The World of Twin Pregnancy

The world of twins is a very interesting place. In typical "me" fashion, as soon as I found out I had two little babies growing inside me, I set about reading anything I could to help me prepare. My family jokes that I am a huge fault of useless information. I say it is only useless until you need it!

Anyway, preparing is what helps me cope with stress: making lists of items I will need to purchase or borrow now that another baby is on the way, imagining the logistics of 2 newborns, a 2 year old, and a puppy, and reading other's experiences has all be very helpful.

But I just want to say: the world of twins is already a very different place.

I guess I always just figured everything was roughly the same, other than a larger belly and 2 babies in the end. But I've been very surprised by several things so far:

1.) I am showing only a little.
I would have thought I'd be showing more by now. If I hadn't seen 2 babies in our ultrasound, I would never guess I am pregnant with twins. I am 11 weeks pregnant today and I look about the same as I did at 13 weeks with Victoria. Seeing as it is my 2nd baby, I should be showing earlier, but seeing as it is my 2nd AND it is twins, I would have thought I'd have a much larger belly by now. Being tall is probably what is working to my advantage here, and I like to think working hard to regain my muscle tone is helping too. But I know this is all going to change VERY soon, as there are two babies in there doubling in size every few weeks!

And here is my glamorous 11 week post-workout "I should probably take a pregnancy belly photo before I forget" photo

2) EVERY symptom is at least double
My nausea is at least twice as bad, my exhaustion is worse, I am already having to get up to use the bathroom several times per night, and today I started getting heartburn (ALREADY?!?!). So it has been odd that I don't look pregnant with twins, but I feel twice as bad!

3) Twin weight gain is a completely different ballgame
I gained more weight than I wanted to with Victoria, but I was ok with that because I went so far overdue and she was a huge baby. But still, I imagined that this time around I would be a little more careful about overindulging. Well, all of those plans went completely out the window the second I started researching twin pregnancy. Apparently, research shows a very strong correlation with early pregnancy weight gain and the ability to carry twins longer and for them to have healthier weights. Specifically, very significant and very early weight gain. Every book, article, and other bit of research I have looked at has said I should make it a goal to gain around 30-45 pounds by 28 weeks of pregnancy, with at least 20-30 of that by 20 weeks. (Are your eyes bugging out of your head????)

The research, all done with multiple studies, show that twins actually mature faster in the womb than singlets, so they need to calories early on. Also, as you get larger, it becomes increasingly more difficult to eat and consume enough calories to sustain all 3 of you, so early weight gain is key.

4) Double the nausea and weight gain don't go together
So I am slowly starting to feel a bit better, but I am often not able to eat much, and that means that weight gain has been very very difficult for me. With my hopes of a natural birth and no NICU time, I know I need to get some weight on, but the nausea is making it an uphill battle. I am trying not to stress about it and just do my best, but my 1st trimester weight (which should be somewhere between 5-15lbs), is at a whopping 3 pounds for far, and I fought hard for every one of those pounds. I am just hoping for the nausea to ease soon so I can start doing what I need to do for these babies.

5) The birth is already bringing on a whole new level of uncertainty
I told my husband that I was looking forward to labor and delivery this time because I knew I could do it, as I had already done it once. But now I am back in uncertain territory with a twin birth, something I have never done, and which takes on a whole new level of complication. There are a lot more risks with a twin delivery than with a singlet, and while many are born without complications vaginally, a grand majority are not. I had planned another home birth with this baby, but now that it is twins I have been trying to really pray through my options and decide what is best for me.

The issues with pursuing a home birth are:
-They will only deliver my twins if I make it past 36 weeks (they may have changed this to 37 weeks, but I will know more this week). The average twins are born at 35 weeks.
-There is a potential for a lot more blood loss in a twin birth
-There is a much higher potential for a hospital transfer between births or post birth

The issues with pursuing anything other than a home birth are:
-Hospital midwives won't take twin pregnancies, so I would have to be under a doctor's care
-I would automatically be considered high risk and subject to a lot more scrutiny and potential interventions
-I will almost certainly be forced to induce if I don't go into labor by 38 weeks. Seeing how I carried Victoria until almost 42 weeks, and how I firmly believe in not inducing without a signs of distress from the baby, this could cause some real tension between me and a doctor.
-Some doctors will only deliver twins vaginally if both twins are head down, and some will deliver them vaginally if only the first twin is head-down. It all depends on your doctor, but it isn't unheard of to have 1 baby vaginally and the other baby by caesarian. Talk about a double whammy

I have had some great talks with lots of knowledgeable mamas, one of which had a fantastic home birth with her twins at 39w4d. My husband and I have decided that we will get care from both the homebirth midwives and an OB that the midwives recommend to us. If everything looks good and I carry the babies long enough, we would still like to pursue a home birth. But if we need it, we like the option of having a doctor we know and trust helping us.

Please pray for us as we seek His wisdom in this. I am trying to make the healthiest decision for all of us, and sadly, I have lost faith in the medical world's over-interventionizing (is that a word?) of birth. I am hoping we find the right path, whatever it may be!