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Antenatal Care for Multiple Birth Mums
It’s hardly surprising that many parents-to-be are initially shocked and then a little overwhelmed when they find out they’re having twins, triplets or more!
Hopefully, the discovery is made early in the pregnancy, then the health care professionals who care for the expectant mother can provide comprehensive guidance and care for the twin pregnancy week by week.
Mums and dads need time to adjust to the idea of having more than one baby, they need to plan and learn as much as they can about multiple births. But the first thing to realize is that they are not alone! Today, there is one set of twins for every 62 live births. That’s around 10,000 multiple births in the UK each year.
Twins present a whole new set of challenges both practically and financially.
Key to the progress of the woman’s twin pregnancy week by week will be her prenatal care program which should cover tips on having a healthy multiple pregnancy, dealing with common ailments and being aware of possible complications of carrying of more than one baby.
Women with twins or more are automatically categorized as ‘high risk’. But they should try not to worry about this terminology and remember that having a baby – even more than one – is a natural process.
The mother of twins will not automatically experience complications, but being on the high risk register will mean that she will be monitored more closely and any potential problems will need to be quickly picked up and treated efficiently.
This increased level of prenatal care will give parents the opportunity to ask many questions and learn exactly how their twin pregnancy is progressing.
A multiple pregnancy is divided in the same way as any pregnancy with three phases that make up the first, second and third trimester.
Your multiple pregnancy
If you are pregnant with more than one baby, the routine tests you undergo may vary depending on where you live, but your GP should be able to outline what your prenatal care program will include at the start.
Your first full prenatal appointment will probably be around 11-14 weeks, when your height, weight, blood and urine will all be checked, and it’s during this first ultrasound that you’ll likely discover you’re carrying twins.
In an ideal world, you’ll be checked from around 8-10 weeks, but, like many women, you probably won’t suspect you’re carrying twins this early.
You will have several more prenatal appointments during your pregnancy. The number and frequency will depend on your hospital or clinic, your health, the number of babies you are carrying and your pregnancy history.
Your care can be provided by a specialist obstetrician, specialist obstetrician and even a specialist sonographer (a radiographer or midwife trained in ultrasound) with experience of multiple births.
You can be referred for other specialist help from a physiotherapist for pelvic pain or back pain, a dietitian if your diet is worrying or even a counselor or psychotherapist if you are too anxious about the birth.
During your pregnancy, you will have frequent ultrasound scans to check the positions and growth of the babies. As in singleton pregnancies, other diagnostic tests (eg for Down’s syndrome) will be offered at relevant stages of pregnancy.
The first ultrasound scan at 10-14 weeks will confirm the number of fetuses and how many placentas there are, and whether they are in separate chorionic and amniotic sacs. If the babies share an amniotic sac, they will be identical. But sometimes identical twins each have one, so even with two amniotic sacs, your babies can be identical.
Babies who share a placenta (monochorionic) are at higher risk of complications, such as Twin to Twin Transfusion Syndrome or damaged cords, and scans will most likely be carried out every two weeks in these cases.
Further scans throughout the pregnancy will check that the babies are developing normally and the position of the placenta.
Around 34 weeks into the pregnancy, the position of what is called the “frontal” twin will help your medical team decide on the safest method of delivery (vaginal or caesarean section).
Some hospitals have special prenatal classes for multiple pregnancies. Prenatal classes are especially important if you have a multiple pregnancy, but since twins often arrive early, make sure you complete the course before your babies arrive.
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