finding a therapist, often felt like another burden.

Coping strategies

In addition to psychological interventions and medication, there are a number of things new moms can do to help cope with the stress of parenting two babies. Using some or all of these coping skills in the face of PPD can help improve outcomes and manage symptoms. 

1. Get some exercise. Okay, maybe you aren’t ready to hit the gym but simply taking a walk, going for a bike ride, or even a few minutes of dancing with cranky babies can go a long way. 
2. Make time for yourself. While finding a few quiet moments for yourself may seem impossible, they are so important. Make sure to take a break and focus on yourself. Take a shower, talk to a friend on the phone, meditate, or do anything that makes you feel like yourself again. 
3. Stay on top of your diet. This point covers two important aspects. First, if you are breastfeeding make sure you are getting enough calories. Second, be sure you are making good food choices that will fuel your tired mind and body. 
4. Get your rest. This is probably the most laughable on our list. Once you are done chuckling at our suggestion, read on. We realize that adding an extra hour of sleep to your day is highly unlikely, remember that rest is more than sleep. A 20-minute power nap, meditation, or mindfulness and just a micro-break a few times each day can help keep you going. 
5. Connect with people. One of the biggest sources of melancholy new moms report is feeling isolated. Long hours spent just you and your babies can be an isolating experience. Connect with friends or family or join a Moms of Multiples group near you. 

Despite the growing body of information about postpartum depression and its impact on moms of multiples, there is still a gap that needs to be bridged. Too many women are left untreated and suffering in silence. The more information moms-to-be and new moms have, the more they can understand what is going on. 

Postpartum depression is a real diagnosis and is very treatable. Be on the lookout for the signs and symptoms. If you or someone you love are experiencing any, be sure to talk to a medical professional right away. There is no need to suffer in silence.  

Resources:

American Psychological Association – What is postpartum depression & anxiety?

Journal of Psychiatric Practice – Perinatal Mental Health Treatment Needs, Preferences, and Barriers in Parents of Multiples

Journal of the American Medical Association – Prenatal and Postpartum Depression in Fathers and Its Association With Maternal Depression

Medical News Today – What to know about postpartum depression

National Public Radio – Mommy Mentors Help Fight The Stigma Of Postpartum Mood Disorder

National Public Radio – Pssst: Parenting Twins Can Be Depressing

Obstetrics and Gynecology – Early breastfeeding experiences and postpartum depression

Pediatrics – Multiple Births Are a Risk Factor for Postpartum Maternal Depressive Symptoms

Postpartum Support International – Depression During Pregnancy & Postpartum

US Preventative Services Task Force – Perinatal Depression: Preventive Interventions

The post The Truth About Postpartum Depression appeared first on TWINS Magazine.