Twin Talks
Twinning: How Does It Happen?

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Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

DR. SEAN DANESHMAND: Are you one of the many twin parents who were complete shock after having just been informed that you were carrying more than one baby? Have you wondered how this could have happened to you especially if there are no twins within your family?

What are all of these medical terminologies that you’ve heard about like DiMo mean? I’m Dr. Sean Daneshmand from Perinatologist at the San Diego Perinatal Centre here to talk about twinning. How does it happen? This is Twin Talks Episode Number One.

[Theme Music/Intro]

CHRISTINE STEWART-FITZGERALD: Welcome to Twin Talks broadcasting from the Birth Education Centre of San Diego. Twin Talks is your weekly online on-the-go support group for expecting new parents to twins. I’m your host Christine Stewart-Fitzgerald.

Have you heard about the Twin Talks Club? Our members get bonus content after each new show plus special giveaways and discounts. Subscribe to our monthly Twin Talks Newsletter and learn about the latest episodes available.

Another way for you to stay connected is by downloading free Twin Talks app available in the Android and iTunes Marketplace. I want to tell you about our Virtual Panellist Program. I will turn this over to Shelly our producer.

SHELLY STEELY: Hey, looking for another way to stay connected with Twin Talks? You can follow us on Facebook and the Twitter. If you want to be an active part of the conversation; we have a Virtual Panellist Program through Twitter. Use hash tag #TwinTalksVP to participate in our conversations live.

CHRISTINE STEWART-FITZGERALD: Okay, well let’s take a moment and introduced ourselves and our panellists here. Tell us about yourselves please.

SHANNON CEBALLOS: I’m Shannon. I’m almost 32 in 10 days I think. My daughter’s almost five and I have fraternal twin boys who are almost 11 months.

CHRISTINE STEWART-FITZGERALD: Well, congrats you’ve almost made it to the first year. I hope we know that’s the topic. So, we’re just glad that you are here.

SHANNON CEBALLOS: Thank you.

SHELLY STEELY: I’m Shelly. I’m 30. I’m a high school history teacher. I have identical twin boys who are almost 15 months.

SUNNY GAULT: I am Sunny. I have already mothered to Sayer and Urban. Sayer is three years old, Urban is about 17 months old and I’m seven months pregnant with identical twin girls. They are expected to be born December 2nd via C Section.

CHRISTINE STEWART-FITZGERALD: So, now I got to hand it to you. You’re going to have four on to four.

SUNNY GAULT: I know. I already looked for website. I’m like: “That will be a really cool website to have.” You else’s is taken and I don’t know who took it and I know. I really don’t know what to expect with that. It’s definitely going to be a circus. That’s really all I can say about that. But, we’re looking forward to it.

I’m really excited that I got my girls finally. Doing the boy-thing for a while and so, it should be a packed house; very busy.

CHRISTINE STEWART-FITZGERALD: As your host, I’ve got twin girls that are four. They just turned four, identical girls. I also have a singleton who will be one year next week. So, I guess I’ve had three on to three. Sunny, you’ve got that one.

Well here’s a question from one of our listeners. This comes from Sandy of Kansas and she writes:

I’m pregnant with twins. I’m not very far along yet. So, I’m still nervous and praying that they both make it through the first trimester safe and sound. But, I’d love some advice in the meantime.

Anything different that I need to do with my diet besides in just more calories, any special gear for pregnancy and beyond that I need to make sure I have. I’m really trying to learn everything I can so, any all advice is greatly appreciated.
- Sandy

JONAROSE FEINBERG: Hi Sandy. This is JonaRose Feinberg. I’m an IBCLC, mama’s twins and editor of BreastfeedinTwins.org. As I’m sure you’re already learning; there are some things about expecting twins that are a bit different from being pregnant with one baby at the time. Here are some things to think about and do during pregnancy.

First and most importantly: “Listen to your body.” Some moms finally need to make a lot of lifestyle and dietary changes while they’re pregnant and some don’t need to change much of anything. Some moms are up and about that their normal activity levels and some need to limit their activities early on.

This puts on to so many things:

• Your previous activity level
• Your job conditions
• You need circumstances of your own pregnancy

There is no single set of rules that is right for everyone. Please check with your own health care provider to help you make decisions about your own unique pregnancy. Many nutritionists suggest increase in not only your overall calorie intake but specifically your protein intake while pregnant with multiples.

Protein helps your baby’s development and while many moms carry their twins to 37 weeks or more; some moms deliver early. It’s important to ensure that your babies are growing well early on. It’s definitely you should live on the milk shakes and cheeseburgers but you may want to incorporate additional protein sources in your overall diet.

There are lots of moms like making smoothies with protein powder because it’s an easy way to get a lot of healthy ingredients and extra protein into one meal. I recommend a book called: When you’re Expecting Twin, Triplets or Quads by Barbara Luke for a really good explanation of diet and nutrition during the multiple’s pregnancy.

To keep you feel comfortable, I strongly suggest adding some extra pillows to your sleeping arrangement. You may want several pillows; maybe one behind your back and another between your legs or you may be most comfortable with a long body pillow or other maternity pillow to support your growing belly.

Many moms also find them more comfortable using a belly support then in there pregnancy to help support their growing mid section. Sometimes you can have your care provider prescribe a special band or get one from a maternity specialty store.

Finally, pregnancy is a great time to reach out to other moms – sharing your local twin’s club to reach out to other moms in multiples online. Local groups often have expecting new moms’ group you can attend now to get advice from moms who have recently been through the adventure of twin pregnancy.

Note that local clubs have different personalities, programs and offerings. If one group does not a great match, you may be able to find another nearby or online that will meet your needs.

Again, congratulations on your pregnancy. Take it easy, keep them [inaudible] and enjoy this new adventure. Come visit me online at www.BreastFeedingTwins.org for more information and tips.

[Theme Music]

CHRISTINE STEWART-FITZGERALD: Well, today’s topic is: “Twinning, how does it happen?” We’re talking with Dr. Sean Daneshmand who’s helping us understand what’s going on inside the conception and formation of twins.

We’ll learn not only about the differences between identical and fraternal twins but also what are some of the things that may cause twins to be conceived, is it a completely random act or can you influence twinning? Thanks for joining us Dr. Daneshmand.

DR. SEAN DANESHMAND: Thanks for having me.

CHRISTINE STEWART-FITZGERALD: Great, active in the studio today. It’s like being home. What’s difference between identical and fraternal twins?

DR. SEAN DANESHMAND: So, identical twins also known as monozygotic twins is when the ovulation or fertilization of one egg happens of one who’s side and then it divides. Paternal twins are dizygotic twins is when ovulation or fertilization of two separate oocytes happen. So with monozygotic twins, it depends on once the fertilization happens then depending on when the zygote divides and determines what kind of placentation we have.

So, there are two things that we talk about. One is identical versus fraternal. One is the number of placentas and the number of amniotic sacs that you have which is more important in twins at least in the management of the pregnancy. So, identical versus fraternal; maybe not so important but the chorionicity or the number of placentations is really important during pregnancy and we’ll go into that I’m sure as we talk further.

CHRISTINE STEWART-FITZGERALD: So, you sum of the different terms like mono, dichorionic, amniotic; so, what are those means?

DR. SEAN DANESHMAND: So, chorion is the number of placentas. Remember identical twins can have two separate placentas as well depending on when the zygote divides. So, for the fertilization of an oocyte happens and if that zygote divides between zero to three days then you have two separate placentas which is much better.

If the zygote divides between days’ four to eight then you have one placenta and two amniotic sacs. If it divides between 8 to 13 then you have mano-a-mano which comprises of one percent of identical twins – that means both babies are in the same sac with one placenta. If it happens after 13, that’s usually conjoined twins.

CHRISTINE STEWART-FITZGERALD: So, basically you’re saying that so the sooner the division happens is the better and that’s for the health both of the babies as well as the mom as well.

DR. SEAN DANESHMAND: That’s a monozygotic twin. Fraternal twins are dizygotic twins, they have two placentas. So, that’s because there’s fertilization of two separate oocytes, different genetic material and complications with those babies is significantly less. We treat fraternal twins much differently.
I wouldn’t say fraternal but dichorionic, diamniotic twins differently than we’d take care of – monochorionic, diamniotic twins. So, two placentas are much better than one placenta. None [inaudible] necessarily what happens but you got to watch those babies a lot more carefully

CHRISTINE STEWART-FITZGERALD: Okay.

DR. SEAN DANESHMAND: There’s a reason for that. I can get to into it now. When two babies are sharing one placenta, they have a high risk of developing something called twin-to-twin transfusion syndrome. Remember if they’re sharing one placenta, so many times these babies are sharing vessels.

One of the major complications were to having one placenta, there were twins is that: “One baby can give more blood to the other.” Everyone who has twins knows about this because it’s merely mention to them: “We’re looking at a twin-to-twin transfusion.” So, everyone’s is very informed about this.

Ten to 15 % of the time that happens and that carries a significant risk with it. Also, growth restriction is higher with one placenta with one of the babies. Many times you may have to necessarily deliver the pregnancy, the babies because one baby is not growing as well. Also, congenital abnormalities with identical twins or at least one placentation is higher; mainly hard defects.

So, every mom who’s got twin gestation with one placenta – we look at the baby’s heart usually around 20 to 23 weeks. Christine, twins in general have a higher risk of developing gestational diabetes. Now, like you mention: “We talk about a lot of these medical complications. We scare moms a lot.”

There are many moms that do fantastic just like you did when you and I were talking before the taping started. But, gestational diabetes and soon that is higher and the general population is about five to six percent. Twins are about 13% of hypertension or hypertensive related crisis goes up such as preeclampsia or gestational hypertension which is hypertension developed during pregnancy, cholestasis which is stasis of bio sought.

Shelly there is nodding her head because she had that 37 weeks that she ended up getting delivered, acute fatty liver. So, these are things you just have to have in the back of your mind and obviously, monitor patients that have that. Most important thing I think Christine is: “Having good communication with your patient and having trust.”

That’s the most important I think at least one of the things that I talked about with patients: “If I feel like we are not on the same page, we are not communicating well, we have to separate our ways. That’s what a [inaudible]

CHRISTINE STEWART-FITZGERALD: You wouldn’t know what’s going on.

DR. SEAN DANESHMAND: You have to be informed absolutely.

CHRISTINE STEWART-FITZGERALD: Their whole history and their lifestyle and look at the whole picture.

DR. SEAN DANESHMAND: You need to be communicative. I mean it’s about the patient. It’s about those babies and right, there’s got to be mutual respect.

CHRISTINE STEWART-FITZGERALD: So, overall I’m hearing some statistics as far as the incidents of sharing a placenta or sharing the amniotic sacs and as well as the different conditions – I think you’re saying that really the large majority of twin pregnancies do not have these conditions.

DR. SEAN DANESHMAND: Majority of twin pregnancies, 2/3 of them have two separate placentas. So, monozygotic twins or identical twins are the rate of having those babies have remained constant. It’s about 3 to 5 per thousand live births. Dizygotic ones are just fraternal ones that have change to do.

For example in fertility treatments, drugs, and advance maternal age – the older you are the more likely you’re going to have twins. The heavier you are, the taller you are more likely you’re going to have twins; family history, genetics play a part.

CHRISTINE STEWART-FITZGERALD: Right. So, for all the twin moms out there who are just finding out that they have twins; we’re throwing a lot of these kinds of conditions or opposites. So, let’s not freak about it.

DR. SEAN DANESHMAND: Absolutely not.

CHRISTINE STEWART-FITZGERALD: In your practice, you see a lot of high risk patients. It’s the acceptation rather than the rule.

DR. SEAN DANESHMAND: Of course. Once we see two separate placentas, I’ve had them. You’re complication rates are significantly lower now. One of the things we always worry about is premature birth. But, congenital abnormalities are not higher and babies that have two separate placentas. So, we treat them not as aggressively or as intensely as we would ones that have just have one placenta.

It really boils down to the number of placentas we have. That’s how we basically layout the management plan with the patients. It’s important to see these wonderful moms early on in the pregnancy because you can tell – later, I’m sure we’re going to get into ultrasound. How do we determine if there are two placentas?

It’s better to see these moms early in the pregnancy because you can determine that much easier when the mom is early on in the gestation than later on.

SUNNY GAULT: So, my girls are identical and we knew from the very beginning that they were; but they didn’t actually tell us that we were pregnant with twins until like 14 weeks. Well, I had an ultrasound that like eight week. My first prenatal appointment and they didn’t see twins apparently. I don’t know if one was hiding behind the other.

I went back my first trimester screening test. So, I just thought that this was a regular appointment. I didn’t go with my husband. He was watching our boys at home.

DR. SEAN DANESHMAND: Sunny, that’s fantastic.

SUNNY GAULT: She took one look at me and; she was a Sonographer that I’ve never met before. She took one look at me; she’s like: “Twins.” It’s a twin appointment and I didn’t realize this was a twin appointment not like I’m informing that you have twins. I totally thought that she was joking like I really was looking for the candid camera stuff.

DR. SEAN DANESHMAND: That is so funny.

SUNNY GAULT: Again, identical; we don’t have twins in our family. I’ve already had an ultrasound. So, for me the experience – it started off very normal because I already have two boys. I knew what prenatal appointments were like. All of the sudden, they find that there’s two babies. They determined: “They were sharing the same placenta but they were in different sacks.” So, that part was good.

CHRISTINE STEWART-FITZGERALD: Did you find out early on?

SHELLY STEELY: I got married two years ago. My husband and I honeymooned in Italy. I came back thinking I was jet-lagged. Then, for a week I’d never travelled internationally before. After a week and then two weeks, I’m really stone tired and I haven’t had a period so maybe I should. Okay, so we’re pregnant.

I was thinking my mom had – there are three of us. She saw midwives for all of her pregnancies. She was just one of those glowing, health, loved every minute of pregnancy like completely med-free delivery and really enjoyed that experience.

So, I went to my first appointment thinking that we’re going to be talking about seeing a mid-wife versus an OB and getting some questions answered about what kind of like less intensive care and I was thinking: “Less intervention.”

So, my husband and I went back and forth about whether he should come or not. He finally decided: “Okay, I think I might as well.” So, we go into the appointment and I talk to her: “I’m a little bit overweight. Should I see somebody about that? What kind of weight gauge I’d be expecting? What are my options for midwives?”

We have this great conversation and then they got to do the dating ultrasound because I’ve had irregular periods and let’s do a vaginal ultrasound to kind of date the pregnancy. It literally, she puts into the ultrasound wand. She turns the screen and she goes: “Twins.” Just like that and then she looks at me and looks at my face and she goes: “Were this spontaneous?” Yes, clearly.

CHRISTINE STEWART-FITZGERALD: Did you see her face?

SHELLY STEELY: She had no idea. She figured: “You didn’t know?” We were like: “We did not know.”

SUNNY GAULT: Why do they think we know? Why?

SHELLY STEELY: I think you know, “It’s common that they see a lot of high risk pregnancies.” A lot of people who knew they were expecting twins. She just seemed shocked that we had no idea. So, instantly the conversation went from what kind of care to here is your doctor’s number. You will be seeing him for the rest of your pregnancy. Don’t pass out on coming straight over there on the ultrasound.

She told that there were fraternal which she really just meant dizygotic twins, two separate placentas, and two separate sacs. I have fraternal twins in my family. So, I figured: “Luck of the dry, gotten the fraternal twins.” I had a well-monitored but a really uneventful pregnancy. I did have something called: “Velamentous Cord Insertion” the cord inserted to the side of the placenta and that can affect growth.

So, I have your regular growth ultrasounds but they really watched to make sure that my baby was growing well because of the position of his cord. But, it was a boring twin pregnancy. Those cervical checks every time, it was long-closed, nothing going on.

SUNNY GAULT: That’s good though.

SHELLY STEELY: So, I was really helpful that I would still be able to end up going full term as it turned out though like Dr. D mentioned: “I ended up getting Cholestasis.” The number one sign of that is that: “You itch everywhere but you don’t have any rash.” It’s crazy because your entire body is itching but you can’t see any evidence of it.

So, luckily my doctor he sees only multiple pregnancies. When I went inside and said: “I was itching.” He kind of gave me a gnawing look, took a blood test and then informed me that 37 weeks was when I would be going to the hospital for the health of the babies. So, I ended up having an emergency C Section which was not in my birth plan at all in the beginning. But, you just kind of go with it. So, it is what it is.

SHANNON CEBALLOS: My first appointment’s with the midwife. I walked in and I’m kind of a [inaudible] anyway. So, I said it telling her about how we couldn’t get pregnant and what we have done to try to get pregnant. So, she knew my whole story. She said: “Normally, we don’t do ultrasounds but I’m going to do an ultrasound because I like you.”

DR. SEAN DANESHMAND: That’s so funny.

SHANNON CEBALLOS: Like it was a reward or something. So, she did an ultrasound and she started laughing. She said: “Does twins run in your family?” I literally sat up. What? No, they don’t run in my family. She was just laughing at me. Wow, you wanted to get pregnant.

CHRISTINE STEWART-FITZGERALD: I think this ultrasound talks. A little bit of twins.

SHANNON CEBALLOS: I think I actually really went into shock because I just remember like shivering like uncontrollably. I wasn’t because I was like: “My gosh. This is awful.” I was shocked. I was sitting on the table, shivering. Did you really just say twins? So, you could tell right away that they were in two different sacs. You could see once you printed out the ultrasound that they were into different sacs.

DR. SEAN DANESHMAND: There are patients that obviously don’t know they’re having twins but what are the signs? One is: “The uterus being a little bit bigger.” So, you’re showing a little bit more. One is your pregnancy hormones if they did for example I just said random [inaudible] pin – that maybe much higher.

Also, if you have abnormal screening tests; when you do your screening test, if they are abnormal – one of the differentials is twins. That’s the most common actually reason why this is where twins go in. So, an early ultrasound is really the way to diagnose.

CHRISTINE STEWART-FITZGERALD: Okay, so ultrasounds were looking for the heartbeat plural.

DR. SEAN DANESHMAND: Absolutely. They determine your date which eliminates a lot of the problems later on. Let’s say for example, “If the baby’s too big or if the baby’s too small or babies. At least that way, you established early bidding.” That makes such a big difference.

If someone comes in; as I have a patient with this, it’s not a patient who came in; a physician called me and start the patient as I think Cholestasis. She’s itching all over liver. In times, it’s very elevated but she did not have adequate dating. She showed up at 34 weeks during the pregnancy.

So, it’s hard to determine really exactly how many weeks is she? When do we deliver her? Normally, we deliver them at 36, 37 weeks with Cholestasis. So, an early ultrasound very important and especially important is making sure of what type of placentation the twins have.

CHRISTINE STEWART-FITZGERALD: Great, we have a lot of really great discussion going here. We’re going to take a break and then when we come back, we’re going to talk about some other things that affect twinning as well.

[Theme Music]

CHRISTINE STEWART-FITZGERALD: Welcome back, today we’re talking about twinning, how does it happen with Dr. Sean Daneshmand; how common our twins today? Have the numbers changed much?

DR. SEAN DANESHMAND: For example in 2011, 3 1/2% of all deliveries, live births were getting a multiple twins. Twins account for 96% of all multiple deliveries. The numbers have changed just because the fact that more older women are having children. There’s the number of infertility treatments have gone up, have sky rocketed; so absolutely.

Other reasons like we talked about earlier; so, fertility dries number one. That’s the biggest boost to having twins. Older women, ethnicity and geographic areas; we talked about earlier before the show was starting.

In the US, about 8 per 1000 live births are twins. In Japan for example, 1.3 out of the 1000 – so, much lower. In Nigeria, the highest is 50 per 1000 live births. So, we’re talking about earlier maybe due to their diet. That’s what we’ve thought about all these years; maybe due to an increase in taking yams. What else – increase body mass index again and genetic reasons.

So, genetics definitely play a role if mom has had a family history of it that is a factor. If dad the father, the babies had a family history; dad doesn’t have an impact on their twinning.

CHRISTINE STEWART-FITZGERALD: It’s only along the maternal line.

DR. SEAN DANESHMAND: Along the maternal. But, dad can’t pass on the genes to his daughter.

CHRISTINE STEWART-FITZGERALD: Okay.

DR. SEAN DANESHMAND: His daughter would have an increase risk. So, definitely genetics play a role in the oocyte and be x.

CHRISTINE STEWART-FITZGERALD: Is that why people – there’s that myth kind of that twins skip generations. So, that would be twins run on the male side because the woman has to release the eggs. So, the father has nothing. I hear that a lot. People say: “You had twins. Do they skip generation? Were you the one?”

DR. SEAN DANESHMAND: Right.

CHRISTINE STEWART-FITZGERALD: But, when we talk genetics, we’re specifically talking about fraternal twins, correct?

DR. SEAN DANESHMAND: We’re talking about fraternal.

CHRISTINE STEWART-FITZGERALD: Fraternal twins. Okay.

DR. SEAN DANESHMAND: The rate of the incidents of monozygotic, identical twins has remained constant for years.

CHRISTINE STEWART-FITZGERALD: Okay.

SUNNY GAULT: There’s nothing else that we don’t really know what causes that right?

DR. SEAN DANESHMAND: No, we don’t know exactly what causes that.

CHRISTINE STEWART-FITZGERALD: So, having identical; it’s just this completely random, magical thing

SHELLY STEELY: You should play the lottery.

SHANNON CEBALLOS: Honestly, we should. We really should have.

SUNNY GAULT: I tell my husband that all the time. We need to win the lottery. I’m like: “Honey, we already won the lottery.” Really, you consider that winning the lottery?

DR. SEAN DANESHMAND: You won the lottery because you’re doing very well to not kind of win. There is one way – that’s fantastic.

CHRISTINE STEWART-FITZGERALD: It’s awesome. Advanced maternal age, tell us about that. How does that play into twinning?

DR. SEAN DANESHMAND: So, advance maternal age as we all know is a term that we really don’t necessarily mentioned that much anymore just because the fact that all these screening tests and diagnostic tests are offered to every woman. But, with twins as we have two babies; advance maternal age with twins 31 to 33 versus 35 with the singleton.

CHRISTINE STEWART-FITZGERALD: Really?

DR. SEAN DANESHMAND: Great. I know.

SHELLY STEELY: I snuck at 29. I just hit it.

DR. SEAN DANESHMAND: You’re amazing. Sunny, the women that are older have higher intimates of having multiples and that’s because their FSH levels are higher that’s what this with the thought process is. We mentioned fertility treatments even going on clomid. It carries an increase risk for having twins 48%.

Shelly was mentioning as far as with infertility treatment – implanting two fetuses or embryos; with these treatments obviously there’s that has caused that significant increase risk in multiples.

CHRISTINE STEWART-FITZGERALD: So, let’s just women who are just mid thirties or above and they’ve decided to undergo some type of fertility treatment

DR. SEAN DANESHMAND: Expect that you have a higher risk of having multiples. I have to also mention that with these fertility treatments, the instance of vanishing twins or losing one of the babies is very high as well. So, spontaneous reduction of one of these angels is quite high and it’s reported anywhere from 11 to 78% in the literature.

So, you can tell a patient: “Until you pass really 12 weeks, I probably would not mention anything to anyone.”

SHELLY STEELY: I remember being terrified because they tell you that the appointment at eight weeks – you’re having twins. Here’s a book read about it and the whole first chapter is all about vanishing twins. I spend the next two weeks until I ultrasound; a nightmare as every night that one was just going to disappear.

In 10 weeks they said: “You have two good strong heartbeats. They’re looking great.” If you want to tell people now you can cut kind of take a deep breath and rest easy now, at this point.

DR. SEAN DANESHMAND: That becomes a factor for screening test for example. So, let’s say you come in at 10 weeks and one of the babies is unfortunately pass away then that becomes an issue for screening test.

You are limited for example that what you can do such as the blood part because remember: “With the screening test that we have; we have the Nuchal Translucency Screen and there’s also a blood work that’s associated with it.” But, those proteins, those hormones will be affected if you have twins.

CHRISTINE STEWART-FITZGERALD: So, you’re going to have higher levels of blood strain.

DR. SEAN DANESHMAND: Even if just one is lost then you’re not going to get necessarily the ideal results that you’re looking for; these accurate results that you’re looking for. It’s very limited.

SHANNON CEBALLOS: My first appointment was at 12 weeks. So, they saw the two babies right away. But then, I got placenting capsulation and it turned out that my Baby A was an identical twin and my Baby B would have been the third fraternal twin. So, they said: “My doula who did my placenting capsulation, she did it with a midwife.” She said that: “The doctors could totally they would have seen that but they just no one just said anything to me.” Why wouldn’t they tell me?

Why wouldn’t they tell me but I was like: “Thank God.” When I found out, I was like: “Thank God.” It was crazy because I had my Baby A; Manny, I had him vaginally; and Baby B was a C Section because he was breech.

So, the try to turn him and they weren’t able to get him has Baby A’s placenta because Baby A’s placenta was so big. The reason it was so big was because it would have been

CHRISTINE STEWART-FITZGERALD: It was a shared placenta.

SHANNON CEBALLOS: It’s should have been.

SHELLY STEELY: I know somebody else who have the same. She has the other one though she had identical twins. They found another sac in there that would have been the third.

SHANNON CEBALLOS: It was pretty crazy when I found that I would be: “Thank you Lord. You knew I couldn’t handle more than two.”

SHELLY STEELY: Two is good.

DR. SEAN DANESHMAND: You would have triplets.

SHANNON CEBALLOS: I would have triplets.

DR. SEAN DANESHMAND: That what you mentioned as far as vaginal delivery and a caesarean section. That happens in 10 to 30% of women. So, especially when one baby is head down and one was breech.

SHANNON CEBALLOS: So, we were helping that we’re going to be able to turn. I had this perfect birthing plan in my head. It didn’t work out but that’s okay.

CHRISTINE STEWART-FITZGERALD: So, in addition to kind of age and fertility treatments; I have always been curious. Are there any kinds of environmentally factors? I think we’ve mentioned eating hand or is there something that you might be doing that kind of cause them for those of us who’ve had fraternal twins? If a woman wanted to conceive twins.

So, is there anything she could do? I get this all the time when I’m out in the stores: “You got twins. I really want twins.” I’m thinking: “No, in the mind.” We want twins but when in midnight – it’s like saying: “At yours.” What is your phone number?

DR. SEAN DANESHMAND: I think that if a woman wants to conceive twins, the best way is medication to be honest with you. I think it could really be the yams causing this; the wonderful women in Nigeria to have such a higher instance of having twins.

But twins, it has a lot of work. It’s really there are more complications as suppose to be with them. So, but it is wonderful to have twins. What a blessing.

CHRISTINE STEWART-FITZGERALD: It’s a gift. Absolutely

DR. SEAN DANESHMAND: It really is.

CHRISTINE STEWART-FITZGERALD: Thanks so much Dr. Daneshmand for joining us. For more information about twinning and how does it happen or for more information about any of our experts or panellists. Visit the episode page on our website. This conversation continues for our members of our Twin Talks Club. After the show, Dr. Daneshmand will tell us about: “Women having more than one set of twins.”

For more information about the Twin Talks Club, visit our website: “TwinTalks.com.” We have a special segment, it’s called Twin Oops. It’s where we talked about sort of those parenting mistakes, gaps and things we laughed at that our listeners can share. If you have one that you’d like to share; you can go to our Facebook page or you can also call our voicemail at 619-866-4775.

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CHRISTINE STEWART-FITZGERALD: This one comes from Hilary in Cleveland Ohio. She says:

This morning at Playgroup, one of my two year old boys runs out to the leader and says: “Hello, I’m Steve.” So, she says: “Hi Steve.” The other one runs up and says: “Hello, I’m Steve.” The poor lady just looks at me and because they are in different clothes so either I change Steve really fast or actually my twin boys the same day.

By the way, neither of them is named Steve. Their favourite book is about Blue’s Clues and it starts with: “Hello, I’m Steve.” So, now they’re going around calling each other Steve and they think it’s hilarious. - Hilary

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CHRISTINE STEWART-FITZGERALD: So, that wraps up our show for today. We appreciate you listening to Twin Talks. So, join in on the discussion by posting your comments on the Twin Talks Facebook page or calling our voice mail at 619-866-4775.

Don’t forget to check our sister shows: “Preggie Pals for expecting parents, The Boob Group for moms who breastfeed their babies and Parent Savers an online support group for new parents.” So, this is Twin Talks, parenting times two.

[Disclaimer]

This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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