"Hope for the best, prepare for the worst"

[annettemarie]

This is the advice I keep getting over and over again-- hope you'll go full term, or as close as possible, hope you'll have a vaginal birth, hope you won't end up on bed rest, hope the babies will be healthy and come home with you... but be prepared for things to go otherwise.

What do you think of this advice? And how did you go about preparing for the worst?

[OGirlieMama]

Well, I had the first half of that down really well. My preparing for the worst consisted of me saying "Yeah, twins often come early so maybe instead of the end of March (3/27) it'll be the beginning. Gee, I hope they don't come on my brother's birthday (3/6)."

Yeah, they came on my FIL's birthday, instead - 1/10. I had no clue. I was totally unprepared for the NICU, and this despite having spent two freaking weeks on strict hospital bedrest with PTL prior to the birth. WTF was I thinking?!

For me, that lack of preparation dovetailed nicely with being a first-time Mom with zero breastfeeding experience. Awesome! Cue the mad scramble to get a hospital grade pump before I was discharged, and cue months of struggle. At least that bit will be familiar to you, having done it before (though yeah, preemies are different for sure, at least you'll know what the heck "right" feels like.)

Do you have "Mothering Multiples"? She did a pretty decent NICU chapter, IIRC. It's probably enough to just sort of give you some kind of background, and it's not so much reading that it'll be a huge waste of time when you have 41-week 7-pounders. Other than that, you already know there's a NICU/Preemie forum here, which I wish I had known back in January of 2010. If you end up needing to know more, it's a great resource.

I guess if I were doing it again, I wouldn't go nuts preparing for it, but I wouldn't go as far deep into denial as I did.

How many weeks are you now?

[annettemarie]

I'll be 13 weeks on Monday. After two losses, making it this far was my first goal. My next goal is to make it to 23 weeks.

I think I might have Mothering Multiples down in the LLL library. I keep meaning to look, but I am soooooo tired.

I think I am a little in denial. All my babies have gone late and I assume these babies will be term, or pretty darned close.

[DoomaYula]

I think that's kind of downer advice.

I'd go for a realistic look -- your own history, and what "type" of twins you have. I have MZ (mono/di) twins and they had TTTS dx at 18w. Realistically, I thought I'd have them early and they would be in the NICU for a while. That's pretty much how it happened, and I think being mentally prepared was helpful. But I never thought about having micropreemies or serious problems due to prematurity. I pushed very very hard for a vaginal birth and I ended up getting one.

They were born at 34 weeks, in the NICU for a week and then the pediatric ward for 3 days, and then home. I didn't breastfeed them past a month, but I never intended to (unfortunately; I wasn't very knowledgeable at the time). I realize it could have been worse, but it seemed about what I expected.

I guess what I'm saying is, yes, give some thought to "worst case scenarios" the same way all do when pregnant, but I'd focus on the reality and the facts of your particular twin pregnancy.

[lolar2]

I've heard and used that expression many times, always as financial advice. As in, make sure your insurance covers proper NICU treatment and that sort of thing, make sure you have extra childcare lined up and budgeted-for in case of a C-section, etc. The financial context is the one in which I always hear that expression.

[Molliejo]

Originally Posted by DoomaYula

I think that's kind of downer advice.

I'd go for a realistic look -- your own history, and what "type" of twins you have.

Yes to that. Everyone told me I would go early. I heard it constantly. I was mentally ready to have my babies at 36 weeks (and was shocked that I got to that point since everyone told me how hard it would be). But...I ended up having my girls at 40 weeks and six days. So, everyone was wrong.

And, I had gone over 40 weeks with my other pregnancies, so why was that strange? That was just normal for me. And since your other babies usually come 'late', that really is in your favor.

Good luck!

[dknees]

My older ds was in the NICU for a few days after he was born at 37w. (He was fine at birth, but got dehydrated afterwards, long story.)

I never thought for a minute that the twins would be born early, but also had had the experience with the NICU (though not on the scale of preemies) and knew generally what to expect from there.

I think the advice sounds a little harsh, but it's a shade of reality. It is possible you will go 40 weeks with twins, and it is possible they could be born early. I try not to worry too much about what hasn't happened yet and what I cannot control. I do think it's a good idea to know what all the possibilities are, and to have a general idea of how you'd handle the situation if it arises.

[queenofchaos]

I try to put things into perspective. No matter what kind of pg you have, there's always a chance for just about anything to occur. Yes, multiples tend to be riskier. But still, in a lot of ways it's all a gamble. That doesn't mean you can't do your best, which is probably what you are trying to figure out. One of the books on twins I got is "Juggling Twins" and in the start of the book the author basically says that while there are many things out of your control, getting enough rest and eating well are something positive you can do. (I am not recommending the book, just thought the nutshell advice was pretty good.)
This book, "When You're Expecting Twins, Triplets, or Quads: Proven Guidelines for a Healthy Multiple Pregnancy" by Barbara Luke is very good for nutrition advice. Some of the other advice I think is a little too cut and dried, but at least you have an idea of how you should deal with a multiple pg.
What I am getting at is that it isn't enough to hope for the best, you need to know what that is so you can go for it. On the other side of the coin, the best thing you can do about the worst is find out what that is and means. Read up on prematurity, NICUs, etc. just to have the knowledge on hand. Think about how those things may impact your life and have some sort of idea how you might cope. That's probably the best you can do to "plan for the worst."
The only other thing I can think of, is live your life with lots of margin. If you tend to be Superwoman, think about how you can cut back so you have lots of time to rest, eat properly, stay hydrated and basically take wonderful care of yourself. While this is important for any pg, it is even more so for multiple pgs.
I found out at 10 wks I was pg with the twins and it totally freaked me out. I have 6 other kids and you would think all this pg stuff would be old hat, but a multiple pg is quite different. You'll feel better once you find your bearings.

[Nanasi]

No one would tell you such a thing if you were pregnant with one baby. I know that twins come early more often than single babies, but it is not as simple as that piece of advice makes it out to be. MDC is the only community I found that didn't seem to believe all twins come early. There are lots of examples of women who carried their twins full-term.

When I was pregnant, I knew three other women who were also pregnant. I carried my babies longer (40 weeks) and grew them larger (7lbs 12oz & 7lbs 10oz) than any of those other women. Yes, part of that has to do with my boys being di/di and the fact that I worked from home and had no other children to tire me out during pregnancy. But I think it also had to do with my belief in myself and the process. My mantra was "big, healthy babies." I told everyone that they were going to be December babies (38.5 weeks or more) and I wanted them to weigh between 7 and 8lbs each.

I know positive thinking can't make everything go according to plan, but without it, you're screwed. I wound up with a c-section instead of the homebirth I'd planned, but I the heartache of giving up the birth I wanted was much easier to endure than the heartache many MoMs have gone through with two or three babies in the NICU. Personally, I skipped over the NICU chapters in the twin books because I didn't want to even consider it. If it had come to that, I probably would have been woefully unprepared. But I'm not sure anything--book, hospital tour, class, even personal experience--can prepare you for that experience. Trust in your body.

[annettemarie]

Well, while I don't want to be fatalistic and negative, neither do I want to bury my head in the sand and pretend like it's not true that twins often come early. I do trust birth and I do trust my body, but trust only gets you so far, you know? Lots of people trust birth and still end up with less than optimal outcomes.

That said, I do believe that my past pregnacy and birth experiences will definitely work in my favor. My OB said as much when I pointed out that my other babies had to practically be dynamited out, LOL! I've never had huge ginormous babies, except my last who was 9 pounds, but they've all been respectable weighhts and I've never really had complications.

I'm due on 12/6. I'm aiming for Thanksgiving babies. I'll be thrilled if I have them on 11/29. The 29th and 17th are special days in our family-- my 4th was born on 4/29, my 3rd on 9/29, and my husband on 11/29. My 1st in 2/17 and my birthday is 8/17 and our anniversary is 12/17. I suppose I'd settle for 11/17 as well, !

[f&p'smama]

I think it's decent advice, actually. Yes, kind of a downer, but so is life insurance and making a will.

My twins came at 37 weeks. Once I made it to 36 weeks and had an ultrasound that predicted big babies, I thought for sure I'd dodged the NICU. One of my girls was only 4-1/2 lbs and spent 3 days in the NICU, first for observation and then because she developed jaundice. I had no idea what to expect from the NICU and didn't have a plan for nursing in the NICU. I wish I'd thought about it more ahead of time and talked it through with my DH.

I'm not so sure singleton pregnancies are a good predictor of what a twin pregnancy will be like. As I said, mine came at 37 weeks. I was in early labor, but they were born because I developed pre-eclampsia. If that hadn't happened, perhaps they would have stayed put a bit longer. One was 4-1/2 lbs and one was 6-1/2. My singleton (VBAC) came at 40w, 5d on his own and was 10 lbs, just a pound less than his sister's combined weight! Something must have been amiss with my littlest one's placenta.

Anyway, I wouldn't dwell on it, but I would look into the NICU at the hospital where you will have the babies, learn a bit about their policies, read up a bit on nursing preemies. From my experience, there is a huge difference between 37 weekers and a nearly 41 weeker. They were a whole lot sleepier, much more difficult to keep awake while nursing and get enough mama milk into. With the large family you already have, it may be wise to have some help lined up in case you do go early or need to be on bedrest.

Hopefully you'll never have to use your worst case scenario plans. Congrats on making it to 13 weeks!

[annettemarie]

Thanks1

I realize I'm not guarantee to go late just because my other babies did. What my OB said was "Well, that makes me a lot happier than to hear that you went earlier and earlier each baby."

[MamaChicken]

Completely anecdotal, but I have four kids:
-DS1 came at 37 weeks, 5 lb 12 oz, and spent 24 hours in NICU
-DD came at 39 weeks exactly, 7 lb 12 oz, no NICU
-Twins came at 37.5 weeks, 6 lb 6 oz and 6 lb 11 oz, 8 hours of observation in NICU

Honestly, I think I would have carried them longer and better if the had been a bigger gap between them and DD. She was 9 mo when I found out I was pregnant with them. My body was pretty tired still.

As far as planning for the worst, I made contingency plans at work and made an arrangement with my mom to help me out if I needed it at anytime.

I did hypnobabies and focused at lot of time and energy tipping the odds in my favor as far as rest and nutrition.

So yes, hope (and work HARD) for the best, but be realistic about other-than-best.

[queenofchaos]

Originally Posted by annettemarie

.

That said, I do believe that my past pregnacy and birth experiences will definitely work in my favor. My OB said as much when I pointed out that my other babies had to practically be dynamited out, LOL! I've never had huge ginormous babies, except my last who was 9 pounds, but they've all been respectable weighhts and I've never really had complications.

Like you my OB said that my past pg/birth experiences are a good indicator that I would do well with my twin pg. This is pg #7. At 34 wks., things have been very uneventful. It seems I am just a baby-making machine! LOL I am realistic in realizing that my past OB history guarentees nothing, that's why I've read up on things and tried to be as prepared as possible. The hard part is reconciling yourself to the fact that you just won't know when lightning will strike. But you could say that about anything in life.

[yogafeet]

I was in complete denial that my twins could come early b/c of always being on MDC. Giving birth at 30 wks 5 days was a complete shock. I think it's good to be prepared for anything. Kind of like the Boy Scouts, ykwim? I think it's a good idea to do more laying down/getting of your rump when pg w/ twins, too. Good excuse to relax and take it easy.

[Llyra]

My approach was to control what I could-- to watch my diet, to get enough rest, to pay attention to my body when it came to deciding how much exercise was right for me, etc. To lay some plans for what we'd do if things didn't turn out optimally-- some financial plans, some plans for help with my older DD, etc. But at some point, things are out of your control, and so I had to work on letting go of those things. So I'd say to myself, and to everybody else, "it will be what it will be, and worrying won't change it," and after awhile I started to believe it.

It's more than just preterm birth or low birth weight. Lots of complications are more common in multiple pregnancies-- I'm a classic example. I had trouble with tachycardia (because of the additional blood volume), Bell's palsy in the second trimester (because of fluid retention), and cholestasis (liver disease more common in multiple pregnancies, probably related to higher hormonal levels), and then wound up with a nice case of PUUPS immediately postpartum, probably also the result of wider hormonal fluctuations.

But being prepared wouldn't have helped with any of those. What I really needed was the ability to stay calm and think clearly and pay attention to my body's signals, so that I could make decisions about what level of medical intervention was really needed at any given time.

[mama2toomany]

Twin girls came at 39 weeks 3 days

Baby M weighed 6 pounds 4oz and Baby R weighed 6 pounds 12oz

That was my longest pregnancy, all my singletons came earlier.

[hergrace]

Originally Posted by Llyra

My approach was to control what I could-- to watch my diet, to get enough rest, to pay attention to my body when it came to deciding how much exercise was right for me, etc. To lay some plans for what we'd do if things didn't turn out optimally-- some financial plans, some plans for help with my older DD, etc. But at some point, things are out of your control, and so I had to work on letting go of those things. So I'd say to myself, and to everybody else, "it will be what it will be, and worrying won't change it," and after awhile I started to believe it.

It's more than just preterm birth or low birth weight. Lots of complications are more common in multiple pregnancies-- I'm a classic example. I had trouble with tachycardia (because of the additional blood volume), Bell's palsy in the second trimester (because of fluid retention), and cholestasis (liver disease more common in multiple pregnancies, probably related to higher hormonal levels), and then wound up with a nice case of PUUPS immediately postpartum, probably also the result of wider hormonal fluctuations.

But being prepared wouldn't have helped with any of those. What I really needed was the ability to stay calm and think clearly and pay attention to my body's signals, so that I could make decisions about what level of medical intervention was really needed at any given time.

I had triplets, so the risks were higher, but my approach was always to do what I could to assure the best outcome, pay attention to what was actually happening, and be flexible.

Early on in my pregnancy, I did a lot of medical research and decided which sources I felt comfortable trusting (don't remember which now, sorry). Anytime anything changed about my health or my babies' health, I would turn to my already trusted sources for advice.

[~bookcase~]

as another mom of many, my biggest tip is to listen to your body and take it easy as possible whenever you need to. otherwise enjoy

i did think i was going to have preemies, but hoped to get to 34 weeks. we went to look around the NICU as i wanted to see how it was and my dh and i left that place saying, noooo way we're coming back here but we did. for 4 weeks in the end

what i wish i'd done is taken it easy. dh and i were living apart at the time and i was home edding 4 children. not conducive to rest, but i really should've listened to my body better. i would add that the preemie thing has really defined my experience of multiples. i'd still like to have a full term, homebirth duo

just stay attuned and you'll do fine whatever. and pray your list of wants.
easy pregnancy, full term, healthy and well, awesome birth, kind health workers, good b'feeders and weight gainers, easy characters, good sleepers (HAHAHA. is that possible with twins ), great response from siblings, sturdy marriage......hmmmm, what have i missed anyone??!?

hey - you've got three heartbeats in your body right now. how awesome is that

[Red Pajama]

My advice is more "plan for what you want, but also plan to be flexible"
I do think you need to be aware of potential complications, and listen to your body, and do whatever monitoring of the babies you and your doctor are agreed to.


My own personal story was one of a fairly uneventful pregnancy until about 28 weeks. I over did it over thanksgiving weekend, and found myself on bed rest and in and out of the hospital for the month of December. I was released to house arrest for January and into Feb. until they were born at 38 weeks.
In my mind, I figured I'd at least work until christmas break. My hospital admission was completely unexpected, at least for me.

My MIL was talking with someone from her church who had sextuplets and mentioned I'd been put on hospital bedrest. Her reply was "good. She'll rest." At the time, I certainly didn't see it that way, and I hated skipping christmas, but bedrest is finite.


On a lighter note, while pregnant with twins I referred to myself as "the collective".