What to expect when you're expecting (163 page)

What’s up with the lack of tact? The truth is, many people don’t know how to react to the news that you’re carrying multiples. Sure, a simple “Congratulations!” might be in order, but most people assume that twins are special (they are) and therefore need to be recognized with a “special” comment. Curious about what it must be like to be pregnant with twins, in awe of what you’ll be going through once they’re born, they’re clueless about the right response—so they dish out the completely wrong one. Their intentions are good, but their follow-through stinks.

The best way to react to the rudeness? Don’t take it personally, and don’t take it too seriously. Realize that even as your friend opened her mouth and inserted her foot, she was almost certainly trying to wish you well (and she probably has no idea that she offended you, so try not to take offense). Remember, too, that you’re the best spokeswoman for moms of twins everywhere—and you’ll have lots of chances to spread the wonderful word on multiples.

“People keep on asking me if twins run in my family or if I had fertility treatment. I’m not ashamed that I conceived my babies using a fertility drug, but it’s also not something I want to share with strangers.”

A pregnant woman brings out the nosy like no one else, but a woman expecting multiples becomes everybody’s business. Suddenly, your pregnancy goes public—with people you hardly know (or don’t know at all) prying into your personal life (and bedroom habits) and prodding you for personal information without thinking twice. But that’s just the point—these people aren’t really thinking twice—or even once. They’re not asking to be intrusive, they’re just curious (multiples are fascinating stuff, after all), and they haven’t been educated in the fine art of twin etiquette. If you’re open to spilling the juicy details, then by all means, go for it (“Well, first we tried Clomid, and when that didn’t work we tried IVF, which means that my husband and I went to a fertility clinic …”). By the time you’re halfway done with your story, the questioner will probably be bored to tears and looking for the nearest exit. Or, you can try one of these responses the next time someone asks about the conception of your twins:

“They were a big surprise.” This can be true whether you’ve conceived with or without fertility help.

“Twins run in the family—now.” This will shut them up while keeping them guessing.

“We had sex twice in one night.” Who hasn’t at some point? Even if the last time was on your honeymoon, it’s not a lie—and it’ll be the end of the line for their line of questioning.

“They were conceived with love.” Well, that’s a given, no matter what—and where do they go from there?

“Why do you ask?” If they’re TTC (trying to conceive) themselves, then maybe it’ll open up a conversation that could help them (infertility can be a lonely road, as you probably know). If not, it could stop them in their nosy tracks. After all, they’re not nearly as interested in talking about their own lives as they are about yours.

Not in the mood for a witty retort—or to even respond at all (especially after you’ve been asked the same question five times in a single day)? There’s nothing wrong with letting the questioner know that the answer is none of her business, which it isn’t. “That’s a personal matter” says it all.

“We’d barely adjusted to the fact that I was pregnant when we found out I’m carrying twins. Are there any extra risks for them, or for me?”

Extra babies do come with some extra risks, but not as many as you’d think. In fact, not all twin pregnancies are classified as “high risk” (though higher-order multiples definitely fall into that category), and most expectant mothers of multiples can expect to have relatively uneventful pregnancies (at least in terms of complications). Plus, entering your twin pregnancy armed with a little knowledge about the potential risks and complications can help you avoid many, and will prepare you should you encounter any. So relax (twin pregnancies are really safe), but read up.

For the babies, the potential risks include:

Early delivery.
Multiples tend to arrive earlier than singletons. More than half of twins (59 percent of them), most triplets (93 percent), and practically all quadruplets are born premature. While women pregnant with only one fetus deliver, on average, at 39 weeks, twin delivery, on average, occurs at 35 to 36 weeks. Triplets usually come (again, on average) at 32 weeks, and quadruplets at 30 weeks. (Keep in mind that term for twins is considered 37 weeks, not 40.) After all, as cozy as it can be for your little ones in the uterus, it can also get pretty crowded as they grow. Be sure you know the signs of premature labor, and don’t hesitate to call your practitioner right away if you’re experiencing any of them (see
page 300
).

Low birthweight.
Since many multiple pregnancies end early, most babies born of multiple pregnancies arrive weighing less than 5½ pounds, which is considered low birthweight. Most 5-pounders end up doing just fine healthwise, thanks to advances in caring for these small newborns, but babies born weighing less than 3 pounds are at increased risk for health complications as newborns, as well as for long-term disabilities. Making sure your prenatal health is in top-notch condition and your diet contains plenty of nutrients (including the right amount of calories) can help get your babies to a bigger birthweight. (See
What to Expect the First Year
for more on premature babies.)

Twin-to-Twin Transfusion Syndrome (TTTS).
This in utero condition, which happens in about 15 percent of identical twin pregnancies in which the placenta is shared (fraternal twins are almost never affected because they never share a placenta), occurs when blood vessels in their shared placenta cross, resulting in one baby getting too much blood flow and the other too little. This condition is dangerous for the babies, though not to the mother. If it’s detected in your pregnancy, your practitioner may opt to use amniocentesis to drain off excess fluid, which improves blood flow in the placenta and reduces the risk of preterm labor. Laser surgery to seal off the connection between the blood vessels is another option your practitioner may use. If you’re dealing with TTTS, check out
fetalhope.org
for more information and resources.

Multiple Benefits

Good news! There’s never been a safer time to conceive, carry, and give birth to more than one baby, and for lots of reassuring reasons. Here’s what you have going for you as a mom-to-be of multiples these days:

A heads-up. Since the discovery that you’re carrying multiples almost always comes early on in pregnancy these days, you’ve got extra time for planning and preparing for your babies, plus plenty of time to get the best possible prenatal care. And good prenatal care is the ticket to a healthy pregnancy—doubly so in a multiple pregnancy.

Lots more practitioner visits. Good prenatal care starts with more frequent practitioner visits. You’ll likely be seen every two to three weeks (rather than every four) up until your seventh month and more frequently after that. And those visits may get more in-depth as your pregnancy progresses. You’ll get all the tests singleton moms get, but you may also get internal exams earlier than a singleton mom-to-be would get (to check for signs of preterm labor).