Double (or Triple) the Fun

What to Expect When You’re Expecting Multiples

Story by Amy Newman

Tasha Aina of Palmer, mom to 5-month-old twin girls, knew her third pregnancy was different. She was growing by the day, and she’d never experienced such terrible morning sickness. Yet she still wasn’t prepared when her 16-week ultrasound showed she was carrying twins.

“I looked at (the technician) like he was crazy and screamed, ‘You mean there’s two of them in there?’ ” she recalls.

The initial shock of finding out you’re having twins or triplets is quickly followed by a sense of panic. Will mom and babies be safe? Will we drown in baby stuff? Will we ever sleep?

It’s true, a multiples pregnancy may be more than mom expected – common complaints such as nausea, heartburn and aches and pains are usually magnified. And the early days handling multiple infants are generally a blur, thanks to sleep deprivation (also magnified).

But parents will quickly find that nothing quite compares to the unique experience of raising multiples.

Consider complications

Keep in mind that the majority of moms expecting twins or more give birth to healthy babies. Still, it’s important to be aware of possible complications. The more babies you’re carrying, the higher your risk for gestational diabetes, preeclampsia, growth restriction and preterm labor, says Corinna Muller, D.O., maternal-fetal medicine specialist at Providence Alaska Medical Center. And it’s important for doctors to know early on what kind of twins mom is carrying, Muller says.

Identical twins who share a placenta are at risk of developing twin-to-twin transfusion syndrome (TTTS), which is caused by an unequal sharing of the placenta, Muller says. TTTS results in one twin receiving more blood from the placenta, causing him to be larger and surrounded by more amniotic fluid than the other twin. Although the risk is small, identical twins need close monitoring in case intervention is necessary, Muller says.

The biggest risk facing multiples is prematurity, Muller says. A pregnancy is considered full-term at 38 weeks. The average gestation for twin pregnancies, however, is 36 weeks, and 33 weeks for triplets, she says. This means most multiples will spend at least some time in the neonatal intensive care unit (NICU).

To prepare parents for this possibility, Jennifer Aist, mom of twins and facilitator of Providence’s Expecting Multiples class, stops at the NICU when she takes her students on a tour of the maternity ward, so they have some idea of what to expect if their babies are admitted.

“My goal is not to freak them out. (But) if I can take away a little bit of that fear, that’s a good thing,” says Aist, who is also manager of Maternity Outpatient Clinics & Services at Providence.

For moms wanting a vaginal delivery, Muller says it’s possible, if both babies present in the head down position. She estimates that 40 percent of twins are delivered vaginally, albeit in the operating room in case an emergency C-section is required. But even if both babies present in the optimal position, a lot depends on the experience and comfort level of the delivering obstetrician, she adds – meaning your choice of obstetrician or where you live could mandate a C-section.

Managing all those babies – and your sanity

Once those double bundles come home, many parents quickly become consumed by the demands of multiple infants, especially if they attempt to do everything “on demand.” To cope, most parents create some type of schedule, Aist says.

“I can’t imagine having any time to sleep in the very beginning if a schedule wasn’t followed,” says Stephanie Slette of Delta Junction, mom to 2-year-old triplets. “I think I was only getting an hour between feedings at most as it was.”

Bethany Buongiorne of Palmer, mom to 2-year-old twins, agrees. “It’s less about being a drill sergeant and more that they will ask for food/nap/play at the scheduled times because that’s when they have come to expect it,” she says.

Infants who spend time in the NICU generally come home on a three or four-hour feeding schedule, and most parents stick with that, making adjustments as their babies’ needs change. Some parents feed each child back to back and change diapers as needed, while others do both simultaneously, says Aist.

Parents also attempt to coordinate their babies’ sleep schedules, putting both down when one gets tired, and letting them wake naturally. However the schedule is structured, Aist says, most parents agree on one major detail – when one baby wakes at night to eat, wake the other and feed them both.

“Your body has to have rest at one point,” Aist says. “People think they can maintain (a demand schedule). They keep it up for several weeks, and then they hit the wall, and they hit it hard.”

How much stuff will we need?

One infant comes with a lot of stuff. With two or more, your home can quickly resemble a Babies ’R Us showroom. So does having multiples mean buying multiple everything?

For some items, yes. One car seat per infant is a given, as is one high chair. Each baby will eventually need his own bed, though some parents co-bed their infants the first few months. One Boppy pillow per infant is also useful, particularly as a feeding aide when the babies can hold their own bottles. For larger items, like bouncers and swings, some parents insist on having one per infant, while others have one of each and set them up as activity stations, rotating the babies between them throughout the day, Aist says.

Raising multiples is definitely a whirlwind. To truly enjoy it, Aist advises parents to give up the idea that they must do it all – and do it all on their own. “Ask for help,” she says. “Get over it and ask for help. Nothing has humbled me more, or made me appreciate the little things more, than having twins.”