25 Feb

Why are twins double trouble?

From conception onwards, having twins seems to raise the bar. Through pregnancy and birth, mothers having twins are viewed as twice as delicate, with their precious double burden, placing a pressure on babies and parents that impacts on the birth as well as the early days and weeks of the babies’ lives.

Google “having twins is” and autofill offers the options of “hard” “so hard” “a blessing” and “a nightmare.” It must be difficult to focus on the blessing when society is so hell-bent on telling you you’re in for double trouble. “The way the majority of people turned my twin pregnancy into a negative really surprised me,” says mother of twins Jen. Another mum Mally adds “It makes you feel incredibly isolated. People are incredibly arrogant to think that they are much better off with ‘just the one’ (at a time).”

Having twins is increasingly common in the UK, partly because the overall birthrate is increasing, and medical advances means that more twins survive when born prematurely. In addition, women tend to wait a little longer to have babies, and over the age of 30 the likelihood of releasing multiple eggs, and therefore having twins, increases. Assisted conception through IVF and fertility drugs is another contributing factor. And more twin pregnancies means more opportunity for little old ladies to hover over your bump or your pushchair, giving advice and telling you what hard work it’s all going to be.

Kate, who has triplets, says: “Apparently it’s perfectly fine for the first question out of the gate to be ‘are they natural?’ Or ‘How were they conceived?’. What difference does it make? But it always feels like a loaded question to me.” It is loaded: with the assumption that you couldn’t have managed this all by yourself, and therefore that you cannot possibly birth, feed, or generally manage these babies all by yourself.

Most mothers who are having twins give birth to healthy babies. Some complications are more common in twin pregnancies, and modern medical practices mean monitoring for high blood pressure (a sign of pre-eclampsia), gestational diabetes and anaemia, all of which can usually be managed. For the babies, the complications that are likely to arise are a result of prematurity or low birth weight.

Giving birth to twins without medical professionals hovering around like cats on hot bricks seems unlikely. Even in the most uncomplicated twins pregnancy, it can be a challenge to avoid being channelled down the high-risk route and straight into theatre for a c-section. The effect of this is that skills and confidence in giving birth to twins without intervention are gradually eroded, and this is self-perpetuating.

I had the lady serving me in the post office say ‘twins? Poor you!’ the other week. I was so shocked I just stared at her. She then said ‘so you’re done now then’. I thought about her comments all day and got more and more upset. (Marie-Claire)

Once the babies arrive, the focus switches to all the things you surely cannot manage to do with two babies: breastfeed, sleep, get out of the house, retain your sanity. Most of the time I talk to singleton mums who tell me that all of those things are difficult; I’m not convinced that they are twice as difficult with twins, and one thing I know is that twins mums are a little better at recruiting the help they need. Life with any number of new babies can be hard work, and it’s hard to define “more” sleep-deprived when you’re as sleep-deprived as it seems possible to be.

Society needs to stop feeling sorry for mothers of twins; it’s a judgement they probably don’t need, and they get twice as much of it.

Thanks to members of Reading & District Twins Plus Club for their input. We’re talking about having twins in the next episode of Sprogcast.
Cross-posted from Huffington Post.

30 Nov

Twins: Leo & Isla’s Birth Story

Sharon is a mother of three and an NCT Breastfeeding Counsellor

Imagine our surprise when the sonographer pointed out, ‘Here is the heartbeat, oh, and here is the other heartbeat!’ and there began our very different birth experience. We were already parents to Rosa, now 6 years old, and were looking forward to being parents again. However, this was to be an altogether more complicated event!

We were very keen to have a home delivery with Rosa, and carefully researched the best birth pools on the market. I wanted as natural a delivery as possible. I laboured for the most part at home, but delivered in hospital due to her heartbeat going too high at the last minute. Back home the next day, no complications.

I naively thought we might be able to gun for a similar scenario this time round, but to my surprise, twins were considered ‘high risk’ and I would be strongly advised to deliver in hospital, probably by induction by 37 weeks, and in any case, in theatre. Not what I was hoping for at all. I knew all the risks associated with inductions and managed deliveries (continuous monitoring, more risk of interventions and C-sections) and wanted to do my best to avoid them!

Luckily, I am quite an assertive person so at the many of my antenatal appointments at Royal Berkshire Hospital (monthly scans from 20 weeks for twins!) I clearly set out my concerns to the various consultants and managed to agree to a compromise. Intermittent monitoring and stretch and sweeps to start off with instead of going straight to a routine induction.

Unbelievably, I got to 39 weeks (albeit sporting a giant tummy and unable to move much beyond a slow shuffle) before I finally agreed to be induced. The stretch and sweep hadn’t worked, and the risk of placenta failure after 38 weeks in twin births goes up drastically, so on Monday 15th October I began the induction process at 3pm. My mother was at home looking after my daughter and my husband Jon stayed with me as we waited for the progesterone pessary to take effect.

Nothing much happened initially, so Jon went home that evening and I stayed overnight, contractions not really getting going until later that evening. By the morning, they were much stronger and more regular, and very painful. Unfortunately, despite all this, I remained at 2 cms dilated, so by Tuesday afternoon, it was agreed that my waters would be broken. This really got things underway, and contractions came hard and fast. They were much more painful than I remember with Rosa, but I coped well with gas and air and good old fashioned breathing techniques.

The hospital were careful to remember my wishes and I was able to labour in private with one midwife and my husband, and only have intermittent monitoring of the babies heartbeats. That way, I was able to remain more mobile and hopefully speed labour up a bit.

The last shift change of staff meant that by some strange coincidence, the midwife who delivered our first daughter was with me for the second stage of labour. I reached 10cms and was swiftly taken into theatre for delivery. They tried to put in a spinal block in case I needed forceps assistance or a C-Section to deliver the second twin, but as they tried to put one in, our first twin decided he could wait no longer, and popped his head out!

All I remember at this point was chaos as staff ran around waiting for him to come and decisions were made about what to do if there was a problem with our second twin. Leo Jacob was born at precisely midnight Wednesday 17th October weighing a whopping 7lb 3oz. All was well and he was promptly placed on my chest for some skin-to-skin, before being handed to a very proud Daddy.

Now for twin two! She had been breech during the last few months of my pregnancy, and showed no sign of shifting her position, despite the extra room Leo left for her after his birth, so I ended up delivering her bottom first, much to the surprise of the theatre staff, still only using gas and air! Strangely enough, I felt very much in control at this point which helped me push her out in a rather rapid manner! Isla Estelle was born at 12:15, 6lb 3oz and a little traumatised by her delivery. She was whisked off for some oxygen and got suctioned as she had swallowed a lot of blood. However, she was fine within 5 minutes and went for cuddles with Daddy whilst I was stitched up. I got off rather lightly, I think,with a minor second degree tear.

We were elated by their arrival and were able to stay in a single room to begin to enjoy our babies. Isla took to breastfeeding immediately but Leo wasn’t so interested, and by the middle of the next day, I realised he had quite a pronounced tongue-tie. This meant that he had trouble latching on, and as a result, I had to express my colostrum (a major feat that took an hour for just 1ml!) in order for him to get some sustinence. He was getting dehydrated so the hospital staff were worried enough to keep us in longer, until they were satisfied that he was taking enough.

We finally left hospital in Friday 19th October, with a referral to get Leo’s tongue-tie snipped at a later date.

Looking back, I feel proud that I managed to stand firm and get as close to the birth experience that I wanted. All too often, twins seem to equal unnecessary complications. I am convinced that my positive experience has been beneficial in helping me bond with them, and also succeed in getting breastfeeding established under difficult circumstances. As it stands, it transpired that Isla also had a tongue-tie so both babies had them snipped by an independent lactation consultant at two weeks old and are now doing well. In fact, both are looking very bonny and the frequent feeds have done wonders for my waistline!

Despite the constant feeding, changing what feels like hundreds of nappies and lack of sleep, they really are the most precious gift and memories of painful contractions and hospital drama are fast fading as we look forward to our first Christmas as a family of five!

26 Nov

Fiona’s story of Breastfeeding Twins

As a mum of two already, I knew the benefits of breastfeeding and also of natural birth and wanted both for my twin delivery and well-being when they had arrived. We joined Penny Price’s ‘Having Twins’ classes and made some great friends and learned loads. One class was tailor made for feeding, it was totally un-biased and we all discussed several ideas, different bottles, sterilisers, breast pumps and all our options also having a long session with an NCT breast feeding counsellor who talked about feeding two and showed us pictures and ideas of how to try, should we wish to.

I think if the boys were my first pregnancy I would have taken professional medical advice about delivery and feeding which in my opinion now, would have been a mistake. The Royal Berks deliver 90% of their twins by C section and the research behind this (which I extensively trawled through) is that it’s ‘safer’ to plan and deliver twins by C section. Midwives are also out of practice delivering twins, the less they deliver the less experience presumably they get and it becomes a ridiculous ever decreasing circle. I was very stubborn throughout and insisted I wanted to deliver them and feed them myself but came across very negative medical professionals. As it was they were both breech throughout my preganancy. My Consultant told me that no.1 had to be head down or it’s a non-starter anyway. Harrison turned round and engaged the night before my section… Apparently an impossibility itself and “too late” to change their plans at the RBH. Obviously the Specialist had a round of golf booked at 2pm.

Once they had arrived at just before noon, Harry roared in indignation at being removed and then decided that he couldn’t be doing with this breathing lark, causing mild hysteria and a quick trip upstairs to SCBU. It took the staff about 5 mins to realise he was a total drama queen (like me) and well over four hours (paperwork and procedures) to return him to his anxious mother.

Alex latched on in ‘Recovery’, beautifully, encouraged by a smashing midwife and we admired him for what felt like hours. He had several snuggles and sucked away like he had done it many times.

At about 5pm we were reuinted as a family and I was relieved no-one had given, Harry any formula. He was quite wriggly but we had a go at double feeding. I had my best friend and fantastic doula Ailsa on hand and she propped me up in bed with two V shaped pillows and tucked a baby under each breast (rugby ball style) and we were all happy and comfy. It was frankly a euphoric moment and one I will treasure forever.

We slept like that, I had my catheter in still and a steady stream of drinking water, biscuits and my iPhone so why move? In the morning the midwife was amazed and asked me if I was ok and did I need any formula. We had had a good night, just the three of us. We all drank, snuggled, snoozed and updated facebook. Why would I have needed formula?

I stayed in the RBH for a week which is unusual but the boys weren’t putting on ‘enough’ weight … and I was encouraged many times to give them a bottle. I have to confess to feeling I would be a failure if I did. It got to a point where I just wanted to get my boys home and settle so I tried the bottled milk, I always fed them myself first and then topped up with a weeny dose of the stuff. It worked a treat and we trundled home like a travelling circus of bags, balloons, flowers, buggy.

We managed to breastfeed Alex and Harry for the first six weeks of their lives. I was lucky enough to always have Carl on hand to help, Ailsa my doula ‘extraordinaire’ and a huge circle of family and friends who cooked for us, walked dogs, got our shopping, did the school run and endless errands and jobs.

My advice to any Twin parents would be

  • To prepare in advance and do all the research so you know how to breast feed and where to get help if it gets tricky
  • To get hold of several pillows (V shaped are awesome) and take them into hospital
  • To remember you are not ill (and neither are they) so medical professional may not be the ideal source of advice. You are the parents and most likely your gut feeling is right; join twin clubs and make other twin parent friends and ask them what they have been through and tried.
  • To accept ALL help available
  • Cherish every moment, it’s a unique club and although its hard work I genuinely believe its not all that much harder than a single baby, just a million times more special.

NCT Breastfeeding Counsellors can support you with feeding twins. Call the NCT Breastfeeding Line between 8am and midnight, 365 days a year, on 0300 3300 0700