Note: I wrote this post well over a week ago so it’s a bit dated but, still relevant.
Being pregnant with twins is different. Of course, many things are the same, but I notice that a lot are not. Those things that are different are often misunderstood by the general population (no harm intended and by no fault of anyone’s own, we only have what we know about pregnancy, which is usually a singleton, to relate). For me, however, that can conjure up all kinds of personal insecurities of not being strong enough, being wimpy or simply wondering why it feels so different for me.
Fortunately, I’ve had some encouragement as of late.
OB Visit
I saw my OB on Monday. I did my glucose test (drank that nasty sweet stuff and tried hard not to vomit, but headache and nausea ensued) which I’m sure will come out fine– they test for diabetes and gestational diabetes.
From the ultrasound report, our OB confirmed that our babies are healthy with lots of fluid around them and are exactly at 50th percentile in growth– she looked me in the eye and made sure I knew (again) that is the average for singletons. So, for twins, I’m doing (and they are doing) “extra great”. Smile. Exhale.
I weighed in at 174, measured 37cm (37 weeks- 11 weeks ahead) and BP was 118/74 (super low).
Then she checked in with me on how I’m doing emotionally. I told her I had stopped working and was so tired and achy now it seems to be getting hard. Then she leaned in close and said this:
“Having twins is a mental pregnancy. You can’t think of it like a singleton or you’ll feel awful and go crazy. You are at the stage that most women are ready to get the babies out of them, except you still have at least 10 weeks to go.
Here’s what I want you to do: break it down into 2 week segments and celebrate each time you make it through that milestone. Here are the milestones I’ll be tracking: 28 weeks. We get you there and yahoo! Babies have a more than a 90% viability rate then. Then, 32 weeks, another developmental milestone. Lastly, 36 weeks. We get you there and we can dance naked on the tables we’ll be so happy.
But for you, it’s mental now. You MUST let yourself acknowledge that you want these babies out of you, even though in your heart you want them to stay in. It’s not easy. Most women feel so guilty about this, they can’t acknowledge it. But you HAVE to. It’ll keep you sane. And in a few weeks, it’s only going to get worse. So, hang in there, K?”
Okay.
I called Gina and gave her the down low. In doing so, it occurred to me, we are in the homestretch. Wow. While I was trying and hoping for 40 weeks, I may change my tune here and shoot for 38 and be thrilled even if we get to 36. Gina makes a good point that it might be best to not get fixated on a specific week but rather, healthy babies, no NICU and no intervention. That Gina. Always so wise.
As far as mental toughness goes, I know that gig well. I was a strong, competitive athlete for more than 2 decades of my life. I know what it takes and what it means to be mentally tough. I’m already pulling on that and appreciate the heads up and coaching to pull on that reserve again now and in the coming months even more.
Gina also recommended that we make a little advent calendar of sorts… a way to sort of track and celebrate each day and then each two week hurdle. I’m going to make some affirmations and place them around the house too. Ten weeks feels like a long time, but in reality I know it’s not that long at all. Especially when I think about all there is to do still before they get here and more importantly, that this may be the last weeks of my life that I am ever pregnant again.
All in all… it was good validation from my doc and from Gina. Good perspective and a good reminder to honor my pregnancy exactly how it is and how it is not.
The Twin Book
My friend, Amy, gave me a couple twin books recently and as I’ve been reading through them, I found some surprising validation.
“Women expecting twins may be able to work though much of their pregnancy so long as there are no complications. However, most women are ready to stop work or cut back their horse around 24-28 weeks of pregnancy. Women of higher-order multiples (trips, quads, etc.) generally need to stop working much earlier, around 20 weeks. If you have the luxury of not needing to work, quite your job now. You may not realize how much stress your job places on you until you stop working.”
Hallelujah, amen, I’ll tell ya! Ain’t that the truth. I’m 27 weeks this Wednesday and I am so ready to be done working; both physically and mentally. So, perhaps it has nothing to do with my “advanced maternal age” (what the medicals call my being 39) and really, just everything to do with the fact that I have twins: my belly is the size and weight of an almost full term mama. Hmmm. A little perspective does a girl good.
Some other chapters specific to twins are on Nosy Questions, Your Fast-Growing Body (and your concerns about how it will stretch to hold both babies), Missing the “Golden Trimester” (jumping from nausea to the size and feel of Third Trimester), Your Unique Blood Circulation (and the impacts of that)… these are all things that I (and other twin mamas) think about and deal with. I find the fact the someone is writing about these topics really supportive/healing/helpful in and of itself, as you know and have seen me thinking about, dealing with and processing.
Lots of people ask me (kindly), “Why are you stopping work so early?” or “Why is it important to be on a modified bed-rest?” Truth is, I would have asked those same questions of a twin-mama because it’s just something most of us don’t know about until we know about it. Again, we only have the majority of pregnancies to relate our experience to. Reading this book, The Multiple Pregnancy Sourcebook, helped me understand my own pregnancy better and also gave me some sound-bites and ways to intelligently answer the questions. Here’s a bit more from the book.
Twin Pregnancy Risks
Average gestational age at birth is 35-36 weeks.
Two and one-half times more likely to have pre-term labor than singleton pregnancy.
Seven times more likely to have pre-term birth from 28-31 weeks; about 6% of twins.
Nearly six times more likely to have preterm birth from 32-36 weeks; about 45% of twins.
Three times more likely to have placenta abruption (early detachment of placenta).
Two and a half times more likely to have high-blood pressure; about 20% of twins.
Babies are seven times more likely to be admitted to the neo-natal intensive care unit (NICU), about 50% of twins.
8-9% have birth defects.
Eight to ten times more likely to have low birth weight (less than 5 1/2 pounds) or very low birth weight (less than 3 1/2 pounds).
Average birth weight is 5 1/2 pounds.
Understanding Pre-Term Labor
Compared to a woman with a singleton pregnancy, having twins makes you about two and one-half times more likely to have preterm labor and 5-7 times more likely to have pre-term birth.
No one totally understands why preterm labor occurs, but there are many suspected contributors. It has long been thought that a woman’s large, over-distended uterus can trigger labor. Some think that the weight of the babies on the cervix stimulates labor (which is why women are often put on bedrest). Urinary tract infections and dehydration can bring on contractions and lead to labor and birth. Rupture of an amniotic sac can stimulate preterm labor and lead to infection.
Other risk factors include all kinds of things, but a few are: diabetes, heart disease, previous pre-term labor, age younger than 18 and older than 35, standing long periods of time, long work hours, high levels of stress, sexual contact and stimulation.
Contractions
Women with multiples feel and experience contractions much sooner than a singleton– and need a keep a close eye on them as well. Some contractions tense up just certain parts or just one side of the uterus; these are called uterine irritability contractions and usually last less than 40 seconds each. They often occur when you get up from a chair or when you need to urinate, and even when the babies move (I experience all of these all the time and sometimes more than others, like in the heat as you saw in my recent posts). Women with twins or more are likely to have uterine irritability. These contractions can lead to organized pre-term labor contractions. Organized contractions are an overall hardening and rounding of the uterus. Women often describe these as feeling the babies “balling up”. I experience this daily as well– there is no danger and no alarm so long as they don’t become rhythmic and/or regular.
Contractions in pregnancy are often called Braxton Hicks. In singleton pregnancies these are common “practice” for labor. With multiples, however, it can lead to preterm labor and women should never ignore a contraction no matter what it’s called or how it feels.
Sometimes, if the contractions feel like they are coming a bit more than normal or more than 4-5 an hour (a warning signal), you’ll find me laying on the couch with a piece of scratch of paper and times written up and down it– my way of tracking the frequency and regularity (or irregularity).
The bugger is that water is my best friend, as you may remember, but it makes me have to pee… a lot. The peeing gives me contractions as does the getting up and going every 20-30 minutes. So, it’s a bit of a conundrum but I opt for more water, especially in the heat, and then usually just head back to the couch or bed asap. Midwife says as long as the contractions are settled down when I’m in a resting state, we’re all good. So, when they are coming on, I try to not get up more than 4 times an hour so as to not cause more than 4 contractions as hour. But I also can’t let my bladder get too full either. Tricky, eh?
Balance
As I’ve written before, there is a balance that Gina and I work to keep in terms of fully understanding why we are considered a “high risk pregnancy” & really being responsible for that AND not relating to it in a way that rules us or dominates our life or our experience(s). It’s possible (and we take the stand) that we have a completely healthy, normal pregnancy and birth. There are just a bit more precautions for us to take– and we don’t mess around or push it, sometimes easier said than done (for me in particular). Luckily, all Gina’s nagging I used to complain about is now really coming in handy. 🙂