Twins: A practical guide to parenting multiples from conception to preschool - Softcover

Bowman, Katrina

Softcover

ISBN 10: 1743318669 ISBN 13: 9781743318669

Publisher: Allen & Unwin, 2014

Synopsis

When Louise and Katrina discovered they were having twins, both had the same thought once they recovered from the shock: buy a book that explains what to expect in order to get organised and to prepare emotionally and physically for the anticipated upheaval to their lives. When they couldn't find such a text, they decided to write it themselves.

Based on extensive research as well as their own and other twin parents' experiences of pregnancy, birth and twin toddlers, Katrina and Louise offer sound practical advice that is backed up by medical practitioners and health professionals where relevant. Detailed information with user-friendly explanations of medical jargon is peppered with amusing and moving stories of catastrophe, chaos and coping. There are at-a-glance hints and survival tips at the end of each chapter and easy-reference tables of information throughout.

The number of multiple births is rapidly increasing due to IVF and the older age range of new mothers. More people are having twins (or multiples) than ever before. This is the book they have to have.

About this title

About the Author

Katrina Bowman and Louise Ryan both have active roles in the main Australian support network for parents of twins (AMBA).

Excerpt. © Reprinted by permission. All rights reserved.

Twins

A Practical Guide to Parenting Multiples From Conception to Preschool

By Katrina Bowman, Louise Ryan

Allen & Unwin

Copyright © 2014 Katrina Bowman and Louise Ryan
All rights reserved.

ISBN: 978-1-74331-866-9

Contents

Foreword, 
Before you read on, 
THERE'S A PAIR IN THERE: FINDING OUT IT'S TWINS, 
TURKEY PLATTERS AND TOILET BOWLS: PREGNANCY, 
SAFETY, CUPBOARDS AND COMPOST: GETTING ORGANISED, 
HOW WILL THEY GET OUT: BIRTH, 
WHY ARE YOU CRYING: HOSPITAL, 
THE RIGHT SUPPORT: BREASTFEEDING, 
SIXTEEN BOTTLES SITTING ON THE BENCH: BOTTLE-FEEDING, 
I'M COMPLETELY ALONE EXCEPT FOR TWO BABIES: HOME, 
ELLEN DEGENERES IS MY NEW BEST FRIEND: MOTHERHOOD, 
DYNAMICS AND DYNAMITE: RELATIONSHIPS, 
THE BLURRY PERIOD: SLEEP, 
COMING, READY OR NOT: PRE-TERM BABIES, 
WHEN BAD THINGS HAPPEN: LOSING A TWIN, 
WHICH ONE IS WHICH: THE TWIN SITUATION, 
ACTUALLY, THERE ARE THREE: TRIPLETS, 
Notes, 
Glossary, 
Recommended Reading, 
Resources, 
Acknowledgements, 
Australian Twin Registry, 

CHAPTER 1

There's a pair in there

FINDING OUT IT'S TWINS

FINDING OUT IT'S TWINS: OUR STORIES

In the past many women didn't know they were having twins until the birth. We're now most likely to find out well before our babies are born. Doctors sometimes find twins when they're checking for a heartbeat and hear two, or by feeling two heads through your abdomen. Usually the discovery is made during an ultrasound at any time between six and 20 weeks. If you've had fertility treatment, earlier miscarriages, bleeding or any other reason to be concerned, you may be given an ultrasound scan at around six weeks (where two tiny heartbeats may be detected). Ultrasound scans for a naturally conceived twin pregnancy are usually done between 18 and 20 weeks, unless there is a suspicion that the woman is bigger than usual. The vast majority of women have an ultrasound at 12 weeks to test for Down syndrome (nuchal translucency).

You may have suspected you were having two babies before it was confirmed by ultrasound. Sometimes it's because of extreme sickness, especially when you can compare it to an earlier pregnancy or because you seem larger than expected or have put on a lot of weight. Or you may have had no idea.

Katrina: Are you sure you're not having twins, you're big for 20 weeks, was the comment from a wry colleague. There aren't any twins in my family; I just had a bit of padding there to start with, was my equally lighthearted reply. My sister and I joked the day before the ultrasound that if it's twins she can have one of them.

At our first ultrasound the technician kept remarking on how the baby was moving around a lot. I was very eager for confirmation that we were having a girl. Then he said it. There are two babies. We laughed; surely he was joking. He showed us the screen and pointed out two heads.

I spoke my first thought. 'Are they Siamese?'

'What do you mean by Siamese?'

'Stuck together.'

'There's nothing to indicate that.'

I burst into tears.

'It's not that I don't love them,' I tell my husband. 'I'm just a bit shocked. How will we ever cope with two?' He reassures me, 'We'll do it together.'

On the way home in the car the tears were still flowing and I realised I was wrong. I didn't love them. I didn't want them. I didn't want two babies. It was too late for a termination. Perhaps I'd lose them. How would we ever manage? How could I have been so unlucky?

I have always felt sorry for twins. Having someone who looks just like you, always competing with you. They lose their individuality. I didn't want my children to have that.

I had always wanted children. We delayed it for some years, then when I decided it was time we managed to conceive first try, much to my husband's disappointment! If I'd known I was going to have twins, I thought, I would have really questioned having children. Still, it had been my decision to have a baby. This was actually my fault. What had I done?

I had an instant and desperate need to know more about twins and how we could raise them as individuals. We spent the evening researching. It appeared from the scan that our twins were probably identical, which is not genetic, just a one in 250 chance of a pregnancy being identical twins. It was my egg that had split. Perhaps I shouldn't have jumped in that hot tub? Did heat cause eggs to split? This really is my fault. That seed of self-blame was planted.

I quickly realised that a large part of my distress was grief. I was grieving for the loss of a single baby. For years I held in my mind's eye a peaceful image of me rocking my baby in the sunshine. But now I was not going to have any peace, no one-on-one close contact. I felt I was being denied time to love my children. I would be too busy just coping. I felt very sorry for myself.

I knew I had no right to moan. It wasn't like someone had died. My babies appeared healthy. I shouldn't have felt like this. I should have been over the moon. What was wrong with me? Why was this happening?

Louise: Getting pregnant is an accident for some couples, easy for others, hard work for many and, sadly, for some couples it's impossible. I knew one in eight couples had difficulty conceiving, so I never assumed I'd fall pregnant easily but of course hoped I would. After eight months of unsuccessful well-timed effort my partner and I went for tests to discover what was going wrong. The problem was sperm antibodies interfering with fertilisation. Each of my eggs needed to be fertilised by being injected with one of his sperm. This would be done via IVF.

The process of IVF is an emotional roller-coaster; exciting and terrifying when you begin a cycle and devastating when it fails. The snorting and injecting of hormones, the blood tests, internals and ultrasounds would be easy if you could be sure you'd be pregnant this time or next time or the time after that. The traumatic part is, you have no idea whether you'll ever fall pregnant and if you do, that you won't miscarry.

Looking back, I'm amazed that for our treatment cycles we were so keen to have three fertilised eggs transferred. This meant possible triplets, but also possibly still no pregnancy. Having become so used to not becoming pregnant we wanted to give it the best chance. I've since spoken to many IVF twin mums who chose to transfer two fertilised eggs even after a couple of unsuccessful cycles. Oddly, while doing the cycle, we talked a lot about whether or not I'd be pregnant but barely mentioned twins, let alone triplets. We both knew that a pregnancy after three fertilised eggs have been transferred meant a 20 per cent chance of twins and a five per cent chance of triplets.

I've since learnt that when two good-quality eggs are transferred there is a 25 — 35 per cent chance of pregnancy and with three good-quality eggs, the chance of pregnancy is only increased to 26 per cent. I wish I'd known and been able to weigh up our chances versus the risk of triplets, given the physical, social, emotional and financial consequences.

Having done my second IVF cycle, I found out I was pregnant the day my period was due. My nurse said there was a possibility of more than one baby, as my hormone levels were high but I put that possibility straight out of my mind. Didn't dare to hope. I had an ultrasound four weeks later. Any ultrasound scan done at that stage of a pregnancy shows a tiny little stick with a beating heart, which is what we saw on the screen. One tiny little stick with a heartbeat. Just beautiful. I have a vague memory of the ultrasound technician also mentioning an unviable sac. I was pregnant and happy.

Being determined to know absolutely everything there was to know about my condition meant reading everything I could, so when friends commented on the fact that I was 'showing' I strongly denied it. I knew that a first pregnancy wasn't noticeable until after 12 weeks. There was no way that bulge had anything to do with the baby, I was just eating too much. At six weeks I was desperate to feel some nausea, a physical sign of my precious state. Come on, come on, why don't I feel sick? Am I still pregnant? Then it hit me. I felt sicker than I'd ever felt in my life. I puked all day and all night. For four weeks I lay in bed with a towel and a bucket. The sickness was totally debilitating. My brother came around every day with a cure. The girl in the milk bar said lemonade. His mate's wife used ginger tablets. Dry biscuits, grated apple — I am never, never, never doing this again. Why would anyone ever have a second pregnancy? I lost six kilos and thought back to those earlier weeks when I was begging for that sick feeling.

The other overwhelming feeling during these early days was terror at the prospect of miscarriage, made even worse by the prospect of being unable to fall pregnant again. I was counting down the days till I hit that magical 12 weeks when I could be confident that things might turn out OK.

At 14 weeks, nausea all but gone, it was time to go back to the clinic to check out our baby. The night before the ultrasound I lay in bed thinking about the size of my belly. Maybe there are two babies in there. No, obviously the baby had 'oesophageal atresia', where the foetus can't swallow amniotic fluid so the amniotic fluid builds up causing dangerous problems. That's what's wrong with the baby. I'm way too big. I panicked.

Lying on the table at the clinic I was looking at the screen but couldn't make out a thing. Suddenly the technician said, 'Well, [long pause] there are two babies here.' Silence. Relief. It wasn't a terrible amniotic fluid problem, I wasn't dying and neither was the baby. I laughed and laughed while Tony sat there with a huge grin on his face. Then suddenly I felt horrified. One baby hadn't been there last time. The new baby was tiny. 'It's too small. Quick, measure it. Is it normal? Will it be OK?'

It seemed to take forever to measure the baby but it was within the normal range. Everything looked fine. Relaxed again, we chatted, fell silent then laughed all the way home. We rang our families immediately. Then we rang everyone else. Everyone.

It was after the news had really sunk in that I admitted that since I'd been pregnant, I'd felt intense pangs of jealousy whenever I saw a woman with two children. My mind would wander onto whether I'd need to do IVF again and whether I'd be successful. I had greedy, selfish thoughts of wanting more than one child.

As we digested the news we tried to figure out exactly how difficult our new life was going to be. We knew we were in for hard work but how hard? And what about the pregnancy? What should we expect?

Adjusting to the news

For many, it's great news to hear you're having two babies. But for just as many, it means a big adjustment. Many parents experience negative feelings at first. Most women's feelings swing from one extreme to the other during pregnancy. The extra hormones caused by a twin pregnancy mean these swings may be more dramatic. Regardless of whether your pregnancy makes you delighted, depressed or somewhere in between you will probably experience highs and lows.

Psychological or emotional concerns

• You might be concerned about having two babies at once.

• You may have been counting on having only one or just one more baby.

• You may fear losing one or both babies.

• You may feel that people are ready to discuss the positives but are unable to deal with the negative emotions about your pregnancy.

• You may feel isolated from those you know who are having one baby at a time.

• You may be a single parent and find the idea overwhelming.

• You may be concerned that your other children's needs might be neglected because of the demands of two small babies.

• You may be concerned about the emotional strain on your relationship.

• Feeding two babies may be a mind-boggling concept.

Physical challenges

• Twin pregnancies are more physically demanding and are considered more risky.

• You may need more medical intervention during your pregnancy and labour.

• Twins are more likely to be born pre-term or small: 37 — 38 weeks is often considered full term.

• Your babies may need to be in special care and so they will spend more time in hospital.

• You will obviously be larger than you would be with one baby and this will slow you down in getting ready for your babies. (The chance of spending some time unable to do much or on strict bed rest is more common with twin pregnancies.)

• Older couples expecting twins may be worried about meeting the physical demands of two babies.

Financial issues

• You may have to leave work earlier, as the physical strain may be greater than with a single pregnancy.

• You may have timed this pregnancy based on the cost of one baby and be concerned about meeting the costs of two.

• You may need to pay for help around the house.

• Your plans to return to work may be altered when you find it's two babies, not one — childcare for two (or more) can be more expensive.

• You may have to move to a larger home.

• You may need a bigger car.

Being shocked or devastated is a healthy reaction to such big news, as is an overwhelming feeling of joy. Feelings of inadequacy are also a natural response. Some women hope to miscarry one baby or even both. If you are concerned about your emotional response or feel you need more than a friend to talk to, get help straightaway. Your GP can refer you to a counsellor. There is a comprehensive list of phone numbers you can call for help in the back of this book.

Remember many people have 'bad' thoughts as a natural response to big news. Don't be hard on yourself.

Pregnancy after fertility treatment

ANOTHER MUM SAYS 'My two-year-old twins are a complete joy. They're great friends and my husband and I are so proud of them.'

The idea that fertility treatment and programs increase your chances of conceiving twins often appeals to couples who have spent years unsuccessfully trying to conceive. In 2004, 25 per cent of multiple births in Australia resulted from fertility programs. In 2008, 20 per cent of multiple births in Australia resulted from fertility programs. This is a consequence of more one-egg transfers rather than multiple-egg transfers.

Some couples feel that they are bound to have twins because they are using fertility treatment and are disappointed when they have an ultrasound showing a single baby. Others are relieved to be having just twins, not triplets or more, after ovulation induction or a three-egg transfer.

Often for couples using IVF, GIFT or other fertility treatments, the desire for a baby is so strong that when they learn they are expecting twins they feel they should be over the moon. It's not always that simple.

Infertility is a social problem as well as a medical one. It can still be surrounded by secrecy and taboo even though it is incredibly common. Some statistics say that up to 20 per cent of Australian couples have difficulty conceiving. Complete strangers will ask mothers of twins whether they took fertility drugs or whether their babies are 'natural'. Try not to get annoyed. Some people are insensitive or nosey but a percentage of these people will be approaching you because they are unable to get pregnant themselves and may prefer to talk about it with a stranger. The experience is isolating and can cause intense feelings in both partners, who often feel they are 'going crazy' and are desperate to discuss their feelings with those who can reassure them they are 'normal'.

There is no increased risk for postnatal depression after fertility treatment. Those who do have difficulty find it is because those around them believe they shouldn't, because their dream of having children has finally been realised. This denial can reinforce feelings of inadequacy and also prevent those with problems from talking or seeking help.

Another positive outcome of fertility treatment is that you become more confident about asking for what you want and are more used to medical procedures and intervention.

ANOTHER MUM SAYS 'I was counting my blessings. To fall pregnant with one baby using IVF was such great news. When they found an extra baby at my second ultrasound I felt like I'd won Tattslotto.'

Emotional responses

Emotional issues arising from medically assisted conception of twins may include:

• A pregnancy that's been difficult to achieve may make you more fearful of something going wrong. Talk to your doctor or obstetrician about your concerns. Talking with friends or family may also help.

• You may not have expected to fall pregnant at all, let alone with twins, so you may be upset when fertility treatment is finally successful.

• You may be concerned about the higher chance of caesarean section — 68 per cent of twin pregnancies.

• You may be concerned about the increased risk of prematurity with a twin IVF pregnancy. For unknown reasons IVF pregnancies are more likely to be pre-term than spontaneously conceived pregnancies.

• You may feel you 'shouldn't' complain about fears or discomforts during your pregnancy because you're 'lucky' to be pregnant and your doctor and family are so delighted.

• You may resent that the possibility and implications of a twin pregnancy and of raising twins was skimmed over in fertility treatment counselling.

• You may be used to a lot of attention, being prodded, pushed, blood tests, everything — then suddenly when you're pregnant with twins, the IVF team has finished with you and you're waiting to see a doctor or obstetrician who doesn't need to spend much time with you. You may feel abandoned while also feeling precious.

• IVF pregnancies can be considered high-risk.

ANOTHER MUM SAYS 'By the time my IVF worked, I'd had four treatments and I'd just come to terms with being child-free and had planned my whole new independent life. My doctor said to me "It's worked, Mum" and suddenly I was expecting twins. I felt my life had come to a complete end. Then I felt so guilty for not appreciating this more. I didn't bond with my babies until way into the pregnancy when I could feel them kicking. I started to allow myself to love them.'

(Continues...)

Excerpted from Twins by Katrina Bowman, Louise Ryan. Copyright © 2014 Katrina Bowman and Louise Ryan. Excerpted by permission of Allen & Unwin.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Edition details

• Publisher: Allen & Unwin
• Publication date: 2014
• Language: English
• ISBN 10: 1743318669
• ISBN 13: 9781743318669
• Binding: Paperback
• Number of pages: 368