Pregnancy comes in all shapes and sizes:
Then twins made us a family of six!
Guest Post from Collette at Truly Madly Cuckoo
Twin pregnancy may mean double the excitement and double the fun but it can also place the pregnancy under so much more pressure. Women having a twin pregnancy have to consider screening options more carefully as the consequences can be more complicated than in a singleton pregnancy they are also at higher risk of pregnancy problems such as anaemia, preterm term labour, gestational diabetes, fetal growth restriction and if the twins are identical then there is a risk of Twin to Twin Transfusion Syndrome (TTTS). Thankfully Collette and her twins never suffered this but it must have been a huge concern.
TTTS is where one twin gains the lions share of the blood supply and the other twin has a reduced supply. Both twins can suffer greatly as a result, in some cases it is fatal. Pioneering work can be carried out where lasers are used to try and correct the flow of blood to both twins. However this treatment is not without is not without high risks itself. To read more about this check out TAMBA or Twins Uk. Or read this really informative leaflet from Prof Mark Kilby at Birmingham Children’s Hospital.
On to the guest Post…
Tell us a little about your family
We are a family of six. I have two sons aged 16 years and 12 years and have twin daughters aged 5 years. I had my boys in my early thirties and the girls were born when I was forty.
Tell us about the day you found out you were expecting twins. What were your very first thoughts?
We didn’t actually find out that we were having twins until I was 20 weeks pregnant! It was a shock to put it mildly. I had an early scan at around 7 weeks due to some early bleeding, so it was felt that I wouldn’t need a 12 week scan. Hindsight is a wonderful thing. Interestingly I had visited my GP before the 20 week scan, as I felt I was bigger than I should be for the dates. My GP said I was larger than expected, as it was my 3rd pregnancy and my muscle tone wasn’t as it used to be!
The sonographer broke the news to us by asking us if we had twins in the family, I answered “No!” To which she replied, that we did now as she could see 2 heads!
I think then my husband and I entered a state of hysteria. I couldn’t stop laughing (with nerves I think), my husband went a deathly shade of white. All I could think of was, that the house is too small, the car’s too small and how could we cope going from a family of four to six. The sonographer asked us if we wanted to know the sex of the babies, by which point we just thought “bring it on!”. We were over the moon to find out we were having girls.
The scan continued and the sonographer said the girls were identical i.e. sharing a placenta. Identical twins normally share a placenta, but are in their own sacs, however the sonographer couldn’t see a membrane between the 2 girls, meaning that they could be in the same sac of fluid. MCMA twins (mono chorionic/mono amniotic) are extremely rare. It was decided that we would need a more detailed scan at Leeds General Infirmary. As we didn’t know anything about MCMA twins, we were non the wiser as to how potentially serious it could be. We were unaware of the roller coaster of worry to follow.
How did you find the reactions of others when you told them you were expecting more than one baby?
It was time to pick up my son’s from school on the way home from the scan. We were still in a state of shock and told a few friends, who were surprised but happy. We then made the huge mistake of telling our son’s in the playground, my youngest was fine, but my eldest burst into tears, made worse when we told him the twins were girls. In hindsight we should have been more sensitive and waited till we got home! The rest of the family were shocked, but everyone was excited.
Was your pregnancy straightforward or did you encounter any complications?
Quite soon after our initial scan we went to Leeds. The consultant there thought she could see a very thin membrane separating the twins, but she couldn’t be absolutely sure, as the babies were too large. This type of scan should have been done at an earlier gestation. Had she been able to say definitely that the twins were MCMA they would have been delivered by planned cesarean at 32 weeks! The consultant’s advice was to treat the pregnancy as if they had a membrane, but to carry out more scans than usual. We made the massive mistake of googling MCMA twins and found some horrific statistics relating to their survival. The risk of the twins both sharing a sac is cord entanglement and cord compression, the risk of which greatly increases as the babies grow larger. All through the pregnancy the twins remained equal sizes and they were closely monitored and scanned.
We had a planned cesarean at 36 weeks. We then found out that the girls were actually MCMA twins! We were so lucky, as the outcome could have been very different. They were sharing the same sac, so space would have been an issue, we were lucky that although the cords were indeed plaited and tangled, the cords were so thick and healthy that the blood flow hadn’t been affected. I dread to think what the outcome would have been if the pregnancy had been allowed to go full term. ON the other hand I also dread to think what would have happened if they had been delivered at 32 weeks. The girls would have needed to be in hospital for a long time.
Did you find the support and advice from health professionals regarding birth options adequate?
It was never a question about whether I should have a cesarean or not, as my boys were both delivered by cesarean. The pregnancy was also too high risk. As I’d had a previous emergency cesarean and a semi planned one I knew what to expect.
Please tell us briefly about the birth?
The birth was very calm as it was a planned cesarean, there was certainly none of the panic and stress I have experienced previously. The cesarean took a bit longer than before and one of the twins had wriggled quite low in my pelvis, so a lot of pulling and tugging going on! Amazingly when my first daughter was born, her twin was holding onto her leg as if to say “don’t leave me!”. There is 1 minute between them. My second born twin was taken overnight to the SCBU, as her blood sugars were low and she was a bit drowsy. She was fine the next morning. It was then that we were told the girls were MOMO twins. We are so lucky!
In those first moments after the babies were born, what emotions were prominent?
Joy that they were both healthy. The panic of looking after two babies arrived the next morning when my second twin was back from special care!
Do you feel you received adequate support with feeding more than one baby whilst still in hospital and once home?
I had decided to try to breastfeed the twins and to be honest I received very poor support whilst in hospital. I was overwhelmed with emotions, my cesarean hurt more this time than on previous births and the girls would not stop crying. Alarmingly I was discharged without having any clue as to how I was going to feed two babies, I didn’t know the best way to position them or anything. It took an excellent midwife when we got home to help by getting a double breast pump for me to borrow from SCBU. By this point the twins had dropped in weight more than expected. The breast pump was amazing, my milk came through quite quickly. I then expressed into bottles for around 6 weeks, when my husband returned to work I changed to using formula milk.
What is the best piece of advice you would give to someone else expecting more than one baby?
When the babies arrive take each day as it comes, don’t try and do too much in a day! Accept help from anyone who offers, especially if it’s the chance to sleep for a couple of hours! Join a twins group or start your own – I helped start one in our area and six years later we still keep in touch. It’s great to know that there are others in your situation. I found it very hard in the first year, however now the girls are the best of friends (most of the time!) and they have a built in playmate. When they go to school/nursery/anywhere they are never on their own.
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