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When you find out that you're carrying more than one baby, your first instinct may be to wonder if there's room in there for more than one baby! But, there are other issues which commonly come up for multiple mums-to-be. We give you the lowdown on multiple pregnancies.
Twins can either be identical (from one fertilised egg which then splits) or non-identical (from two separate eggs). Identical twins have to be the same sex, as they have the same genes. Non-identical twins can either be the same sex or one of each.
How twin pregnancies happen
- Identical twins. One egg splits after fertilisation into two separate cells – each one of these growing into a baby (usually sharing the same placenta). Having developed from the same cell, they are always the same sex and look alike.
- Non-identical or fraternal twins. Two eggs are fertilised by two different sperm at the same time, (each baby having its own placenta). They can be different sexes and probably will not look any more alike than any brother or sister.
Twin Pregnancy Diagnosis
Twin pregnancy used to be diagnosed clinically when the mother reported that her symptoms of pregnancy were worse than usual and the womb was found to be bigger than expected for the gestational dates. Sometimes twins were diagnosed for the first time in labour – certainly a surprise for both the expectant couple and the obstetrician alike. Nowadays, the ultrasound scan performed routinely between the 16th and 20th week usually allows a much earlier diagnosis.
Effects of a twin pregnancy
Many mothers expecting twins say it's harder and more tiring. You have a greater load to carry – not just an extra baby, but an extra placenta, and extra amniotic fluid. The added weight can mean the likelihood of more backache and more fatigue. Your blood pressure is also likely to be higher. You may need to rest more than a mother expecting one baby, and you may want to think about stopping work sooner.
Birth of twins
Although there's a higher chance of twins being born pre-term, most are born only a little earlier than term – at about 37 or 38 weeks.
The birth of twins usually goes smoothly, with both born head down. But caesarean section is more common with twins, and the main reason is simply one of space. One or both of the babies ends up in a less-than-perfect position, because that's the only way he or she can make room for himself.
So one or both might be breech, coming bottom or feet first. Occasionally, one baby actually lies across the uterus. If it's the twin nearest the exit lying like this, a caesarean is essential.
Twins can be small, and weaker than single babies. Sometimes, a caesarean might be the easiest, least stressful way for twins to be born.
Because twin pregnancy and births have the potential for more challenges, you'll find you will see the obstetrician more often, and all aspects of your pregnancy and the labour and birth will be monitored very carefully. Twins are more likely to need some time in special care after the birth; you'll probably be advised to stay a little longer in hospital yourself, even if your twins are fine and perfectly healthy (as most are). This will give you the chance to become more comfortable with feeding your babies, and build your confidence about their routine, day to day care. See our feature on Twin births for more information.
Breastfeeding twins
Your body can make as much milk as your babies need – twice the stimulation of the supply, twice the amount made. It's the practical aspects that might be harder for you – how to hold them so you are all three comfortable, or whether to feed one at a time instead of both together. The babies may not have the same appetite, and they may be hungry at different times, too. You'll need plenty of help to assist with the other aspects of the babies' care, such as bathing, nappy changing and clothes washing.
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