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Antenatal Care for Multiple Birth Mums
It’s hardly surprising that many expectant parents are initially shocked and then a little overwhelmed when they find out they are having twins, triplets or more!
Hopefully the discovery is made early in the pregnancy then the health care professionals looking after the mum-to-be can provide thorough twin pregnancy week by week guidance and care.
Mums and dads need time to adjust to the idea of having more than one baby, they need to make plans and learn as much as they can about multiple births. But the first thing to realise is that they are not alone! Today there is one set of twins for every 62 live births. That’s around 10,000 multiple births in the UK each year.
Twins present a whole new set of challenges both practically and financially.
Key to the woman’s twin pregnancy week by week progress will be her antenatal care programme which should cover tips on having a healthy multiple pregnancy, coping with common ailments and being aware of possible complications from carrying more than one baby.
Women having twins or more are automatically categorised as ‘high risk’. But they should try not to worry about this terminology and remember that having a baby – even more than one – is a natural process.
The mum of twins will not automatically experience complications, but being on the high risk register will mean she is monitored more closely and any potential problems should be picked up quickly and dealt with efficiently.
This heightened level of antenatal care will give parents the opportunity to ask lots of questions and learn exactly how their twin pregnancy is progressing.
A multiple pregnancy is divided the same way as any pregnancy with three phases making up the first, second and third trimesters.
Your multiple pregnancy
If you are pregnant with more than one baby the routine tests you will undergo could vary depending on where you live, but at the outset your GP should be able to outline what your antenatal care programme will include.
Your first full antenatal appointment is likely to be at around 11-14 weeks, when your height, weight, blood and urine will all be checked, and it is during this first ultrasound scan that you will probably discover you are carrying twins.
In an ideal world you will be monitored from around 8-10 weeks, but, like many women, you will probably not suspect you are carrying twins so early.
You will have several more antenatal appointments during your pregnancy. The number and frequency will depend on your hospital or clinic, your health, the number of babies you are carrying and your pregnancy history.
Your care could be provided by a specialist obstetrician, specialist midwife and even a specialist sonographer (a radiographer or midwife trained in ultrasound) with multiple birth experience.
You may be referred for other specialist help from a physiotherapist for pelvic pain or backache, a dietician if your diet causes concern or even a counsellor or psychotherapist if you are overly anxious about the birth.
Throughout your pregnancy you will have frequent ultrasound scans to check the babies’ positions and growth. As in single pregnancies, other diagnostic tests (eg for Down’s Syndrome) will be offered at relevant stages of the pregnancy.
The first ultrasound scan at 10-14 weeks will confirm the number of foetuses and how many placentas there are, and whether they are in separate chorionic and amniotic sacs. If the babies share an amniotic sac they will be identical. But sometimes identical twins have one each, so even with two amniotic sacs your babies could be identical.
Babies sharing a placenta (monochorionic) are at higher risk of complications, such as Twin to Twin Transfusion Syndrome or entangled cords, and scans will most likely be carried out fortnightly in these cases.
Further scans throughout the pregnancy will check that the babies are developing normally and the position of the placenta.
Around 34 weeks into the pregnancy the position of what is called the “leading” twin will help your medical team decide on the safest method of delivery (vaginal or Caesarean).
Some hospitals have special antenatal classes for multiple pregnancies. Antenatal classes are especially important when you are having a multiple pregnancy, but as twins often arrive early, make sure you have completed the course before your babies arrive.
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