When there are several:
What do twin or multiple pregnancies mean for mothers?
Further reading : What diet should I follow to have twins?
Diagnosis of twin pregnancy
Most twin or multiple pregnancies are discovered through ultrasound.
The first ultrasound is quite important, as it allows you to know not only the number of fetuses but also whether they share the same placenta. Familiarly, babies who do not share a placenta (dichorionic) are called twins, and those who share a single placenta (monochorionic). Depending on whether you have twins or multiples, the type of monitoring will be different. For twins, this must be stricter, with ultrasounds
every two weeks. Periodic ultrasound evaluation of the anatomy and size of the fetuses is important to discover malformations or growth restrictions in the babies, which is more common in twin pregnancies than in single ones. It is also essential to measure the cervix and assess the risk of premature birth. Additionally, certain specific pathologies only appear in certain types of twins, such as twin-to-twin transfusion syndrome in monochorionic twins, which can be successfully treated intrauterinely.
What does a multiple pregnancy mean for you? once properly diagnosed.
Multiple pregnancies require special attention, and taking care of yourself is the best way to take care of your baby.
Diet and weight gain.
You should follow a healthy and balanced diet, increasing your intake of vegetables, fruits, and foods rich in vitamins, iron, and calcium, while avoiding alcohol, tobacco, coffee, soft drinks, or products high in saturated fats.
However, although nutritional advice is generally the same as for a single pregnancy, if you are pregnant with twins, you will need to pay more attention to what you eat during these months. Following a diet during this type of pregnancy is more demanding as a higher nutrient intake is necessary since energy expenditure is 10% higher than in a single pregnancy. In caloric terms, pregnant women should not consume twice as many calories as during a single pregnancy. In fact, the increase is only 300 calories per day. In other words, if the recommended daily calories range from 2,200 to 2,500 during a twin pregnancy, they will range from 2,700 to 2,800, although this figure is adjusted based on the mother’s body mass index (BMI).
Finally, in multiple pregnancies, it is more common to enrich the diet with vitamin, iron, and folic acid supplements, but always on the recommendation and under the supervision of your doctor.
Regarding weight gain, it is generally recommended that women who had a healthy weight before pregnancy gain between 15 and 20 kilos, most of it during the first two trimesters to increase the “nourishing” capacity of the placenta and prevent premature births and the birth of low-weight babies.
More frequent visits. A woman expecting more than one baby will need to see her obstetrician-gynecologist more regularly. Your doctor will determine the frequency of visits, which will generally be monthly or biweekly, depending on the characteristics of each twin pregnancy. You may need more frequent ultrasounds and other tests, especially as your pregnancy progresses.
Can you exercise during a twin pregnancy?
Moderate exercise helps control weight during pregnancy, prevents symptoms such as water retention or back pain, and helps women stay active. Therefore, during a twin pregnancy, you can engage in sports such as dancing, swimming, or walking whenever the doctor or gynecologist deems it appropriate.
Twin pregnancy: high-risk pregnancy? What are the most common complications?
Medically, a twin pregnancy is considered a high-risk pregnancy because complications can occur more frequently during pregnancy than in single pregnancies, but this is not necessarily the case. Most women experience and enjoy a twin pregnancy without health problems.
Although most twins are born healthy, it is important to consider potential complications. For example:
- Premature birth. The more babies there are at the same time, the less likely your pregnancy is to reach full term. If you show signs of premature labor, you may receive injections of a medication to speed up the development of the babies’ lungs. In cases of prematurity, babies may experience complications such as respiratory and digestive difficulties, vision problems, and infections. Bed rest is generally not recommended to prolong pregnancy, as it has not been shown to reduce the number of illnesses or deaths in newborns or to prevent premature births. Twin pregnancies rarely reach the 40th week and usually end between weeks 36 and 38, or even earlier. This is why visits to the gynecologist are so frequent during the last trimester, to prevent complications and plan the best time for the birth of your babies.
- Gestational diabetes. This condition leads to hyperglycemia that can affect your pregnancy and the health of your babies. It is more common in this type of pregnancy. Your gynecologist and endocrinologist will teach you how to control your blood sugar levels; in most cases, a proper diet is sufficient, and insulin administration may be necessary if the diet is not enough.
- High blood pressure. If you have a multiple pregnancy, the risk of developing high blood pressure disorders during pregnancy, such as preeclampsia, is higher. Your doctor will guide you on how to manage it.
- Cesarean delivery. In the case of twins or multiples, vaginal delivery is usually possible if the first baby is head down. Otherwise, a cesarean may be recommended. In some cases, complications after the vaginal delivery of the first baby may require a cesarean delivery for the second. For pregnancies with more babies, cesarean delivery is the recommended type of birth.
- Feto-fetal transfusion. In the case of twins sharing a placenta, it is possible that the shared placenta’s blood vessels cause one of the babies to receive too much blood and the other too little. This is a serious complication for both babies that could lead to major complications and require fetal intervention during pregnancy. This type of twins will therefore be monitored with specialized checks every two weeks.
- Growth restriction. In twin pregnancies, the chances that at least one of the two babies grows at a level below normal are increased. However, having two babies means they can never grow as if they were just one, so the growth of each must be monitored more closely.
The most important thing: rest and do not neglect your emotional health
During twin pregnancies, women must rest properly, take care of their mood, and avoid stress. It is normal for the expectant mother to be particularly worried about her health and that of her children, or because she is more uncertain about childbirth and raising her children.
Fortunately, multiple births are common today, and professionals are increasingly ready to help them. You can consult your doctor about the specifics of twin pregnancy, ask for advice, or request to be put in touch with other women who have
do not hesitate to express your feelings to your partner and close circle to relieve your worries. And, if you need it, do not hesitate to contact an expert to help you channel your emotions experienced during this experience. Do not during these months of happy waiting.
And… after childbirth? Caring for multiple babies.
Multiple healthy babies have the same needs as other newborns. However, you may need more rest and support than you can imagine, especially if the babies are born prematurely or need special medical care after birth. You are also at higher risk of developing postpartum depression. If you experience symptoms of postpartum depression, do not hesitate to talk to your doctor.
If you plan to breastfeed your twins, seek specialized help so they can tell you everything you need. Initially, it is best to breastfeed the children individually to fully dedicate yourself to each of them and practice. Once you feel more confident, you may be able to breastfeed both at the same time.
Take the time to enjoy your baby; ask for help from your friends, loved ones, and others when you need it.
For more information, you can check the following links:
- Madrid Association for Multiple Births: AMAPAMU: amapamu.org
- Spanish Association of Primary Care Pediatrics:
- http://www.somosmultiples.es Multiple Birth Associations: http://www.mellimama.com
- First Twin Association in Spain: GEMESPA: http://www.bebesymas.com
- National Association for Multiple Births: ANPAMU: http://wordpress.com
- Association for Twins and Multiple Births: TAMBA: www.tamba.org.uk
Dr. Cristina Casanova Pedraz
Specialist in obstetrics and gynecology. University Hospital of Torrejón. Madrid. Master’s in fetal medicine from the Fetal Medicine Foundation. PhD in the official postgraduate program in health sciences and biomedicine. Universitat de València/Spain. Collaborating professor at Francisco de Vitoria University. Madrid.
To maximize your chances, check out this diet to have twins!