Worse-Case Scenario. If you have ever played this terrible game, you know how uncomfortable it can be to imagine all the terrible circumstances in life that could present themselves (aside – do not play this awful game – especially while pregnant). If you are expecting twins, the increased risk of carrying two bundles at once has probably crossed your mind. Some of you may prefer to ignore the concerns associated with a higher risk pregnancy, but is this really the best idea? While there is no need to incessantly worry there is also no need to bury your head in the sand. Good thing for you, most risks that you may encounter are manageable and most twin pregnancies go off without a hitch resulting in happy parents to bustling babies.
What we’d like to do for you today is empower you with some basic knowledge. While it certainly isn’t good for your mental health to fixate on every possible bad scenario, having a baseline level of information about potential complications will enable you to take care of your babies and your body. Knowing what is normal and what is not will help you make informed decisions during your pregnancy and communicate effectively with your health care providers.
Do remember that everyone handles information differently. Some people are relieved by knowing as much as possible about the down side, while others are better off keeping it at surface level so that they don’t get overwhelmed. Understand how you take in information and guard yourself so that you can minimize stressors in your life at this sensitive stage. Here are the key facts to know so you’ll be cool as a cucumber:
The biggest complication you are likely to encounter with a twin pregnancy is pre-term labor and delivery. Anticipating and planning for an early delivery is par for the course for the twin momma to be. There is every possibility that you make it all the way to 40 weeks (if your doctors allow it), but 60% of twin pregnancies end in preterm delivery. So clear that calendar and make sure you are as “ready” as you can be for the big day.
Because our bodies are designed to fully mature in the womb, early arrivals often result in extra hospital time so that your babies can be fully ready to engage with the world. You may encounter issues with low birth weight, lung development, feeding, and higher risk of infection. Lucky for you, NICU and other medical professionals have been honing their skills to get these little ones back on track as quickly as possible. And while you may not be able to control when your cherubs execute their exit strategy, you can do your best to eat well and take care of yourself to give them the best chance of a quick recovery. For example, Dr. Barbara Luke recommends a very high protein diet early to help counter problems associated with low birth weight. This might be a strategy to consider.
Intrauterine growth Restriction (IUGR) refers to when a baby is smaller than it should be as it is not growing at the normal rate inside the womb. This can be caused in any pregnancy by any number of factors, but multiple gestation one of the causes. Your babies will be measured frequently during your prenatal visits, and doctors will be able to determine from your ultrasounds if IUGR is a concern for your pregnancy (usually around 30 to 32 weeks). Make sure that you are checking in regularly with your doctors so that they can monitor your littles.
Preclampsia is a prenatal issue that causes high blood pressure and excess protein in your urine. This can develop during the last half of your pregnancy and during labor. If this issue arises, babies need to be delivered if you are far enough along. If induction is not yet a viable option, you will be prescribed medicine and placed on bed rest. While this can sound scary, if it is detected it is very manageable.
A temporary type of diabetes, known as gestational diabetes, can develop during pregnancy if you start to have issues with the hormone insulin. Your doctors will check your sugar levels around the beginning of the third trimester to screen for this condition. If you do find you have gestational diabetes, it can be treated and controlled during your pregnancy. There are certain risk factors that are largely out of your control (pre-pregnancy weight, age, family history, the twin pregnancy itself), but making healthy eating choices and watching sugar intake can help to reduce your risk of developing this condition. If screened for and monitored properly, this is also a very manageable complication.
Because it isn’t the easiest thing for two at a time to make their debut, the chances of a cesarean delivery are increased with a multiple pregnancy. Depending on who you ask, the number is somewhere upwards of 50%. This may be disappointing to some mommas, but skilled doctors can make this delivery method very smooth. Regardless, do be aware that the recovery will likely be more difficult than a vaginal delivery, so do your best to plan for the support you are going to need. Most experts agree that 6 weeks is what it usually takes to get through the recovery phase. It takes a while to get back on your feet while managing multiples.
While there are plenty of other rare potential complications to discuss (such as twin to twin transfusion syndrome or TTTR), this isn’t meant to be an exhaustive list of all the possible bad outcomes. Although there are a lot of concerns you could spend your days fretting about, remember that worrying doesn’t help or change anything. There are some things that are in your control and some things that are not. Do your best to act on the things you can control. Get plenty of rest. Stay hydrated. Eat well. Reduce stressors. Incorporate gentle exercise into your routine to the extent possible. You’ll feel better knowing that you did your best for your littles and that is that. Remember that this is just a season. A whirlwind of crazy chaos, but it will not last forever. You will get to the other side and chances are, there will be two healthy happy babies smiling back at you when you arrive.