Prenatal Care
During pregnancy, moms expecting twins need to make sure they have good prenatal care and adequate weight gain and nutritional intake, hydration, and plenty of rest. According to the ACOG guidelines for weight gain a woman carrying twins should gain 40-45 pounds. To maintain an adequate diet, a woman carrying twins should consume approximately 2,700 healthy calories per day. Like all pregnant women, she should also be taking prenatal vitamins. In order to prevent preterm labor, a multiple mom should take in plenty of fluids throughout the day. Dehydration can cause contractions leading to a premature birth. As a rule, she should consume about a gallon of liquid (water, milk, juice) per day. Rest is a major factor in getting a mother of twins to term. By setting up hour long rest periods a few times per day, the woman will decrease the likelihood she’ll be placed on bed rest.
Prematurity
If you are pregnant with twins, you need to be aware of the warning signs of premature labor:
- Greater than four contractions per hour
- Sporatic lower back pain
- Increased vaginal discharge-loss of mucous plug
- Bleeding
- Leaking water
Women who give birth prematurely have a higher risk that their babies may not be fully developed and capable of living unassisted outside the womb. Babies born prematurely may have a low birthweight, underdeveloped lungs, vision problems, renal funtion problems, and more. Therefore, it is vital that a mom of multiples gets proper nutrition, hydration, rest and prenatal care.
A woman who may be in premature labor may be monitored, placed on bed rest, and/or receive a tocolytic such as: Terbutaline (Brethine) or Magnesium Sulfate. Some of the side effects of Terbutaline are: headaches, shakiness, and nausea. For Magnesium Sulfate, side effects include: drowsiness, flushing, perspiration, and nausea. The goal is to get a mom of twins to at least 36 weeks gestation.
Birthing Twins
Childbirth education is very important in all pregnancies, and maybe especially so when expecting twins. Choose a childbirth class that will cover nutrition, recognizing and preventing premature labor, pain coping techniques, labor support techniques, the judicious use of medical tools, cesarean birth, postpartum care, and breastfeeding essentials.
Mothers of multiples are more likely to deliver by cesarean than mothers of singletons. Approximately one half of moms carrying twins go on to have a cesarean. Often the reason for the cesarean is in the position of the babies. Vaginal births are more successful when the first baby is in the vertex, or head down, position. Even if the second baby is breech, she may turn after the first baby is delivered or the caregiver may deliver her vaginally in the breech position. Occasionally, the second baby needs to be born by cesarean though the first was born vaginally. Babies born vaginally may deliver up to thirty minutes apart. Cesarean delivered babies generally are born just a few minutes apart.
