Excerpted from Double Duty: The Parents’ Guide to Raising Twins, from Pregnancy through the School Years (2nd Edition) by Christina Baglivi Tinglof Copyright © 2009 by Christina Baglivi Tinglof. Excerpted by permission of McGraw-Hill. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Top Five Ways to Keep Sane During Bed Rest
Whether for placenta previa or preterm labor, some women are put on bed rest. It doesn’t have to feel like a life sentence, though. Bed rest can be a time to catch up on reading or cuddling older children, who often get lost in the shuffle after twins arrive. Here are some ideas to help make the best of a trying situation.
1. Rainy-day projects. Whether it’s organizing old photos, knitting a few baby blankets, or catching up on e-mails, we all have household assignments just waiting for the right time to be completed. Now’s your chance. Make a list and then complete one a week.
2. Movie madness. Take an informal poll from family and friends of their favorite movies, give the list to your spouse, pop some popcorn, and then lie back and relax. Now if you could only find the remote!
3. The write stuff. Keep a pregnancy journal noting the personality differences of the two baby boxers duking it out in your belly and how you’re feeling from day to day.
4. Mild exercise. If your obstetrician gives the OK, contact a physical therapist through your local hospital for a list of simple exercises that you can perform while in bed. Prolonged inactivity is detrimental to your body (as well as your mind).
5. Parenting Twins 101. Save the romance novels for your next vacation and instead stock up on books educating you on the joys (and headaches) of parenting twins. Or hit the computer and check out the online pregnancy message boards at the Twiniversity website.
If Your Babies Are Born Prematurely
Sometimes even if you’ve been on top of it throughout your pregnancy and following your doctor’s advice to the letter, your babies may decide to show up early. A baby is considered premature when he or she is born prior to Week 37. (Fortunately, though, twins mature in the womb a bit faster than singletons—it’s a little bonus courtesy of Mother Nature.) Even if your duo does arrive early, depending upon their weight and health, they may or may not need the care of the NICU. Premature infants are at a much higher risk for low birth weight, defined as infants weighing less than 5 pounds, 8 ounces at term (2,500 grams), and may be more susceptible to a variety of respiratory problems such as apnea (when baby stops breathing for more than 15 seconds and must be revived) and respiratory distress syndrome (RDS, when baby’s lungs lack a chemical called surfactant). Some premature babies are more prone to dehydration and have problems regulating their body temperature.
Most premature and low birth weight babies will spend some time in the NICU. (According to my surveys, however, 13 babies who weighed less than 5 pounds, 8 ounces at birth never spent a minute in the NICU. Two sets of these twins actually came in at less than 5 pounds each! They were born little but healthy.) Once there, the babies are placed in incubators (sometimes twins can co-bed in the NICU), given oxygen and intravenous fluids, and usually attached to several monitoring devices. The length of their stay depends on their weight and gestational age as well as any complications that may arise.
Highly trained neonatologists and neonurses tend to their pint-sized patients with great precision and compassion, yet when parents see their babies hooked up to the numerous tubes and high-tech equipment, it can be unsettling. Their babies’ appearances don’t match that of their prenatal fantasy of rosy-cheeked infants. Disappointment and guilt often set in as parents question their actions of the last months. What went wrong? While understanding that there is nothing that an expectant mother or father could have done to intervene with nature, talking through their feelings with family members, friends, or the NICU staff can help tremendously and allow parents to come to terms with this highly emotional situation.
“I had them so early and felt that I had lost out on the pregnancy that I had always imagined. I had missed out on my perfect pregnancy. No one ever thinks that they’ll deliver at Week 28. I cried a lot and finally told myself that there was nothing I could have done differently to make it go longer and it was meant to end for some unknown reason to me. The only thing I would have done differently was to talk to my loved ones and let them know how I was feeling and not try to keep it bottled up until I was alone. I was trying to put up a strong front to settle everyone else’s concerns for the babies.”
Top Five Ways to Bond with Premature Infants
When preemies are confined to incubators, it’s often difficult for parents to begin bonding with their children. But there are ways for parents to feel close to their infants even while the little ones are temporarily in the NICU.
1. Visit often. Although recovering from childbirth (cesareans especially) is draining, try to visit your newborns at least once a day. Both you and your babies will benefit greatly. Talk to them softly or read to them. Ask if you can leave behind a tape recorder of you singing to them.
2. Nurse your babies. Yes, it is possible to nurse even premature infants. Speak with the NICU staff concerning feeding schedules. For extremely early arrivals who often have trouble sucking, you may have to express your milk and nurse your twins via feeding tubes. (For more information, read La Leche’s Breastfeeding Your Premature Infant or other books available on the subject.)
3. Experience the magic of touch. When babies are able, practice “kangaroo care” by holding your seminaked baby (he or she wears only a diaper so you won’t get wet) against your bare chest. Drape a blanket over the two (or three) of you to create an intimate cocoon. Research shows that it helps to regulate baby’s temperature, heartbeat, and breathing patterns. The skin-to-skin contact can also encourage breastfeeding as baby can smell your milk. Even if you can’t hold your babies though, your touch and gentle words will begin the parent-child attachment.
4. Be inquisitive. By asking questions about their care and the machines they’re attached to and their importance as well as informing yourself about the needs of premature infants, you will ease your fears. Take an active part in your babies’ recovery by assisting in their feeding and bathing.
5. Use a picture to say a thousand words. Place a photograph of your family inside babies’ bassinets along with an article of clothing that you’ve worn. Your babies will be comforted and begin to associate your scent with you.
Pregnancy Lifestyle Changes
You may not be able to control when your babies decide to show up, but you do have power over your pregnancy lifestyle for the next nine months. From what kind of food you put into your body to how often you lie down and rest, you’re in charge. Changing your day-to-day routine for the better will have a positive effect on your pregnancy. Learn to listen to your body and act according to its needs.
How We Feel
Everything is magnified for women expecting multiples. With the increased hormones that multiple fetuses produce, morning sickness may be heightened. Expect mood swings and moments of irritability. With the extra weight comes pressure on the stomach causing heartburn (a big complaint from the moms I interviewed), pressure on the lungs (causing breathlessness with every step you take), pressure on the intestinal tract (causing constipation and hemorrhoids), and pressure on the back. Beginning in the middle of the second trimester, expect a degree of pelvic pressure every time you stand. Are you getting the picture? Carrying multiples is a tough job. But just wait, the real work begins once they’re born!
Getting Plenty of Rest
Slow down—women carrying twins hear this often from their obstetricians. It can be a major adjustment for women who are accustomed to living life on the go. But as the babies grow and you continue to gain weight, you’ll tire more easily and require more rest. Don’t fight it—give into it. Try to arrange for several naps during the day where you can fully recline, preferably on your left side (keeping weight off your lungs and helping organs function better). If you continue to work full-time and napping isn’t feasible, try to sit in a semireclined position with your feet elevated for at least 20 minutes several times a day.
Top Five Comfortable Sleeping Tips for Extremely Pregnant Women
By the third trimester, most women find it impossible to get a good night’s sleep—I know I did—but with a little ingenuity, expectant moms can get some rest. Start by trying these tips.
1. Try maternity pillows. These specially made pillows like the Leachco Snoogle Total Body Pillow come in all shapes, styles, and sizes and are used to give back support or belly support. Experiment with various positions and styles until you find the right one.
2. Place pillows strategically. If you’re on a limited budget, try using the pillows you have at home. A pillow wedged in the corner of your back (have your partner position it just so), one between your knees, and one under your stomach give you all the support you’ll need. Just don’t move too much in the middle of the night or you’ll have to adjust them all over again!
3. Avoid lying on your back. While it may be comfortable for some, sleeping on your back can decrease the blood flow to the babies. It will often make you feel lightheaded and, therefore, is not recommended.
4. Sleep semireclined. Create a minithrone of sorts on your bed using lots of pillows. Then sleep semireclined with your head resting on a pillow against the wall or headboard.
5. Experiment with other types of furniture. I slept on a soft leather couch during my last month (other moms told me they slept on their living-room couches, too). The cushions molded to my body, and the couch back gave me support. Another expectant mom successfully slept for weeks on her living-room recliner.
“I stopped working out almost immediately. Being an older mom I knew the risks, and I didn’t want to push it. I would walk but gave up the elliptical machine and weights. I started eating well-balanced meals. I forced myself to cover all the food groups because I worried about the babies getting the nutrients they needed. I probably would have been that way with one but with two, I was über watchful.” (Jack and Luke arrived at Week 35½, each weighing 6 pounds.)
Although exercising helps maintain good circulation and muscle tone, many doctors recommend restricting all aerobic activities at approximately Week 20. For some women, vigorous exercise brings on early labor. Yoga, stretching, walking, swimming, and other forms of moderate activity are usually acceptable for most women expecting twins unless they experience contractions—when it is advisable to stop.
Is It OK to Have Sex?
Sexual desire changes as a woman’s body changes. As pregnancy progresses, some women have increased sex drives; others feel so fatigued and nauseated that sex is the last thing on their minds. It’s not unusual for husbands to feel less amorous toward their wives as well. Often a frank discussion will reveal their fears of hurting the babies. Yet sex during pregnancy can be a great time for togetherness, a way for husbands and wives to connect emotionally. With no need for contraception, lovemaking can be spontaneous. For many, the stress of trying to conceive has been eliminated, enhancing their lovemaking even further. Don’t worry about your size, just approach your lovemaking with a sense of humor (not to mention a sense of adventure, since you’ll need to be inventive with your lovemaking positions).
To the disappointment of many couples, though, some doctors recommend abstaining from sex during the last trimester since the female orgasm can sometimes increase uterine activity, prompting preterm labor. In addition, semen contains prostaglandin, which can stimulate vaginal contractions. Be sure to discuss your concerns about sexual activity with your doctor.
When to Leave Work
“My obstetrician recommended that I stop work at 24 weeks, which I thought was way too early since I had worked full-time until 36 weeks with my first child. Believe me, by Week 24, I was ready to stop working and stay home.”
Doctors’ opinions vary regarding the best time for a woman carrying twins to cease working. For some mothers-to-be, leaving work around Week 20, as many doctors suggest, will be a welcome treat, while others face a financial hardship if even a day is missed. Planning ahead by working out a pregnancy budget and making saving money a top priority will help ease the postpartum financial burden.
There are other options to explore as well, such as cutting back on days or hours at work, telecommuting from home one or two days a week, or taking advantage of the Family and Medical Leave Act (FMLA) where eligible employees can take up to 12 weeks of unpaid leave for the birth and care of an infant. If your doctor does recommend leaving work before you had initially planned or orders you on bed rest, be sure to check with your benefits counselor at work to see whether you qualify for disability insurance.