Pregnant With Twins: Questions and Answers

When we find out we are pregnant with twins, a million more questions come up that we weren’t yet thinking about. Can we still have a natural birth, can we still have a home birth? What risks might come up? What do I need to do differently? When we go out into public, especially during pregnancy, people like to give their opinions, and tell you the best thing to do, or the worst stories they’ve ever heard of! So, put on your earmuffs! We need to educate ourselves, talk with our own inner wisdom and decide what the “right” path is for ourselves. To help us out, I’ve enlisted the help of Direct Entry Midwife Brenda Capps who has delivered many sets of twins at home births. The format here is a little different because we haven’t yet sat down for a full interview, so Brenda took the time to answer some questions that I had by email. These answers vary differently that what a Doctor or a CNM might say, or even an experienced unassisted birther might say, so look at all sides and be sure and use your own judgment in deciding what is a good experience for you and your family, even when you are pregnant with twins!

Ashley: Why is it that some people consider twin pregnancy & twin births “high risk? What is the risk?

Brenda: Most consider twin pregnancy high risk due to the fact the Mom is carrying two babies instead of one. This is a day when most professional MD’s or Midwives are not trained to deliver or catch twins. I personally see no high risk in a twin birth unless we have a Mother who is not taking care of herself with nutrition and rest. Another risk is that most of the time one baby is always breech. Some (doctors) will deliver (vaginally) if first baby is head first but then c-section second baby. If both are breech then there is no way mom will have a chance of delivering naturally. Other reasons it is considered a risk: delivering preterm 34-37 weeks, twin-to-twin transfusion. Some twins can share a sac, which is very high risk, which can cause defects from mild to serious; this of course is very rare. Twins can be different in size, which can be a risk.The only risk I would even say is most times the second baby usually has a little problem getting started. We have to work with it a little more than the first. I feel due to maybe a little less blood flow than baby 1.

Pregnant with Twins: Can I deliver at home?

Ashley: Is it safe to deliver naturally or at home?

Brenda: Yes. If a Mother wants to deliver naturally then home is her best way to go. No interference and her body can work the way it is supposed to work to get a baby or babies out.

Ashley: What is it that you most want pregnant with twin mothers to know?

Brenda: I want them to really know the risk if any that is involved and be educated to know if that is something they really want to do. I want them to take responsibility for their pregnancy and eat and stay healthy. I really talk to my parents and we discuss all concerns before hand and talk about them at every prenatal.

Ashley: During pregnancy, what do you recommend to women pregnant with twins?

Brenda: I would recommend at least one ultrasound to confirm twins and make sure they are in their own sac. Continue to exercise if they are used to it, but don’t start something new. Eat six small meals a day as this will help with acid reflux. Eat at least 100 grams of protein a day as this help prevent pre-eclampsia. Eat lots of foods high in fiber, to keep the bowels going and iron to help prevent anemia as twin’s moms have a tendency to be. Keep all appointments so we can keep a check on the growth and progress of babies and Mommy. If a Mother is having her twins in hospital setting and seeing a physician I recommend no pelvic exams as I feel this will increase the risk of premature labor.

Ashley: What, if anything, is unique to twin pregnancy in your experience? Or are they the same as a regular singleton pregnancy?

Brenda: I really find no difference in a singleton or twin pregnancy. The Mother is usually little more uncomfortable as she gets bigger and has more weight to carry. Some twin’s Mom’s do have to go on bed rest sooner due to more pressure in the latter months. Most continue to do daily activities as normal.Twins (whether they are fraternal or identical) who occupy separate sacs are at no higher risk than any singleton birth.

Ashley: Are there any psychological differences in the pregnancy for the mother?

Brenda: I really can’t think of anything special. Just from my own experience with triplets, I sometime felt overwhelmed and tired most days. If she is in a position of not being able to care for her family she may get depressed, but I find that in most Mothers whether singleton or twins.

Pregnant With Twins: What are my nutritional needs?

Ashley: Any special nutritional needs when you are pregnant with twins?

Brenda: I find just a healthy well balanced diet is the best course to follow. More protein, fiber, 8 glasses of water a day, no caffeine, less sugar, salt as the body needs salt to retain the water needed for the increase in blood volume. I recommend to not adding extra salt to the cooked foods. I tell all my Mothers if you must drink soda please drop the caffeine. I allow sweets, snacks, but in moderation.

Ashley: Can you wait for twins to come at full term or do they need to be induced early?

Brenda: There is no reason unless she is experiencing problems (then she needs more professional help than I can give) to induce or recommend the babies come early. Babies do better if left alone and come when ready.

Ashley: Can mothers work when they are pregnant with twins through the pregnancy?

Brenda: I have had some to work up till the last 4-6 weeks and then take off. Most of my Mom’s are stay at home Moms. I did have one though who worked up till Friday and had babies Monday morning. So it all depends on the Mother and her physical condition.

Ashley: Is it possible to see what kind of twin they are before they are born?

Brenda: Most cases there is but sometimes it is hard to determine if the placenta is single or attached together.

Ashley: Are there special trainings or books you recommend for mothers pregnant with twins to be prepared for motherhood of twins (or pregnancy/birth of twins)?

Brenda: I do recommend a book on twins. “TWINS! PREGNANCY, BIRTH AND THE FIRST YEAR OF LIFE”, by Connie Agnew. I have found this to be a really good book.

Ashley: What are the more probable complications when we are pregnant with twins and during birth? What can we do to prevent them?

Brenda: Preterm labor, extra bleeding especially with number 2 or baby B. With my experience this is a hard question to answer as I have never had a real bad complications. The thing we can do is be prepared for the best and worst of the situation and act upon it. Follow the advice of the midwife or physician and I feel all will go well. (Ashley throws in: If you are going with a midwife or physician, make sure you only follow the one you trust & whose words ring true to you!) Take care of yourself in the pregnancy. Not everyone wants to hear this answer but Prayer is the Key to all situations.

Ashley: In general, what do you see as the role of a midwife at birth? And what do you see is the role of the parents?

Brenda: As a midwife I am there to be their helper, teacher, guide, coach, a person whom they can call on 24 hours a day for anything that may be bothering them or any questions they may have. I want to be prepared for whatever happens and takes place, to make the right decisions. If I recommend transferring then I expect the parents to be ready to go. As parents I expect them to take control of their pregnancy and assume the responsibility of the pregnancy and do the required things that I may request. It is their birth and I am just the helper. I expect them to call me with any questions or concerns they may have and have faith and confidence in me that I will not steer them in the wrong direction. I expect them to realize I am human and not GOD and will never try to take HIS place.

Thank you Brenda for your time and experience. It is amazing how few people hold vast experience in this area, and as mothers pregnant with twins it is great to learn from someone in the trenches! Mostly seek out information and people that empower you, no matter what special circumstances your twin pregnancy encounters! Pregnant with Twins back to Natural Pregnancy