Originally Posted by Tigerchild
38 weeks is considered 'term' by the medical establishment for twins. Personally, with a few exceptions, I believe that means that essentially all highly managed twins will be premature because the doctors will not allow the mother to go past 36-38 weeks.
I agree with this. I am a member on another board, specifically for IVF, and the vast majority of ladies preggo with multiples immediately post from their 1st ob appt that the doc has already scheduled their c-sec somewhere from 36-37 weeks. At the first ob appt! I was referred to a peri because my dd has some issues, and the first question from their nurse was "when do you want to schedule your c-sec?" I kept saying, "I'm NOT having a c-sec", but was proven wrong when baby A's cord prolapsed and baby B's placenta partially abrupted during labor. I made them wait until I was 38 weeks to induce, and would have gone longer had my dd not had major medical issues we needed to deal with.
But, this is not the case with a lot of people. I feel that a lot of twin moms don't get the info that might
help them carry longer. A few of us on my twin board all read the Dr. Luke book, and I'm the only one who actually followed the diet. One gal told me that there was no way she would gain that much weight, and another's ob told her it was just a bunch of crap and not to eat that much protein as it wasn't good for her. Two others said, "oh, I tried, but it's too unrealistic to follow such a diet." And, a lot are told by their doctors that there is no point in staying pregnant longer than 36-37 weeks (based on what I've read elsewhere).
The fact is, though, that there ARE certain risks associated with multiple pregnancies. No matter what you do, there are going to be instances where babies are born prematurely, with NICU stays and with problems. The risks are there with singletons, too, just not as much. My ds1 was born at 37w because of my high blood pressure. Developmentally, though, he was a 35 weeker, and had a NICU stay.
As a former IVF patient, I can tell you that after having gone through all the shots, the retrieval, the hormones, the emotional upheaval and all the things that come with it, I would be really angry if my doctor told me he was only transferring one embryo. At least when I was ttc my ds1. My second cycle (the one that gave us twins), I wanted to transfer only 1 embryo, but the doc was insistent on 2, given my previous history with IVF (we had transferred 3 embryos the first cycle, with a chemical pg, then 3 embryos and got my ds1). He tries very hard to keep the multiple rates as low as possible, and does only transfer one embryo pretty regularly to those he feels are good candidates for it (again, anecdotal evidence from the other forum, where many patients from my clinic come for support during their cycles). I do remember reading, though, that there is evidence emerging that suggests the success rates between transferring one and two embryos isn't that different, but the rate of multiples is pretty significant. I just wish I remember where that was.......
At any rate, we did end up with a NICU stay for one that would have happened whether she was a singleton or a twin. She actually was moved out of the NICU on her 2nd day, as she was mainly just being observed for a few days.
Okay, sorry, I'm rambly. I have a lot of opinions on this subject, and think that it's hard to tell someone who's laid their life savings on the line for IVF that "nope, sorry, you can only transfer one embryo on your one shot at getting pregnant." At the same time, I know and recognize the risks of multiple pregnancies, so it's a hard line to walk.