Are You Having Twins? And Other Nosy Questions When Expecting a Singleton

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The first time it was 2 for 1
The first time it was 2 for 1

I am now in my third trimester expecting a single baby, 4 ½ years after having fraternal twins. This time around, the pregnancy feels very different from when I was expecting the twins. In many ways, it’s simpler (less doctors’ visits) and in other ways, it’s more uncomfortable (feeling as big as when there were two in there).

One of the biggest differences are the comments and questions I’m getting from complete strangers. It reminds me of the comments we would get once the twins were born! With the twin pregnancy, I didn’t get nearly as many questions or remarks, probably because I was not out and about as much as I am now. They say with the second pregnancy you show quicker and get heavier. Even more so after having twins because, according to my doctor, the ligaments are stretched out from the twin pregnancy and the centre of gravity changes. Hence I started waddling much earlier than before. And given my petite frame, my ballooning belly sends the signal to everyone that I must be at, or very close to the due date.

With the twins, I was off work shortly after 24 weeks. This time, I’m still waddling around the office at 30 weeks. I can’t count the number of times people in my workplace (mostly women outside of my organization who don’t even know my name) have asked me questions or shown sympathy. One time, it was a lady in the washroom. It took three of my colleagues to reassure me afterwards that I would be fine and not to listen to others. Five minutes later, I had the same conversation with a stranger in the elevator.

Here are how those conversations typically unfold:

“Oh my, you must be due soon. You must be feeling so hot in this heat.”

“I have about two months to go. The heat isn’t too bad.. air-conditioned home, office, car…” (Next time I will tell them I was born in the desert and that Canadian summers don’t bother me.. winter does)

“Two months?? You look like you could go any day! Twins?” (How did she know I already… oh wait I get it)

“No, I already have twins. That’s why I’m so big this time.”

“Wow you have twins! Well you are looking lower than when I last saw you. I don’t mean to discourage you but I think you will go early.”

Next time I go to the bathroom or get into an elevator, I won’t mention my actual due date, or better yet, won’t make eye contact. I’m allowed to act grumpy, right?

What were some of the experiences that stood out for you during pregnancy?

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Multiples in the Womb – National Geographic documentary

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As if we needed any proof that our multiples are miracles, National Geographic has a wonderful documentary about the life of multiples in utero. See 4D ultrasound of siblings interacting before they’re even born.

The In the Womb series also includes a video entirely about identical twins in the womb, which we just loved. Do be aware that there’s a scene in both films with a silhouette of the act of conception that you may want to skip through if you haven’t had The Talk yet. There are also diagrams of male and female anatomy. You may want to watch it all the way through without kids at least once.

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Selective Reduction: Two Women, Two Views

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In the world of infertility, while everyone is focused on shots and ultrasounds and the two-week-wait, there are some decisions that no one likes to talk about. What if I end up with multiples? What if the fetus/baby is sick? What if…

Selective reduction. Two women pregnant with 3 babies chose differently, and neither would have it any other way.A multitude of things cross the minds of women once they see the positive pregnancy test, but this one – this one is probably the most controversial of all. Selective reduction isn’t something society likes to talk about, but it’s a real thing. It’s a real conversation that happens in pretty much every high-risk OB’s office or with the mother carrying multiple babies.

So, in all fairness, and since multiples are a ‘risk-factor’ when undergoing fertility treatments, the HDYDI team decided that if it came up this week, we’d cover it. We’d share with you in a nonjudgmental way. We’d share so that others going down this path know that it IS something you’ll be asked about. That it IS something you need to think about – no matter what your decision ends up being. And that no one – NO ONE – can make that choice but you, and whatever your choice ends up being, that as fellow women, infertiles, moms, etc. – you will find someone that supports you.

In the Grey: Shelby’s Perspective

Shelby pf A Mother to OneShelby is a public health consultant, author, and founder of A Mother to One, a website dedicated to support and information for women choosing selective reduction. She is the mother of a five-year-old, a military wife, and spends her free time traveling the world.

In the summer of 2008, I decided to terminate 2 of 3 fetuses in my womb. No, I didn’t walk into Starbucks and decide to walk into an abortion clinic following. It doesn’t work like that.

Here’s the how: During the spring of 2008, we opted to give IUI a try while my husband was deployed. Voilà, a positive pregnancy test! We were overjoyed beyond belief.

And then, two weeks later, this overwhelming joy was followed by one of the most terrifying moments of my life: a hysteria-inducing ultrasound that revealed three fetuses and caused my 6’4” RE’s face to turn a shade of white I’ve never seen. There’s nothing pretty about vomiting during a vaginal ultrasound, and the sheer terror that plagued me that day is not something easily forgotten.

I knew within moments of hearing, “There are three. We need to talk,” what I would do; my mind had been made up nearly two years prior in a what-if discussion with my husband. The risks were just too much for me to fathom: 40% rate of loss, average gestational age of 32 weeks and a 36% impairment rate.

I was one of the fortunate ones who knew what selective reduction (SR) was even was prior to beginning my fertility treatments. I called it “fertility’s ugly stepbrother;” it existed to clean up the messes fertility drugs caused. My end goal in fertility treatments was always one healthy child, and although the decision to move forward with SR didn’t come easily to me, I reduced from triplets to a singleton at 12 weeks gestation.

I’ve always been open and honest about discussing my SR in public. However, in discussing this choice, I have begun to notice I don’t fit in. The choice advocates aren’t sure how to respond; the pro-life advocates call it abortion; and women who have terminated for medical reasons fume that I would associate my choice with theirs, as I have a child and they do not.

The multiples community looks down on me as cowardly or selfish. From time to time I receive emails confirming this is true.

We, the selective reduction community, don’t fit in anywhere. I’ve had friends who worked at abortion clinics call the procedure “half an abortion” or a “partial abortion”. I’ve had family members suggest I could have adopted the other two fetuses to friends. There’s the always deeply loved “baby killer” moniker that won’t seem to cease, no matter how many times I explain fetal development and the statistics on triplet pregnancies.

Hence, the weird-grey-area of reproductive choice is where I’m comfortable, nearly six years post-procedure. I don’t feel the need to fit into a certain place or space in the world. The grey gives me comfort, knowing I’m inadvertently bridging the gap between the pro-choice and pro-life worlds. Selective reduction doesn’t fit anyone’s expectation on what choice means. When you fall into the grey, it causes this wormhole of stereotypes to occur: where does she belong, where does she fit, this choice makes me uncomfortable… My response: I am where I was meant to be.

Let me push the envelope on what you believe choice means, let me be the one who informs you that choice is not simply a means to an end. Choice can mean a means to a beginning. Choice led me to a very healthy, vivacious, beautiful child.

Confounded? You aren’t alone. These days women’s reproductive health issues are fodder for water cooler discussions at the office. Words like vagina, afterbirth and choice give way to fanaticism in ways that confound me.

I never thought discussing my pregnancy or my vagina would lead to a place wherein I find myself today: the creator of a community, the only life preserver women feel they have when faced with such a complex situation, and the only person willing to use their name and put a face to what selective reduction really is. But, here’s where I sit: a happy mom, who provides support and doesn’t apologize for our decision to terminate two fetuses.

My life is one that will never get uncomplicated. I am a strong-willed woman, born by a strong-willed woman, and I have my own strong-willed daughter. I come from a long line of women who choose to push envelopes. These days, I’m not trying to push them; I want to burn their very existence. I may make you uncomfortable, as the very idea of opting to terminate two of three fetuses in a pregnancy can be disquieting. The grey is that last puzzle piece that can’t be forced to fit into the slot you want it to. We are the puzzle piece left over, and we’re comfortable with that.

You might be reading this asking yourself a lot of questions. Why did she terminate two of three and not one of three? Does she feel bad? Does she question her choice? The answers to those questions are complex and not exactly easy to answer. I made a choice, just as you make choices: how many embryos to put in, whether or not to continue multiples, choosing a donor for sperm/eggs. They’re all choices.

I am a mother, just as you are or will be. And I want the best for my child and for my family at any cost. My question back to you is this: are we really so different, then? We’re just parents or future parents, making the best decisions for our families. Perhaps there’s no line delineating us after all.

 The Aftermath of NOT Reducing: Angela’s Perspective

Angela Bickford headshotAngela Bickford is the mother of triplets, one of whom passed away after 49 days. After three years of infertility, and her subsequent loss, Angela has made it her mission to help other moms going through similar struggles. She works for the non-profit, Hand to Hold, which supports the preemie/NICU/loss parent, and writes about surviving after loss on her personal blog.

When it came time to have ‘that’ conversation with our doctor, I knew what was coming. I’m a type-A, worry-about-it-all, see-the-missing-tile type person who’s already experienced three years of trying and several miscarriages. Part of me felt it would be the ‘smart’ choice, and part of me just wanted the miracle of three, healthy babies.

Deep down, I wasn’t really that conflicted. I knew that I could never reduce – not because of my faith or whether or not it was acceptable – but because I’ve always wanted to be a mom and with it taking so long to get to this point, I wasn’t letting any of them go.

So my husband and I said a quick ‘no’ and moved on. We didn’t need to hear the risks, we wanted all three.

At 14 weeks, a cerclage was placed to help ensure they’d stay cooking longer. At 21.5 weeks along, I was placed on home bed rest with the beginnings of incompetent cervix and told that Baby A was at the most risk. This is when my self-doubt started to creep in.

The second-guessing. The what-ifs. And, of course, it was too late to revisit that conversation… (side note: it wouldn’t have changed anything, but it’s important to note that even after making my decision, my mind still wondered.)

At 23.5 weeks, I landed in the hospital and continued my bed rest there. Eventually, Baby A’s water broke (11 days in), but the babies didn’t make their entrance for another 19 days. All sick. All needing resuscitation. All near death.

It was day-by-day and minute-by-minute. It was a lot of what-ifs and second-guessing. Wondering how we could have done things differently or if the outcome would have been different if we had.

Because, in the end, we lost Baby A – Carter – because that risk – that real risk they talk about in that conversation no one wants to have – it won.

I guess I share all this to say that even though I didn’t personally choose to reduce, I still didn’t get my happy ending. Could reducing have made for an easier pregnancy? Could it have helped my other two stay cooking longer and ultimately be free of the lasting effects of prematurity they have today?

I’ll never know. But what I do know… is that I made a decision. It may not have been a decision someone else would have made, but I own it, and I’m okay with the way it ended up.

Two women, two views. Different outcomes, same question.

We’d like to end by saying that every situation is different – every pregnancy, every woman, every uterus. In life, in the hardest of situations, you have to step up and do what you feel led to do. And we challenge you to put yourself out there and see the other side… to have compassion for someone you may not know for the decisions they make that are not yours to make, whether you agree with them or not. To love and support your friend through their struggle to make this decision and make sure they know you’ll be there on the other side. Because everyone deserves support. Everyone deserves at least that.

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

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Identical Vs Fraternal: What Your Doctor Didn’t Explain About Your Twin Ultrasound

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My Story

(or skip to the basics or the science)

Ultrasound of identical twins at 7 weeks. You can't see the membranes in this image.

I was 7 weeks pregnant when I had my first ultrasound. The doctor pointed out the shared outer sac (chorion) and the two distinct inner sacs (amnions). I didn’t need her to finish. Thanks to Advanced Placement Bio class in high school (embryonic development) I knew I had a miracle in my womb: identical twins. Once we’d called everyone we needed to share the good news with, I hit Google, and quickly concluded from their monochorionic/diamniotic (mono/di) state that my little ones had split from a single cluster of identical cells somewhere between 3 and 9 days after conception. I’ll tell you how I made the calculation in a little bit.

The Basics

Most people don’t know a whole lot about twins or higher order multiples, and are intrigued by them. Folks I run into are usually aware that there are two basic types, identical and fraternal, but often don’t know precisely what the difference is. Part of this comes from the term “identical.” In casual English, “identical” means “exactly the same,” and so people often assume that identical twins should look alike, act alike, and think alike. This assumption often gets extended to fraternal twins, in that they should look different, act differently, and think differently.

I don’t argue with people about whether my children look enough alike to be “really” identical, and instead give them a quick science lesson. You’d be surprised how many medical professionals, even obstetricians, don’t remember the science of twinning they covered in the depths of college or medical school, and therefore jump to possibly incorrect conclusions about whether a set of twins is identical or fraternal. Next time you need to explain the distinction to someone, feel free to use the visual aids below.

TWINS! Understand the basics with this clear primer. Click To Tweet

The Science

Identical multiples grow from the same fertilized egg and therefore have basically the same DNA. Fraternal multiples come from different fertilized eggs, and therefore basically share 50% of the same DNA, as do siblings conceived by the same parents at different times. Sharing a DNA template makes it likely that identical siblings will look very much alike, but DNA doesn’t predict everything.

My daughters, for instance, share their DNA, but have noses of different shapes and different hairlines, due to developmental differences that don’t appear to have a genetic basis. They’re also different heights, likely because one is a pickier eater than the other and because dysphagia related to macroglossia (trouble swallowing because her tongue was too big for her mouth) meant that she ate less than Sissy after she weaned.



Before I go much further into the science, let’s talk about the terminology we’ve been using.

Basic terminology to describe babies in the womb.

So, the embryo is inside the amnion, which is in turn inside the chorion. The umbilical cord traverses the two membranes to connect the embryo to the placenta, which collects nutrition from mommy for baby.

Twins in the Womb

Now let’s talk twins.

Monozygotic twins are identical ones. They started from a single zygote. (Mono means one.) Dizygotic twins are fraternal ones. They started from two zygotes. (Di means two.)

Monochorionic/monoamniotic (mono/mono) twins are monozygotic twins who share a single amnion and a single chorion.

Monochorionic/diamniotic (mono/di) twins, like my daughters, are monozygotic twins who have separate amnions and share a single chorion.

Dichorionic/diamniotic (di/di) twins are monozygotic or dizygotic twins who have separate amnions and separate chorions.

I try to make this clearer in the image below. With one egg and sperm, you can get one baby… or two babies who are mono/mono, mono/di or di/di. With two eggs and two sperm, you’ll always get di/di twins.

The different membrane configurations possible for twins in the womb. The chorion is on the outside, the amnion on the inside.

So here’s the trick. In the image above, you can’t tell the difference between the identical di/di twins and the fraternal di/di twins. And neither can the ultrasound tech. So, if you have di/di twins, chances are good that they’re fraternal, but you just don’t know for sure.

If you have di/di #twins, chances are good that they're fraternal, but you just don't know for sure. Click To Tweet

Reader Noura I was kind enough to share ultrasound images of her di/di identical twins, whose ultrasounds look just like those of fraternal twins. Remember, the mono-di stuff refers to the membranes around the babies, and not the numbers of eggs and sperm.

Dichorionic diamniotic identical twins at 6 weeks gestation.

di di twins 1st trimester

Reading the Ultrasound

What you can know about your twins zygosity from the ultrasound

So, in my little chart above, I had to note that there are extraordinarily rare cases of boy/girl identical twins, but this is a teeny tiny proportion of the population. If you ran across such a pair, you’d recognize them from the news. So, please, just assume that boy/girl twins are fraternal (dizygotic) or that one had a sex change. Either way, it’s not polite to ask. Girl/girl twins and boy/boy twins can be fraternal or identical.

Timing of Monozygotic Twin Split

Here’s a fun fact. The arrangement of amnion and chorion can tell those of us with identical twins when they split apart!

The membranes on your ultrasound tell you something about your identical twins schedule for splitting.

TTTS can be very serious and put both your babies at risk. The placental blood supply is shared unevenly, meaning that one has more than his or her share of nutrition and oxygen, the other less than his or hers. Many obstetricians will closely monitor mothers expecting twins to watch for TTTS. While it’s almost unheard of with fraternal twins, reader Halie H. wrote to us to say, “My di/di fraternal (boy/girl) twins’ placentas fused. They were born with one failed and one really really red placenta; they were sent off to be studied as an example of TTTS in fraternals.”

In #TTTS, the placental blood supply is shared unevenly between twins, putting both babies at risk. Click To Tweet

I’m not an expert on this stuff, but I do love genetics and studied it in college (although I ended up switching away from a biology major junior year). If you have additional questions, I’ll do my best to answer them.

Before I sign off, I need to give a big old shout out to I have been planning to write this post for years, but not having an artistic bone in my body, knew that I couldn’t do it justice without an illustrator. Thanks to the free online graphic design tool, Canva, I was able to create the graphics I’ve included in this post.

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A&D’s Birth Story: 35 weeks 2 days

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Prematurity Awareness Week 2013: How Do You Do It?

World Prematurity Day November 17In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

My pregnancy had been difficult, to say the least. From 6 weeks on, I was beset with a very severe case of “morning” sickness, known as hyperemesis gravidarum. Despite medication, I vomited multiple times every day of my pregnancy (and, in fact, for about a week afterwards). Mr. A did not have a measureable heartbeat at our 7-week ultrasound, and measured very small. He developed a nice, strong heartbeat, but continued to measure behind. When I was 21 weeks, a follow-up anatomy scan revealed a complication, not with the boys, but with me: I had cervical funneling. I was put on bed-rest.

At 23 weeks, a high-risk OB doctor informed me that our Mr. A had fallen completely off his own growth curve, and had a very dim prognosis. The doctor said it was probably a virus, infection, or placental failure. He suggested either delivering between 24 and 26 weeks, or giving up on Mr. A. The panic and helplessness I felt still clutches at my heart. I felt so incredibly torn: why should I punish Mr. D by dooming him to a very premature birth, simply because he was a twin? But how could I give up on Mr. A? Whenever people say, “I always wanted twins!” or wish twins upon someone undergoing fertility treatments, I flash back to this moment, and think no, no, you don’t want twins, please hope instead for a healthy, singleton pregnancy.

It turned out, much to my joy (with a side-dish of pure rage), that Mr. A had no virus, no infection, no failing placenta, but instead an incompetent doctor. The ultrasound machines had switched to different software or something, and hadn’t properly calculated estimated gestational age, and the doctor didn’t bother to look at raw numbers before telling me this dismal news. I had multiple follow-ups at different offices, plus a ton of blood work, and everything was fine. Mr. A was small, but doing just fine.

The weeks crept by, and I remained pregnant. I was even briefly off bed-rest, for 3-week span that included Christmas. I was, however, having very regular contractions. I had non-stress-tests twice a week, and after each one, they wanted to send me to L&D. But my funneled cervix was holding fast, so I remained on bed-rest and carried my boys all the way to my 35th week, much to the amazement of myself and my OB. I was having ultrasounds every 3 weeks to monitor Mr. A’s growth, and he was holding steady on his own curve, with Mr. D riding along at about the 50%ile.

On Tuesday, January 31st, I went in for another NST. My husband happened to have that Tuesday off, and so he came with me. My boys, especially Mr. A, gave the nurses fits at each NST, refusing to stay still for the required 20-minutes of continuous monitoring, stretching these tests into hours-long events. On this day, Mr. A was so wiggly that they decided to simply to a biophysical profile on him instead, and throw in some growth measurements for kicks.

They never got that far. The ultrasound showed Mr. A hadn’t grown in 10 days. He had, according to their measurements, actually shrunk. (I do know that babies do not grow shorter, but they can lose weight. We suspect this is what happened to Mr. A.) More alarmingly, the his umbilical cord was showing reverse blood flow. Mr. D was doing great, but my husband and I were pretty sure we knew what was coming.

But first we had to wait. The tech could not say, “These babies are coming out.” Even the high-risk OB would not say, “Today is the day.” I was sent to my regular OB’s office, where we waited. In the mean time, I called my younger sister, who is an OB in a different state, and left her a voicemail explaining what was going on. And my mother called me, and so I told her as well. About 4 hours after my NST should have been, my OB sat down with me and my husband, and said that she would schedule a c-section for 5 pm, so not to eat or drink. I had very much wanted a vaginal delivery, and she was even willing to perform a breech extraction, but with both my boys being transverse and with my lower baby being significantly smaller than my upper baby, that was off the table. I had kind of seen this coming, and really, the bottom line of my birth plan was “everyone out, alive”, so c-section it was.

The following 2.5 hours were very strange. We went home, I packed a bag and took a picture of my pregnant belly. My husband went to his office to finalize his FMLA. I watched an old episode of “The Daily Show”, thinking, “This will be the last time I sit on this couch without a baby in my house.”

I was wrong about that. While plenty of 35-weekers do indeed come home from the hospital with their moms, with little to no NICU stay, such was not to be the case for my boys. I had gotten beta-methasone shots to mature their lungs about a week prior, so I did have reason to hope. However. Mr. D had what is known as “wimpy white male syndrome”—he just did not do as well as girls or babies of other races would do. Mr. A turned out to have a very rare chromosomal abnormality, and would have needed extensive NICU time even if he had been full-term. I believe with all of my heart that the only reason Mr. A survived at all was because he was a twin. If he had been a singleton (as my current pregnancy is proving), I would not have had cervical funneling, extensive contractions, multiple ultrasounds because they simply couldn’t see Mr. D’s diaphragm or Mr. A’s kidneys due to positioning, etc. My OB-sister thinks that perhaps they would have noticed that my belly was measuring small, but frankly I am not convinced. Of course, if Mr. D had been a singleton, he would very likely have been full-term. Thus I think both my boys were in the NICU solely due to being multiples, but that Mr. A would not have made it that far if he were not.

But dreams about my future eventually gave way to reality, and we left for the hospital. My mother met us there. My husband and I had agreed that his job was to stay with the babies, and my mother felt that it was her job to stay with me.

They monitored the boys for a bit, then wheeled me into the freezing OR room. The room was teeming with people: a full NICU team for each baby, my OB and her partner, the anesthesiologist, a few nurses, and a medical student who got the fun job of holding the little tray while I vomited into it. I have always reacted poorly to medications of any sort, and the spinal and morphine and whatever else they used was no different. My husband came in, dressed to impress in sterile gear, and held my hand while they made the incision. There was a lot of tugging, which felt very odd. Mr. A was really wedged into my pelvis, and extracting him was difficult. But I heard them say, “Here he is!”

Someone—probably a NICU doctor—showed me my firstborn for less than a heartbeat. I was not allowed to snuggle him as I so longed to do, but I could clearly see why: he was a very scary shade of grey, and not crying. “He looks so blue!” I exclaimed, but no one answered. “Will he be ok?” Then I heard a weak cry, and began to sob myself. He would, he would be just fine.

And then, “5:31 pm, Baby B”…and I saw my Mr. D. They let me kiss him. I heard them call out Mr. A’s weight—3 lb 12 oz. That was 6 ounces less than the estimate, but I couldn’t dwell on that. He was 17.25 inches long. They took Mr. D and weighed and measured him: 6 lb 2 oz (exactly as estimated) and 19.5 inches. A’s APGARS were 6 and 7, D’s were 7 and 8. I think they would have let me spend more time with Mr. D, but my Mr. A needed to go to the NICU, as he was having a very hard time breathing and clearly needed surfactant and intubation (not that I could see this, as my OB was still mucking around in my uterus, extracting placentas and massaging blood out and whatever else goes on). My husband left with them, as did my heart.

I was sewn up and taken back to recovery, where things did not go well. I continued to vomit, and began shaking uncontrollably. The nurse seemed unphased, but my mother was very worried, I was I. My husband returned briefly to show me pictures of the boys, then left again. A neonatologist stopped in to give me news I couldn’t yet process: Mr. A had a cleft palate and was doing much worse than he should be. I just wanted to be with them, to see my boys, to hold them, to kiss them. I was eventually taken to a room on the floor, shaking less but still vomiting. I was told I couldn’t see them until I could walk from my bed to the wheel-chair unassisted. They would not even let me attempt this until 5 hours after their birth. When they did, I feared I wouldn’t make it. I believe I walked those 3 steps on will-power alone.

I was wheeled into the NICU, and saw my beautiful sons laying in adjacent open warmers. Mr. D had an IV in his scalp and an NG-tube down his nose, and all the monitoring devices, but no oxygen. I was allowed to hold him for a few minutes. I cried the whole time, at the love I felt for my beautiful son. Mr. A was on an oscillating ventilator, had an umbilical IV and an arterial line in his right arm, an I was not allowed to hold him until his fifth day of life. But I cried to look at him, out of love.

I did not feel a “completion”—a sense of “now I have my babies”, an ending to a birth story. I never really did. I suppose it truly ended 62 days later, when both of my sons were finally home from the NICU, and I was able to hold them both in my arms. It was a very long journey, but worth every minute.

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The Top 10 Worst Reactions To My “It’s Twins” Announcement

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I am 11 weeks pregnant with twins. This isn’t my first pregnancy. In fact, these will be my fourth and fifth babies. Since I’d announced three other pregnancies I foolishly thought this time wouldn’t be any different.

I had no idea that upon hearing “It’s twins” any filter or manners a person may have immediately go out the window. Here are the 10 worst reactions I’ve experienced:

  1. “Better you than me.”

    Why? Do you know something I don’t know?

  2. “I’m sure you’re stoked but I’d die!”

    This was said to me by a nurse practitioner at my pediatrician’s office. Shouldn’t she be easing my nerves? Shouldn’t she have wonderful advice and maybe other twins moms I could talk to? Shouldn’t she stop using the word stoked?

  3. “You’re going to need a new house”

    “You’re going to need a new car”

    Thank you for your concern but do you think that you’re sharing new information? I can assure you that the financial needs of 5 kids were some of my very first thoughts and fears.

  4. “Was this planned?”

    ummmmm… yes? I have always been an overachiever.

  5. “You’re going to HAVE to pump… give formula… get them on the same schedule… hire help.”

    I assume you’re basing this on your vast experience with twins.

  6. “My friend was pregnant with twins but she lost one at ___ weeks”

    Thanks. Like I wasn’t already worried about miscarriage or vanishing twin syndrome.

  7. “Welp, guess we won’t be seeing you next year!”

    Said a teacher at my son’s school. As she’s perusing the buffet I organized for a Valentines treat. No soup for you!

  8. “Maybe NOW you’ll get your girl”

    Because my 3 boys are so terrible?

  9. “Oh! Your poor poor boys”

    Siblings suck. So do big families. WTH?

  10. “You’re going to be HUGE!!!!”

    I know this is true, but I really don’t want to hear about it. Especially from someone wearing a size 0.

Not everyone’s reactions were awful. There are many sweet ones that stay with me when I’m feeling nervous about having 2 babies. The next time someone tells you they are expecting multiples please hug them, tell them they are the perfect mom for their babies, and remind them you’ll be there the whole time.

Elizabeth is expecting twins and is the mom to three amazing boys. She lives in central Texas.

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MoM Elevator Pitch

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Today, I went into the local Army medical center in an attempt to untangle a sitcom-worthy set of mixups of appointments, referrals and prescriptions. While I was waiting, I got to talking to the visibly pregnant lady next to me. She was 25 weeks pregnant with twins, and wasn’t looking forward to her appointment. Since one of her babies was low on amniotic fluid, she was anticipating being checked into the hospital, something she really didn’t want to have to do quite yet. We happened to leave the clinic around the same time, and she gave me an update. Although she wasn’t being hospitalized, she was being put on bed rest. She lamented not being able to be more available to one of her soldiers whose wife is also expecting twins.

In the few minutes I had, I told her that I also had twins, and that I’d delivered them 7 weeks early. Although it was scary at the time, they spent less than 3 weeks in the NICU, and are now flourishing. If bed rest was what her babies needed, maybe holding on to the thought that she’s doing it for them would help the time pass faster. I told her that I’d be thinking of her, and that I hoped that her babies stayed healthy and in her womb as long as they could.

If you had just 2 or 3 minutes to comfort a scared mother-of-multiples-to-be, what would you say to her?

Sadia is an army wife and working mom of 5-year-old identical twin girls. She and her family live in El Paso, TX, where her husband is stationed at Ft Bliss.

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Multiple Perspectives: Interview with a MoM-to-Be

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I’m excited, of course, when friends tell me that they are expecting, but I’m quadruply so when they tell me they are expecting multiples. My co-worker and friend Rachel has met my twin daughters only three or four times, but she became an instant favourite with them because of her warmth and humour. You can imagine my excitement when she showed me an ultrasound image with two separate sacs on display. I talked to her about her impending mother-of-multiples status.

1. What was your reaction when you found out you were pregnant with two babies? [Your husband] Scott’s?

People ask me a lot if I was surprised by the fact that I was pregnant with twins. I’m fairly sure the subtext of that question is, “Were they spontaneous twins?”  Generally, I reply, “I think everybody is surprised by twins!”

In my case, my twins weren’t spontaneous; I’d undergone an ovulation induction cycle, and I knew that the risk of multiples was higher. However, I was also under close observation, and we never had any reason to believe more than one egg had been released.  My hormone levels rose higher than I was expecting them to, so I did wonder if something was up, but at around 5 weeks, 3 days, when I had my first ultrasound, the doctor only saw one gestational sac at first.  The second little peekaboo sac was definitely a surprise!

Scott wasn’t able to make it to that first ultrasound, so I called him at work afterward to let him know.  I told him, “Everything looks good… but we may need to think of some more names.”  He knew what I meant immediately.  He’s a low-key guy, but he was excited, and I’m sure a little bit nervous, when he found out.

2. How did your expectations of parenthood change when you discovered that you would be a mother of multiples.

I was always fairly sure that, despite not having a ton of experience with babies and small children, Scott and I could probably figure out how to raise a child on our own. Raising twins, I’ll admit, still sounds like a much more formidable task than raising one.  You can check with me again in a year to see if I’ve broken them yet.

On the other hand, especially since we struggled with conceiving, I had developed a lot of ideas and theories about how we were going to raise our hypothetical only child. In some ways, finding out that we were expecting twins was freeing. Even in my naivete, I know that there will be times when I can’t meet both babies’ needs at the moment those needs arise. I feel like I’ve been able to give up my expectation of being Super Mom before the kids have even arrived.

3. Can you tell me a little about your experience with doctors specializing in multiple pregnancies? How did you find them, and how do you think working with specialists has benefited you?

I bought Dr. Barbara Luke’sWhen You’re Expecting Twins, Triplets, or Quads,” not long after seeing the babies’ heartbeats at 6 weeks gestation.  I found the information in the book helpful but general, and I wanted advice more closely tailored to me.  I spent a lot of time searching the Internet for resources on twins, especially locally.  While I didn’t find a whole lot locally (aside from the Moms of Multiples group), I did find the Texas Children’s Hospital Program for Multiples in Houston.  I was most interested in the nutritional assessment they offer, to see how it compared to the one in Luke’s book.  Generally, it was fairly similar, but with a stronger emphasis on lower-fat foods. They also follow similar 20 pounds by 20 weeks guidelines.

My twins are dichorionic and diamniotic, and I’ve really had a fairly uncomplicated pregnancy throughout, so I think the program was less helpful for me as it would have been for, say, parents of identical twins with a higher risk of TTTS. But I learned a lot about my babies and was very relieved to have a clean bill of health as we finished up the first trimester. It’s a great program, for those who are able to get to Houston, and it was completely covered by my insurance.

4. What personality traits do you predict for your babies, based on feeling them move?

Even before I could feel them move, I could see the differences in my babies on each ultrasound.  Starting at 8 or 9 weeks gestation, it became apparent that our little boy, Baby B, is quite a wiggler.  Our girl, Baby A, does her share of moving as well, but she’s never been nearly as active as her brother.  I anticipate we’re going to need to get Baby B involved in lots of physical activity to burn off all that extra energy.  On the other hand, our girl really likes to kick her mama in the bladder, so I’m predicting a typically complicated mother/daughter relationship with her!

5. What reactions do you get from people when they learn that you are expecting twins?

The most common reaction I get is, “Do you know what you’re having?” And when I tell them we’re expecting a boy and a girl, they almost always reply, “Oh, wow, that’s perfect! You can be done!”  As though we would have been required to keep trying for the opposite sex if we’d had two boys or two girls.  Or an only child, for that matter.  I’m learning a bit of zen, when it comes to responding to curious comments.  People generally mean well, and I don’t think they really think through their response. It’s as much small talk as anything.  (I’m sure I’ll be less patient when we can’t walk down an aisle at the grocery store without being interrupted, but people generally can’t tell I’m carrying twins, so I feel like I’m undercover for the time being.)

6. You are 33 weeks into your pregnancy right now. How do you feel, physically?

I’m definitely starting to feel tired and uncomfortable!  I anticipated that I would feel progressively worse as the pregnancy went on.  In actuality, it seems a little more cyclical than that. I hit a wall every couple of weeks, then I adapt and feel better for a while.  My quarter-mile walk to the office is definitely starting to feel like a long way, though!

7. What do you know now about multiple pregnancy, or pregnancy in general, that you wish you’d known earlier?

I spent the first two-thirds of my pregnancy mentally preparing myself for the possibility that I might be on bed rest or out of work for a long time.  I didn’t expect that I’d actually be pretty good at carrying twins, and still working at 33 weeks.  Knowing that would’ve saved me a lot of worrying early on!

8. You and Scott will both be returning to work after parental leave. What will your childcare arrangements be? How are you going about choosing?

This July, we spent our fifth wedding anniversary shopping for infant childcare, three months in advance of the anticipated arrival of our twins, and six months in advance of when we’d expect them to start daycare. It felt really unfair that we had to choose a childcare provider to care for our kids when we haven’t even had a chance to meet them or get to know them yet.  We visited four childcare providers and finally chose a Montessori school with an infant program in our neighborhood.   The rates were comparable to most of the other infant daycares in town, but we were impressed with the age-based Montessori classrooms, and we had a great rapport with the teacher in the infant room.  She lives in our neighborhood, as do many of the kids in the school, and she has twin grandsons.  We felt that our babies would be in good hands in her care.  Picking a place close to home means it’ll be equally convenient for Scott or me to drop them off and pick them up, and we hope we’ll be able to get to know other parents and kids in our area.

9. What have you already done to prepare for your twins’ arrival? What do you have left to do?

I feel as well prepared as a naive almost-mom can be. Our nursery is packed full of onesies, diapers, and random plastic baby accoutrements. We have places for the babies to sleep (though they may have to share for a little while). We’ve got a double stroller.  We’ve got infant car seats, and we’ve installed them into one of our two cars.  We’ve gone to all the classes we plan to go to in advance of their birth, and we’re trying to enjoy some nights out together before the nuclear bomb that is parenthood drops on us both.

I do still have a rigorous nap schedule to try to maintain for the next three to five weeks.  And a lot of work to wrap up.

10. What questions do you have for other parents of multiples?

I feel like I’ve heard the answers to most of my questions, and they all seem to vary from family to family. (How long did it take to feel like you had everything under control?  Were you able to breastfeed two babies at once?  How do you handle the financial burden of two infants at once, especially when you add in the huge expense of childcare?)

I’d rather hear words of reassurance.  Tell me when multiples get to be fun!

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Singleton vs Multiple Pregnancy

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In many ways my twin pregnancy was easier than my singleton pregnancy. I had more experience with pregnancy, so I had some clear ideas about how I wanted this pregnancy to be.

First, I chose to be part of midwife-based care program from the beginning.  The midwives focused on issues like nutrition, emotional wellbeing, and staying active during pregnancy. They were also prepared to look at “alternative” therapies to help with pregnancy like nutrition, supplements, acupuncture, chiropractic care, massage therapy, yoga, and other exercises, which gave me a good foundation for making healthy decision even after my care was transferred to a doctor when we found out about the twins.

Second, based on the benefits in my first pregnancy, I started going for pregnancy massage regularly throughout my pregnancy. It helped with the aches and pains of pregnancy, and with the swelling in my hands and feet. My massage therapist was also able to provide lots of advice and information because of her training in pregnancy massage and as a doula.

Third, I started taking medication for nausea as soon as it became a problem. I didn’t wait until I felt so horrible I couldn’t eat and I started losing weight like in my first pregnancy. I continued to take medication until the day before my c-section.  The nausea improved significantly through my pregnancy, but it persisted through the whole pregnancy.

Fourth, when we found out we were expecting twins, we joined a multiple prenatal class.  It provided some helpful information, but most importantly we got a copy of Dr. Barbara Gore’s book When You’re Expecting Twins, Triplets or Quads. The focus on the importance of nutrition and weight gain was the most helpful part. I also joined an online chat group for moms of multiples, and borrowed a lot library books. Having information and answers to my questions helped me to feel in control and prepared to make decisions.

In other ways, my twin pregnancy was harder than my singleton pregnancy. From the beginning, I felt tired all the time.  Part of that was because I had an active toddler to chase around, but part of it was growing two babies. Fortunately my schedule as a grad student was quite flexible. I called my routine “self-imposed bedrest” and gave myself permission to only do what I felt I could handle. In a typical day, I would get my son up, fed and off to the dayhome.  I’d come home and nap for 1-2 hours.  I’d get up and work for a couple of hours and have lunch.  In the afternoon, I’d have another nap before picking up my son. I’d get supper ready and clean up.  In the evenings, I didn’t do much except sit on the couch, and eat – I was constantly hungry.

Throughout my pregnancy, I had more doctor’s appointments, ultrasounds, blood tests, and hospital visits.  These appointments were both physical tiring and time consuming, but I quickly learned to bring my book, my water bottle and a snack. I learned to only plan one activity per day, especially if it involved travelling anywhere because I knew I’d be exhausted by the end of it.

The last 6 weeks (from about 32 weeks) the point where my twin pregnancy really started to differ from my first pregnancy. I was big and awkward. It was hard to get motivated to do anything, and it was challenging even to just leave the house. It was uncomfortable to wear my shoes or boots. My balance wasn’t great and it was icy, so I often stayed home for days in a row. I started getting light-headed, so we decided I shouldn’t be driving alone, and eventually walking any distance got to be too hard.  I ended up borrowing a wheelchair from the Red Cross so I could go with my son for his picture with Santa and to do some Christmas shopping. Even doing things in the house was challenging, so I would plan my day with the fewest trips up and down the stairs.

And, the end of my pregnancy was very different. Instead of a mostly natural, midwife-assisted delivery at 41 weeks, I had a scheduled c-section at 37+ weeks.  And, I got to bring home two little girls, instead of one little boy.

How was your multiple pregnancy different from your other pregnancies?

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