A few years ago, I wrote a post called 10 Things You Should Know About Your Twin Pregnancy. Judging by the number of hits it receives daily, I’m guessing a lot of moms-to-be expecting twins are hungry for accurate information about their impending double of joy. With that in mind, I analyzed the latest research and data available on twin pregnancy. Lots of exciting discoveries have been made since I wrote that post, prompting me to write a follow-up. Call it things-you-should-know redux. Here’s what I found out. For more information on each study, click the link within each bullet.
New twin pregnancy guidelines suggest that women carrying twins need to gain between 37 to 54 pounds.
Now before you start panicking (“I can’t possibly gain that much weight!”), realize that these guidelines vary based on your prepregnancy body mass index (BMI). The more you weigh before you get pregnant, the less you will need to gain. And vice versa—the less you weigh prior to getting pregnant, the more you will need to gain. For instance, if your BMI falls within a normal range, then you should try to gain approximately 46 pounds. Overweight women with a BMI of 25 to 29.9, on the other hand, need to gain 42 pounds.
Women pregnant with twins should have an ultrasound not once but twice to measure the length of their cervix.
Doctors have known for awhile that a change in cervical length (CL) can predict who’s at risk for preterm labor. But recent research has shown that even a “normal” CL at midterm in women carrying twins (25mm or greater at Week 20), a second ultrasound four to five weeks later is important. Why? Studies have shown that when CL shortened 13 percent or more four to five weeks after their initial measurement, moms carrying twins had a significantly greater chance for preterm delivery before Week 32 to 34.
Bed rest may not prevent preterm labor. In fact, it may increase the risk.
I know. I know. Many doctors routinely prescribe bed rest for troubled twin pregnancies. But recent research suggests that it not only doesn’t prevent preterm labor but it may actually aggravate it. The study looked at the treatment of 646 women who were at risk for preterm labor (they all had a short cervix; see above). 40 percent of the women were told to restrict activity—work, non-work and sexual (the definition of bed rest). The result? 37 percent of the women who followed their doctors’ orders ended up having a preterm baby compared with just 17 percent of women who chose to ignore their doctors’ advice and continue on with life as usual.
It’s actually safer for moms carrying twins to deliver early at Week 37.
Yes, you may already know that most women carrying twins deliver early—three weeks on average. But recent research suggests that delivering twins at Week 37 is actually a good thing as it reduces serious risk to the babies. Complications can set in after Week 37 due to overcrowding in the womb as babies grow and compete harder for nutrients. Plus, the placenta begins to deteriorate.
Cesarean section, the recommended mode of delivery for twins by many doctors, may not be advantageous.
Nearly half of all twin pregnancies are delivered by cesarean section. Yet recent research following 2,800 women expecting twins in 26 countries found that as long as the first twin’s head is down, there’s no advantage to a cesarean delivery over a vaginal one. In fact, according to their study, planned cesarean delivery neither decreased nor increased perinatal or neonatal death versus planned vaginal birth. The take-away message? If you have your heart set on a vaginal delivery, take the time to find an Ob-Gyn trained in vaginal twin deliveries.
Women who deliver twins and higher-order multiples are at a higher risk for postpartum depression (PPD).
- More babies mean more hormones. So it makes sense that women carrying twins, triplets or more have a 25 percent of developing PPD, much higher than the 14 percent for moms with singleton births. Furthermore, new moms of twins are known to experience higher level of stress and lack of support (no surprise there). A new mom of twins is most vulnerable the first three months after delivery. So what should you do? First, know the warning signs of PPD and educate your husband or partner so that he, too, can be on the lookout. Next, set up a support system before you deliver. That means recruiting family and friends or hiring a night nurse or even a local mother’s helper.