Frequent contractions may signal preterm labor. Each normal factor gets 2 points for a total of 10 points. Parents want to protect their children from harm. However, prior to birth, many mothers feel embarrassed telling their doctors their fears and worries. This hesitation stems from the fact that many well-meaning mothers do not want to appear overly anxious or to inconvenience their doctors.
Taking this perspective will allow you to freely express your concerns for the sake of your babies, even when you might not have wanted to ask for yourself. Ask these questions during your visit, and write down the answer so you can refer to it later if necessary. You need a direct conversation with a health provider if you have immediate medical concerns. You need the right people to provide that care.
One of the biggest mistakes parents can make is choosing an inexperienced medical team to care for their twins. Pregnancy Providers A variety of health providers, including general obstetricians, family practitioners, and midwives, can provide excellent care to pregnant women. However, every twin pregnancy requires the involvement of a maternal-fetal specialist also known as a perinatologist. Maternal-fetal specialists have specialized training in caring for pregnancies with the greatest risk for complications, including twin pregnancies.
In addition, they have three extra years of focused training in the care of high-risk pregnancies.
It makes sense that if your twin pregnancy is considered high risk, you should have the involvement of a physician with expertise in managing high-risk pregnancies. Newborn Providers A high-risk pregnancy also warrants the involvement of a pediatrician who is trained to care for high-risk newborns—a neonatologist. Advances in the medical care of sick and premature babies have had a substantial impact on the overall survival of twins.
The ideal hospital also has the facilities to care for your newborns should you deliver early or should medical complications arise. These units provide high-level care to premature babies and newborns with serious medical diseases. Research has shown that extremely sick or premature babies have the highest chance of survival when born in hospitals with Level 3 or higher NICUs. Rather, I recommend adding more providers to your care if needed. For example, your doctor can work together with a perinatologist to provide optimal care for your unborn babies.
When I see patients in the hospital, I lead a team of doctors and medical students. I may ask nurse specialists, nutritionists, child life advisers, social workers, therapists, and other physicians to consult in the care of my patients. Knowing the advantages of multiple providers, I chose a team approach for my own pregnancy. Whatever combination of health providers you choose, your active participation is vital to the health of your babies.
You should feel free to openly express your concerns and opinions regarding the care of your babies. Believe it or not, there were even more complications not listed here! Throughout my pregnancy, I had the choice of staying with my obstetrician or transferring completely to the care of a perinatologist.
Each time, I decided that the best medical care for my children would be to see both. I saw my obstetrician for my scheduled checkups. Every two to three weeks, I saw the perinatologists at my regular ultrasound appointments. Prior to my delivery, I was hospitalized for cervical shortening and preterm labor. My obstetrician and the perinatal team participated in planning my hospital care.
When I delivered, my obstetrician happened to be out of town, and the perinatology team stepped in to deliver my babies. The team approach continued after the birth of Faith and Hope. The obstetricians had done a great job of caring for Faith and Hope before birth, but now it was time for the pediatricians to play their role on the team. Fortunately, I had prepared myself for the possibility that Faith and Hope would need specialized newborn care by choosing an experienced pediatric team.
Faith showed serious signs of prematurity, including troubled breathing, which prompted ventilator support. Watching the respirator machine breathe for Faith, I was very happy I chose to deliver at a center that had not only a strong obstetrics team but also an exceptional team of pediatricians who specialized in the care of premature babies. They may view a twin pregnancy as completely routine. Twins, however, especially ones who share a placenta, can have even more complications than some triplets.
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However, being a pediatrician who teaches others how to care for very ill children, I can tell you that what sets the best doctors apart from mediocre ones is the ability to see potential danger in even the most innocuous-appearing situations. Your doctor must view your pregnancy as high risk enough to look carefully for signs of complications. However, this recommendation does not extend to mothers of multiples.
In fact, many obstetricians recommend reduced activity for women pregnant with twins. Although there is plenty of research on bed rest in singleton pregnancies, there are very few solid studies on this issue in twins. The boldest statements against bed rest refer to routine hospital bed rest— automatically being admitted to the hospital to reduce your risk of preterm delivery. Twins need all the calories they can get in order to grow. It makes sense that if you are burning fewer calories, there are more calories available for your twins.
Research shows that reduced activity does result in bigger babies at birth. When a pregnant woman stands or lies on her back, her enlarged, pregnant uterus can compress important blood vessels, resulting in decreased blood circulation to her unborn babies. Lying down on 47 c Women who are pregnant with twins should not engage in any aerobic exercise. The cervix is the narrow passage at the lower end of the uterus through which a baby exits at birth.
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It typically stays long and closed to keep babies inside the uterus until the pregnancy has reached full term. The more risk factors associated with your pregnancy, the more likely your doctor will prescribe some form of reduced activity.
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Pregnancies complicated by preterm labor, pregnancyassociated high blood pressure, a weakened cervix, poor growth, or TTTS often will result in stricter forms of bed rest. Even if your doctor does not formally prescribe bed rest, I still encourage every mother of multiples to implement a selfimposed regimen to increase rest in her daily routine. Sit down or lie down as much as possible. Women who work day shifts typically get better sleep. Research suggests that women who work night shifts have a higher risk of preterm labor.
Then use breaks and lunch time to lie down and even nap if you can. Your body is speaking for your babies. If you feel tired, stop what you are doing and sit or lie down. Many stores now have motorized shopping carts for use by their customers. It also allowed me to purchase important items for my babies, helping me to feel productive and satisfying my nesting instinct. Gather a group of rotating visitors to assist you and keep you company. Join online communities with mothers on bed rest. Sidelines at www.
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Use this time to read. Read parenting books and magazines now, since you will have less time to read after the birth of your babies. Borrow or buy a laptop computer. You can use a laptop to surf the Internet, keep a journal about your pregnancy experiences, or watch movies without having to get up from bed. Get a bedside refrigerator or cooler. Use a number of pillows or a body pillow. Remember that you need to lie down on your side, not your back. Pillows propped in front of and behind you make staying on your side easier.
Poor circulation from inactivity can lead to the formation of dangerous blood clots. Try a new hobby. You can learn to knit and make a blanket for your twins.
You can read some books on digital photography and prepare yourself for all the great picture opportunities you will have with twins. You can watch videos on sketching and draw along. Any hobby you can do in bed will keep your mind active and make the time pass more quickly. Create a schedule for yourself with goals for the day, just like you would before you started bed rest.
That way, you can focus on your daily goals and feel productive during this time. Remember that every day of bed rest means another day for your babies to grow inside you. Each day has a tremendous impact on their long-term health. At twenty-eight weeks, Faith and Hope were not growing normally, and my cervix had suddenly shortened substantially. Leaving my work responsibilities to another person did not come easily.
However, when I looked at what would grant me the most long-term happiness—work success or ensuring the birth of healthy babies—the choice became simple.
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Twins, on average, deliver at about thirty-six weeks. Let your employer know that you are pregnant with twins. Those you work with will be much more sympathetic to your situation if they know they are helping you protect the health of your two babies. Tell your boss that you are pregnant with twins and that sometimes that means an early or prolonged maternity leave.
This will give your employer time to prepare for your absence.
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