Giving birth to twins, triplets or other multiples require special care. You are more likely to give birth to multiples if there is a family history, if you have given birth to multiples before or you belong to a particular population group. Since it is possible to know beforehand whether you are carrying multiples, you need to prepare for birth. This will probably involve better attention to your nutritional needs, more rest, higher gain in weight and preparation of child care for more than one baby. It can be a huge undertaking.

As soon as you come to know that you are carrying multiples, there are a number of things to do. The fact is that multiple fetuses are more vulnerable to prenatal problems and special care is needed to carry your pregnancy to term and deliver healthy babies.

Incidence of multiple births

When a woman gives birth to more than one baby at a time it is known as multiple birth. It may happen due to a number of reasons:

  1. If the mother has a family history of multiple births, chances are higher that she will give birth to multiples.
  2. Recent data shows multiples are more common among certain races, like the African American.
  3. Older women are more likely to give birth to multiple babies.
  4. Women who conceive after infertility treatment have a higher chance of having multiple babies.

The following table of statistics gives an idea about the incidence of multiple births in the USA: (Source - www.cdc.gov/nchs/fastats/multiple.htm)

Number of twin births in USA, 2011 131269
Number of triplet births in USA, 2011 5137
Number of quadruplet births in USA, 2011 239
Number of quintuplet births in USA, 2011 41

Adjusting the mindset to accept twins

Once you are over the initial shock of having multiples, it is time to adjust your ideas. This mental preparation is the first and most essential step that you can take in order to prepare for multiple births.

  1. Now you know that you are carrying not one but two (or more) babies, it is time to set aside your conventional ideas of single fetus pregnancy because things are going to be very different for you.
  2. Rest is essential. No pregnant woman should exert herself, but those carrying multiples have to take special care to avoid fatigue. If you are working, then you may have to stop quite early. In some cases, the doctor may even prescribe bed rest.
  3. If you are pregnant with multiples, you are probably going to experience all the discomforts of pregnancy to a higher degree. For example, you will gain more weight. So, you need to pamper yourself. Bear in mind that taking care of two or more newborn babies is likely to be quite exhausting.
  4. You will need to take better care of your nutrition.
  5. C sections are common during multiple births. Normal delivery is only possible if the lower child is positioned properly. So, you need to prepare yourself mentally for C section.
  6. Finally, two (or more) babies imply higher expenses. You will be too exhausted after childbirth. Your pregnancy is the time when you should discuss the financial aspects with your partner to make proper planning.

Nutritional needs for multiple births

If you are carrying multiple fetuses, your nutritional needs will definitely be higher than other pregnant women. Even in case of single fetus pregnancy, expectant mothers have to take higher amounts of certain nutrients and even take supplements. In your case, the nutritional needs are likely to be even more special. Here are a few facts to remember:

  • You will need to take more calcium. This is best done by incorporating calcium rich foods like milk, broccoli, sardines and fortified orange juice in your daily diet.
  • Iron supplements are a must and the dosage needs to be carefully adjusted. Your blood is nourishing two or more children. So, you need more iron. However, excessive iron causes constipation which will increase your discomfort. Also you need to take adequate vitamin C which helps in the absorption of iron.
  • Folic acid is another very important nutrient and you may be given a supplement for it.
  • Increase your protein intake in case you are expecting multiple births.

Staying healthy

Women carrying multiple fetuses require special care. You need to stay healthy. The following guidelines can help you in this:

  • You are going to require lots of rest. Sometimes, you may even be prescribed bed rest.
  • One of the common characteristics is that you will have to undergo more frequent tests. Multiple birth pregnancies are automatically termed high risk. Hence, you will have to undergo regular testing at greater frequency to ensure your own health and that of your children.
  • Get enough sleep. Chances are high that you will not get much sleep once the babies are born. This is the time to give your body the rest that it craves.
  • Drink plenty of water and fluids.
  • Consult your doctor and go for light exercise like walking.
  • In the advanced stages of your pregnancy, you will need to be monitored closely for signs of preterm labor – a common complication in multiple births.

Tips about what to do and what not to do

Having twins or triplets can be a great experience. Here are a few tips and guidelines to help you understand what you should and should not do:

  • The first thing is to ask for help and accept it. Taking care of more than one child, when your body is already exhausted is not going to be easy. Get help from your partner and anybody else willing to offer it because after a month, you will be heartily glad of it.
  • If you do not know anybody around you who have given birth to multiples, you can join forums like MOST (Mothers of Super Twins). Chat groups and discussions can also help you.
  • You should not be far away from medical aid at any time during your pregnancy. Multiple fetuses have a higher incidence of complications and you need to be able to travel to the hospital at any time.
  • Draw up a schedule of diaper duties, feeding and changing routines and sleeping schedules after consulting your partner. Such a chart can save your sanity later on.
  • You will also need to prepare yourself to deal with any complications which are more likely to arise in multiple births than in a single birth.

Complications of multiple births

Several complications can develop in multiple births. Higher the number of fetuses, greater is the probability of complications.

  • There is a higher chance of C section in a multiple birth. Twins are often delivered normally and even triplets have been known to have been delivered normally, but C section is the norm.
  • If you are carrying multiple fetuses, you have higher chance of developing preeclampsia. This is a serious condition where the blood pressure of the mother rises and amount of protein in urine increases. Preeclampsia can lead to miscarriage and need to be carefully treated and monitored.
  • Preterm delivery is far more common in case of multiple births. If you show signs of preterm labor, you may be given a steroid injection which will help the lungs of the fetus to develop so that it can survive. Preterm infants require special care. They often have low birth weight and underdeveloped organs and may suffer from digestive and breathing problems. In very rare cases, a fetus which is in distressed is delivered prematurely while the others are allowed to reach full term. This is called delayed interval delivery.
  • In some cases, a blood vessel can connect the circulatory systems of the two babies. This is called the twin twin syndrome and aggressive intervention is needed. The babies are often delivered early for this purpose.
  • Finally, there is something called the Vanishing twin syndrome where a twin pregnancy is seen to carry only one baby at the time of delivery. There is no explanation for the loss and it can be quite difficult and confusing to cope with.

In conclusion it must be said that multiple births definitely carry higher risk, but medical intervention have gradually reduced that risk. If you are carrying multiple fetuses, you should get informed on the subject as you prepare to enjoy your children.