A healthy twin pregnancy still carries more risk for complications than a single pregnancy. Your diet, ability to rest, ability to follow though on bed-rest orders and knowledge of the signs of pre-term labor are all factors you must take into account.
One of the first things you should be concerned with is finding the best medical care – a maternal-fetal medicine specialist, obstetrician who has had specialized training and experience . You need to be confident in their ability to see you through what may end up being a high-risk pregnancy. Do your research and choose wisely. Having a healthy twin pregnancy will create healthy babies.
We were lucky enough to have the best of both world’s in that I had a wonderful midwife who had experience in diet and delivering twins, as well as the supervision of an excellent obstetrician who specialized in twin pregnancies and births.
1 week old pre-mature twin girlsThere will be tests done! Some are mandatory, others you can decide if you want or not. Your health care provider should explain each in detail to you. Pelvic examinations, urine tests at every visit to check for ketones (to make sure your diet has enough calories), as well as to check for protein ( which can be an indicator of preeclampsia). Blood test will be done to check for anemia – this can be common in twin pregnancies as there is more of a drain on your iron reserves with two babies. Your blood is also checked for the RH factor-hepatitis B, syphyllis and HIV . Ultrasounds will be done regularly ( which is the best part!). Some other tests are the alpha-fetoprotein test, the fetal fibroconectin test, amniocentisis, chorionic villus sampling and the glucosetolerance test – for gestational diabetes.
I am not going to go into detail about these here as I am not a health care professional, and I personally chose to have the minimum of invasive tests done. This is a personal decision for each expectant mother, so please, ask questions and do your research and make the best decisions on your medical care for your healthy twin pregnancy.
More on some of the possible complications with a twin pregnancy here.
The importance of your diet in pregnancy
What you choose to eat is a major factor in having a healthy twin pregnancy.“Protein, protein, protein” was my midwife’s motto. You are not eating for two – you are eating for three which raises your need for calories significantly. Now is the time to worry about gaining weight – to concentrate on providing the diet and nutrition to build healthy babies. Well nourished babies tend to have higher birth weights and may reduce the likelihood of prematurity. You have to keep in mindthat your pregnancy may not to all the way to term – so how you eat every day does matter. Make every bite count toward a healthy twin pregnancy!
I found the best way to eat was to eat 6 mini-meals during the day rather that 3 big ones. This keeps your blood sugarsteady ( which can help prevent preterm labor) and doesn’t make you as uncomfortable as those twins start taking up all the space. Be creative and think healthy-
apple slices and cheese
cereal with milk and fruit
protein shakes or smoothies ( lived on these ! )
bran muffin with yogurt
scrambled eggs and wholewheat toast
Eating this kind of diet rather than letting yourself get ravenous by waiting helps both you and the babies. You should be eating every 2-3 hours.
I ate this way with my twins who were born at 37.5 weeks and weighed 7lbs8oz and 5lb14oz each. I had gained 60 pounds with this pregnancy, and 50 lbs of it was gone by the 6 week postpartum mark thanks to breastfeeding ! All those extra healthy calories I had eaten had gone to building my babies.
I found it helped to think about the twins – what they would need to grow- protein for healthy muscle development-meat, fish, dairy products, poultry and eggs, calcium for healthy bones and teeth ( NOW is the time to eat ice cream without feeling guilty!),iron rich foods for healthy blood volume, healthy fats for proper nerve development and brain function and of course carbohydrates for energy ! Here is where you should really focus on getting fiber in your diet- it will help with constipation which is common in pregnancy as everything slows down in order for your digestive system to take the most out of the foods you eat to grow your babies. This can also lead to hemorrhoids ( which you don’t want !) – eat lots of whole grains and bran, raw fruits and vegetables.
There are also many liquid nutritional supplements on the market – read the labels, look for ones that are high in protein and have some fiber. Or make up your own with milk, protein powder and fruit. Remember you only have a limited time to give these babies all the nutrition you can ! Some things with this pregnancy you cannot control – but you can control your diet.
Drink Up!
Drink LOTS of water ! Dehydration – even mild can trigger contractions so this is SO important. Your healthy twin pregnancy depends on it. Keep a water bottlehandy all the time. This can help you avoid urinary tract infections which can also trigger premature labor. Water alsohelp ease constipation and headaches. Throw in a slice of lemon or fruit juice to jazz it up. And yes, this will make you pee a lot – but that’s OK – it really is that important to your diet, your healthy twin pregnancy, and the health of your unborn babies.
Things to avoid
You will want to stay away from over the counter medications ( acetaminophen is about all that is considered safe.
NO ALCOHOL!
Can’t stress this enough – it can lead to birth defects- cleft lip and FAS ( fetal alcohol syndrome) – with symptoms like delayed growth, mental retardation, ADHD, cardiac problems, impaired vision or hearing and delayed growth. If this is an issue for youseek medical attention – this problems are irreversible ! Alcohol has no place in a healthy twin pregnancy diet.
Cigarettes are another – it is time to quit for the health of your babies.It raises your risk of miscarriage, as well as low birthweights for your babies. SIDS ( Sudden Infant Death Syndrome) is also linked to exposure to cigarette smoke, so have others around you respect that as well – have a smoke-free home.
Rest and Bedrest
Bed Rest and Rest in general
Again – this will be between you and your health care provider. Sometimes it is imperative to have a healthy twin pregnancy. Your goal is to keep those babies IN as long as you possibly can. Depending on the job you do – if you work outside the home, and the risk factors you have for premature labor, best rest can increase your babies gestation by weeks! Laying down can relieve pressure on the cervix, increase blood flow and circulation, reduce contractions and conserve your energy.
Bedrest can really help increase your babies odds. There are variations on this – you may have to leave work early and limit any lifting, you may be confined to bed but able to sit up, you may have to stay in bed laying down all the time except to go to the bathroom – or you may need hospitalization with an IV and labor-stopping medications. As hard as this can be – especially if you are used to being very busy and active – you need to do what is right for those babies. Ask for support, write in a journal, stay connected with TV and the internet, catch up on all the movies you can , read books and rest. Every extra day those babies have to grow is a blessing. I found it really helped to have a big calendar and mark off each day as it passes, and cheer as we reached each milestone!
Each week they stay inside you is one less week they will be in the hospital. Just try to relax and see that your most important job right now is to sustain a healthy twin pregnancy for as long as possible.
Premature Babies
What if the babies come early?
Get ready for labor and delivery.Signs of preterm labor
In each healthy twin pregnancy – full term is actually considered 37 weeks rather than the 40 weeks of a singleton pregnancy. Almost half of all twins come before that! Preemies who survive can be at higher risk for hearing loss, vision problems, and developmental disabilities. Here are some milestones to work toward.
20-24 weeks – just bordering on viability
25-28 weeks – very early preterm – odds of survival are better but babies at this gestation will need to spend months in the NICU
29-32 weeks – early preterm – the babies will likely have to remain in the hospital for several weeks but the prognosis is generally good !
If the mother is given steroid injections to help the babies’ lung development the babies have an advantage.
33-35 weeks – twins are often born , they are generally well grown and may just need a week or two in hospital to put on weight.
36-38 weeks – this is the ideal for twins ! usually at this stage they will be coming home with you.
If you are having any of these signs – call your doctor- day or night-
-contractions of more than 6 an hour
-persistent pelvic pressure
-menstrual like cramps, with or without diarrhea
-sudden or persistent lower backache
-vaginal discharge – especially if it has changed color, consistency or amount
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