Now, fast forward to the moment you find out you are expecting twins (or more), and that idealistic vision you had just created for you and your one baby has now suddenly changed. Now you are facing the real possibility that you may have to forget about all your home-birth plans and you may even be told you will have to have a cesarean or C-section delivery.

Having twins can definitely take its toll on your body and then add this to having a C-section surgery, and you will soon discover that it may be more challenging and take longer to recover than you initially thought! Here are some tips to help you speed up your recovery process so you can spend less time sore and tired, and more time bonding with your new twin babies:

1. Walk, walk, walk

You will be encouraged to get out of bed at least a couple of times the day after your surgery – or even on the day of surgery – to walk. Don’t try getting up by yourself. The nurse should be at your side the first few times you do get up and walk. In the meantime, get the blood going in your legs by wiggling your feet, rotating your ankles, and moving and stretching your legs.

Personally, I have had three C-section deliveries and I can remember that even walking to the bathroom seemed almost impossible at first, but moving around is important for your recovery, so you need to push through so you will be ready to take on caring for infant twins. It will also help your circulation and make it much less likely that you develop blood clots. What’s more is that it will make your bowels less sluggish, which will help you feel a whole lot more comfortable a lot sooner. For these reasons, you’ll be encouraged to walk each day. Try to take your walks a short time after you’ve taken pain medication – when you’re likely to feel more comfortable.

2. Get plenty of rest

A C-section is major surgery. Just like with any other surgery, your body needs time to heal afterward. Expect to stay in the hospital for three to four days after your delivery (longer if there are complications), and give your body up to six weeks to fully heal. This is where you need to enlist lots of family and friends to help you with chores and laundry when you and your babies come home. I am sure you have already heard people say, “Rest when your babies rest!” This is so important, especially if you are recovering from surgery. The household “to-do’s” can wait, and even taking just a few moments to rest throughout the day can be extremely helpful for you and your postpartum body.

3. Manage your pain

Ask your doctor what pain medicines you can take, especially if you’re breastfeeding. Depending on the level of your discomfort, the doctor might prescribe a pain reliever or advise you to take an over-the-counter NSAID (Advil, Motrin) or acetaminophen (Tylenol). In addition to pain medicine, you can use a heating pad to relieve discomfort at the surgical site. In any case, don’t be shy about asking your nurse for more medication if you’re uncomfortable. You don’t need to suffer in silence, and the longer you wait to ask for the medication you need, the harder it will be to manage your pain.

4. Listen to your body

Be sure to take extra care getting around while you heal, so avoid going up and down the stairs as much as possible. A good idea is to keep everything you need close by, such as diaper changing supplies close to you so that you don’t have to get up too often. It’s also important not to lift anything heavier than your babies and certainly do not try to hold both of them in their car seats at one time, until you feel stronger, because you do not want to risk tearing your incision. Ask for help as much as possible and whenever you have to sneeze or cough, hold your abdomen to protect the incision site. It could take up to eight weeks for you to get back into your normal routine. Ask your doctor when it’s okay to exercise, go back to work, and drive. Also, wait to have sex or use tampons until your doctor gives you the green light.

5. Wear loose-fitting clothing and underwear

You’ll want to avoid putting too much pressure on your healing scar, so it’s best to either wear underwear a size bigger or you can buy special knickers that fit over the area to make it more comfortable while you are healing.

6. Beware of a good laugh

Laughing normally feels good, but not necessarily post a C-section. You can be more comfortable when laughing, coughing, and even pooping if you hold a pillow to your abdomen. This will help your core muscles from aching. Anything that puts pressure on the abdominal area will probably be painful at first, but you’ll feel a bit better day by day. Be sure to use your hands or a pillow to support your incision when you cough, sneeze, or laugh.

7. When to call the doctor

You’ll probably feel some soreness in the incision and you may have bleeding or discharge for up to six weeks after the C-section. That’s normal. But the following symptoms warrant a call to your doctor because they could signal an infection:

• redness, swelling, or pus oozing from the incision site
• pain around the site
• fever of more than 100.4 degrees Fahrenheit
• bad-smelling discharge from the vagina
• heavy vaginal bleeding
• redness or swelling in your leg
• difficulty with breathing
• chest pain
• pain in your breasts

Also call your doctor if you feel sad and your mood never seems to lift, especially if you have thoughts of hurting your babies. Finally, if you have a friend or sibling who went through a C-section, try not to compare yourself to her. Every woman’s experience with this surgery is different. Focus on your own healing right now and give your body the time it needs to get back to normal.

The post 7 Tips on Recovering from a C-Section appeared first on TWINS Magazine.

I was almost 30 years old and resigned to the fact I would never have children. Suddenly I learned I was having identical twins. My husband, a fraternal twin himself, was less surprised, knowing the genetic lottery we were playing.

What we didn’t know …

• Identical twins aren’t hereditary—our girls were just a stroke of luck.

• How sick I would get.

• How big I would become.

• How many diapers we would need.

And on and on. What we didn’t know could fill a bassinet.

What we did know … is that we were very unprepared.

Normally, I am very organized, in my career and my personal life. I’m uncomfortable being disorganized. Even worse, I hate being caught off-guard. Once I regained my senses after “twinshock” and came to embrace the idea I was having two babies, I set out to prepare myself for the journey of a lifetime. But it was very difficult to find what I needed.

I was given books upon books on how to have a baby—one baby, that is. I received countless suggestions and ideas for having a baby—one baby, of course. But where was the advice and hands-on experience for moms preparing to have twins? I spent eight months searching fruitlessly. What I found was eye-opening.

Get Ready To Be Sick

Morning sickness—whether it occurs morning, afternoon, or at night—will be part of your life. With twins, it’s worse than when pregnant with a singleton. A few lucky souls manage to escape twin-nausea, but for most, it is a part of the pregnancy. Morning sickness doesn’t always include vomiting. For me, morning sickness meant constant nausea for three months—24/7. Foods I had once loved, like canned green beans, I couldn’t even bear the sight of.

Allergies, whether chronic or seasonal, are likely to be greatly magnified as well. I was unfortunate enough to be pregnant during the summer and fall. I carried a whole tissue box in my purse at all times. Some mornings I couldn’t even open my eyes. Yes, this is normal.

It Happens So Fast

Avoid reading books about singleton pregnancies. They will only confuse you and make you worry needlessly. In a multiples-pregnancy, things progress much quicker. If you read in a book you should be feeling ligament stretching at 20 weeks, and you’re feeling it at 12 weeks, you’ll more than likely become upset and wonder if something is wrong. Books fail to mention that in a multiples-pregnancy, feeling ligament stretching at 12 weeks is completely normal.

Be Prepared Early

I felt like the worst mother ever when my hospital nurse asked me for the name of my pediatrician, and I responded with a blank stare. “You did pick out a pediatrician didn’t you?” she glared. Well, no, I shook my head. I delivered at 35 weeks and finding a pediatrician had slipped my mind. I felt awful.

A good rule of thumb: Have everything accomplished by 30 weeks. That helps ensure you will be prepared and allows for relaxation during your last weeks of pregnancy. Believe me, you’ll need it and will be thankful for the downtime.

So what is included in that elusive “everything” you should do? The basics:

• Purchase or collect enough clothing for two babies’ first few weeks.

• Have enough bottles, diapers, and formula (if not breastfeeding) for two babies’ first few weeks.

• Decide where the babies are going to sleep and if they will sleep together.

• Line up helpers to be on-call during your first few days at home.

• Select a pediatrician.

Ask for Help

As a self-proclaimed independent woman, I had the hardest time asking for help. I had no idea how much help I would need. Having my mother, mother-in-law and stepmother on hand to help with chores like laundry, dishes, and some light housecleaning was the best gift they could have given me. Chances are you won’t sleep much at night, so having someone available to fill in so you can sneak catnaps during the day is the best way to maintain your sanity.

In today’s society, many women return to work fairly soon after having children. This is especially difficult for moms of multiples, given sky-high childcare expenses and double the “getting ready” time required each day at 7 a.m. I was very clear with my husband about our ground rules from the start: Since we both work full-time, we will co-parent with equal responsibility. Gone are the days when a man wouldn’t change a diaper.

Find Friends

An invaluable resource while pregnant with twins, and one I will continue to use through my babies’ first year is online communities. Wonderful support is available from people going through the same thing you are, at the same time. TWINS Magazine has a variety of articles for families with twins and higher multiples, from pregnancy through the kids’ teen years. Another wonderfully informative site is Pregnancy.org. These sites contain invaluable advice, wonderful friends, and when you need it (which you will), shoulders to cry on.

It Really Isn’t That Bad!

My husband still complains about the reactions he receives when he tells people we have twins. Most people respond with something like a moan and a quip: “Oh, just wait!” or “Double the trouble!”

Yet, having twins not only is not as bad as you think it’ll be but is actually better than you ever imagined. Some benefits of having twins include:

• One pregnancy, instant family. If you never want to have kids again, you already have an instant family!

• Two kids, same age. I pity my friends who have one child finally entering school, only to find themselves pregnant again. Now they must again find childcare again, endure the nightmare of getting a baby to sleep through the night, and experience it all while raising another child.

• Their own best friends. When I put my girls down in their crib at night, if one is still awake, she never cries. Why? Because her sister is lying alongside her. They are never alone. This means more free time for mom since they amuse one another.

Having twins doesn’t have to be scary. Support and reference material is out there if you know where to look. You may feel overwhelmed at first at the prospect of having two babies at the same time, but take solace in the fact that twin pregnancies are more common now. And with numbers on the rise, you benefit from having more people available with more knowledge, more resources, and more support.

I never knew, beforehand, the love I would feel when I see my daughters’ two heads pressed up against one another as I dim the nursery light. I know now I’ve given my children more than life itself; I’ve also given them a best friend.

The post What I Wish I Had Known While Pregnant With Twins appeared first on TWINS Magazine.

Her husband, Scott, managed through sheer force of will to get her to Bethesda Oak Hospital in Cincinnati, on time. Unfortunately, her obstetrician was snowed in. Hours drifted by. Leah was no longer on Terbutaline, the drug preventing her from going into labor. She hadn’t expected to need it. So while Leah waited for her obstetrician, labor contractions started.

At first, she ignored them. She had experienced contractions on and off for months. But the contractions grew stronger until it was apparent she was in full-blown labor. Anxiously, she talked the situation over with her nurse, since there were still no obstetricians in the hospital. She made the decision to go through a “trial of labor” to see if she could deliver her twins vaginally.

Now, in labor, Leah had to make a choice she had not been prepared for: What form of pain relief should she use during delivery? Should she ask for an epidural? If she had had the C-section as scheduled, she would have an epidural or spinal without question. But she really hadn’t explored other helpful techniques like meditation or breathing methods. What about other drugs? Leah regretted not thinking about this earlier.

Pregnant mothers of twins usually decide in advance whether they will be having a C-section or vaginal delivery. Those planning a vaginal delivery have a big decision to make about pain relief during labor. Those planning a C-section may have enough information about epidurals before the big day. Getting an epidural (or a spinal) can be a scary event, and unnecessary fears may be avoided if women are informed.

What is an epidural?

Dr. Phillip Bridenbaugh, president of the American Society of Anesthesiologists in 2015 and editor of the book “Neural Blockade” the definitive book about pain management, described an epidural as a tiny tube placed into the spinal fluid. A small amount of medicine is injected and runs through the tube in a continuous, slow drip.

The medicine is usually similar to Novocain but sometimes is an opiate, like morphine. It temporarily numbs the roots coming from the spinal cord, stopping pain and other sensations. Higher doses can numb the nerve roots more, preventing leg movements.

How is a spinal different?

A spinal is a similar method of pain control. It involves a single injection of the same medicine into (instead of outside) the sac containing the spinal fluid. It causes complete numbness and is safe. It works well for scheduled C-sections or pain during delivery, but not as well for labor pain with vaginal deliveries. This is because it is given as a single dose that only lasts for a set amount of time, typically two to three hours. Labor often lasts much longer.

An informed decision

So, what does one really need to know to make an informed decision about epidurals? Mothers expecting twins have special reasons to consider epidurals for vaginal deliveries. For one, they are more likely to end up having a C-section as there is a greater likelihood of complications delivering multiples. Dr. Bridenbaugh says that once an epidural is in place, no further steps need to be taken if a C-section is required. If a pregnant mother of twins tries natural labor with no epidural, and she ends up needing a C-section, an epidural or spinal has to be put in fast, or she may end up “knocked out” with a general anesthetic.

Women delivering twins may likely end up needing a forceps delivery. Epidurals are especially good for forceps deliveries because they cause the muscles around the vagina to relax more completely, as well as eliminate the pain caused by the forceps.

Mothers of twins also may need “manual” help delivering the placenta. This is when an obstetrician removes the placenta by hand. Difficulties can occur because the placenta is usually bigger with twins, and sometimes there are two placentas. Epidurals protect against pain in this often unexpected procedure. Prolonged labor is another issue. Many women delivering twins choose epidurals when in prolonged labor rather than relying on natural techniques, such as breathing methods, which are hard to sustain for long periods of time.

Should you worry about injury from an epidural? Dr. Bridenbaugh stated that serious or permanent injury to the nerve roots is extremely rare: one in around 40,000 to 60,000 patients. An infrequent complication is a dural puncture, which is a temporary tiny hole in the dura mater surrounding the spinal cord. This may cause a headache after the procedure. However, headaches are much less common after epidurals than they are after spinals.

Epidurals are the best method of pain relief available for labor. While her obstetrician was stuck in the snow, Leah decided to use an epidural while she tried delivering vaginally. She had felt moderately painful contractions for months while she was on bed rest.

When she received the epidural, the pain relief was so complete and immediate she described her feeling as euphoric. She said she finally realized how much pain she had been in all along, and, at that moment, she felt total relief.

Pregnant mothers of twins often get epidurals, as do mothers who already have had twins and are pregnant with another child. Learning the basic facts about epidurals may ease some fears and help with decision making. Those who use epidurals should do so without guilt, disappointment or fear that they are harming their babies.

About the Author:
Karen Jobalia, M.D., of Cincinnati, Ohio, works with many parents expecting multiples.

The post Pain Management – Should you worry about epidurals? appeared first on TWINS Magazine.

Many moms of twins battle the floppy flap that hangs over the jeans long after the births of their babies. The “twin skin” club is exclusive and members love to share their strategies in toning the tummy. So keep talking and start crunching. Either way, misery loves company and you’ve got lots of it.

If there’s one thing any mother of multiples can testify to, it’s this: Your body is never the same after carrying more than one baby in the same pregnancy. Many complain about “twin skin;” some learn to love it, but most want to leave it behind.

Here are some of the remarks moms have made. (No one, however, was willing to have her name mentioned.)

• “I’m going to wrap it around my middle and use it as belt.”

• “I am back to a size 6… but the ‘twin skin’ just won’t shrink.”

• “I’m having a tummy tuck.”

• “Losing the 72 pounds I gained was a piece of cake—OK, a piece of carrot—but this ‘twin skin’ is impossible to budge.”

• “I have lost all my weight and no one would ever guess what my tummy looks like, but what do I do when I want to put on a bathing suit?”

• “My husband says he doesn’t even notice it. He’s the best.”

• “If you have ‘twin skin’ you have to have a sense of humor.”

• “When I lie down, it’s me and my ‘twin skin’; when I roll over, it follows me.”

Is there a solution?

Dr. Roger Goldberg, author of Ever Since I Had My Baby and researcher into the postpartum changes a woman’s body undergoes, cautions women to give themselves some time after their babies are born. “The general rule is, don’t judge from the immediate postpartum appearance,” Dr. Goldberg counseled. “Watch and wait for at least three to six months.” Dr. Goldberg explained that estrogen levels plummet during breastfeeding. When estrogen rebounds, the skin may regain some elasticity. While he says there is not any specific supporting scientific research, he bases his advice on what happens to the pelvic floor postpartum during breastfeeding: The vaginal skin becomes thinner and drier.

In moms of multiples, the ‘six-pack’ muscles can separate and spread. Only rarely, in the more extreme cases, do the muscles never fully return to midline. If you are considering a tummy tuck, Dr. Goldberg offers some very simple and practical advice about this extreme surgery: “Wait until you’ve had your last baby.” Many “twin skin” veterans swear by Pilates because it strengthens the body’s core. You will find a wide choice of Pilates videos online or on DVDs at your favorite store. Other moms say their “twin skin” tightened by simply doing crunches and modified sit-ups at home. (Avoid two-leg raises and full sit-ups; they place too much strain on your back.)

In her books Having Twins and Essential Exercises for the Childbearing Years, Elizabeth Noble offers detailed information and illustrations on prenatal and postpartum exercises—and assurance that “twin skin” need not be permanent.

She recommends that when you are expecting, you should avoid strenuous exercise, but try stretching, walking, swimming, low impact aerobics and calisthenics.

Postpartum, resume your prenatal program gradually and include isometrics and pelvic floor exercises. Noble writes: First you shorten your abdominal muscles, then you strengthen them.

Also, Noble suggests that you try hacking—a quick light chopping with the outer border of your hand—to tighten stretched skin.

Regardless of how you get your reps in, take comfort in the T’s: Tummy toning after twins is tough and tiring.

Pre-pregnancy and prenatal exercises can help you stay in shape if you don’t experience complications. Although it sometimes seems that nothing helps, a pound of prevention is often worth several pounds of “twin skin.”

[author] [author_image timthumb=’on’]https://twinsmagazine.com/wp-content/uploads/2016/12/icon.jpg[/author_image] [author_info]Sharon Withers[/author_info] [/author]

The post Got Twin Skin? appeared first on TWINS Magazine.