Twin Talks
Debunking Myths About Twin Pregnancies

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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]

JOANNA ADAMCZAC: If you’re recently learned you’re carrying twins, you may be anxious about your pregnancy especially after hearing horror stories. You may have had nightmares about being stuck in bed for months holding tiny babies or never seeing your waist line again.

I’m Joanna Adamczac, a perinatologist at the San Diego Perinatal Centre and I’m here to set the story straight about twin pregnancies. This is Twin Talks Episode Number Four.

[Theme Music/Intro]

CHRISTINE STEWART-FITZGERALD: If you’re pregnant with twins or you’re an experienced twin parent, odds are you have heard it all before. Now, it’s time to hear from the experts. This is Twin Talks, parenting times two.

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 and 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 our free Twin Talks app available on the Android and iTunes Marketplace. Right now, I’m going to turn this over to Shelly our producer and she would like to tell us a little bit about our new Virtual Panellists Program.

SHELLY STEELY: Hi, so there’s a few ways to stay connected with us in Twin Talks. You can follow us on Facebook or on Twitter. We also have our new Virtual Panellists’ Program. If you want to join in the conversation from home, you can just use hash tag #TwinTalksVP to stay apart of the discussion.

CHRISTINE STEWART-FITZGERALD: All right Shelly, well before we get started I’m going to go around the table today. We’ve got a full house and I’ll introduce our panellists and everyone in the room. Brandi

BRANDI WALLACE: Hi.

CHRISTINE STEWART-FITZGERALD: Tell us about your unique situation.

BRANDI WALLACE: Well, I am Brandi Wallace. I’m a mother of two sets of spontaneous twins. My first sets are identical boys that will be four years old next week and my second sets are boy-girl twins that are 13 almost 14 months. So, for a short time; I had four children under the age of three. I am still sitting upright just to tell everybody here.

CHRISTINE STEWART-FITZGERALD: Wow.

SHELLY STEELY: Hi I am Shelly Steely. I’m a high school history teacher and I have two children, identical twin boys Greyson and Sawyer who are 15 months old.

SUNNY GAULT: I’m Sunny Gault, an owner of New Mommy Media which produces Twin Talks as well as Preggie Pals, Parent Savers and The Boob Group. I’m a soon-to-be mom of twins. I actually have two little boys at home right now not twins. Three years old and 18 months and I’m pregnant with identical twin girls and due here in about another month.

CHRISTINE STEWART-FITZGERALD: That’s going to be awesome.

SUNNY GAULT: I’m taking notes from all of you ladies today.

CHRISTINE STEWART-FITZGERALD: I can imagine your house is going to be the boys versus the girls.

SUNNY GAULT: Yes, right. We’re two-on-two.

CHRISTINE STEWART-FITZGERALD: So, for me as your host, so I got my twin girls are now four years old. So, they’re pretty close to Brandi’s. I do have a singleton girl. She just turned one; so all girls on our household. So, before we start today’s show. Let’s take a look at one of the news headlines that we have today.

I just recently read an article that came out from the New England Journal of Medicine with they’re looking at comparing twin pregnancies: “The C section versus regular vaginal delivery.” This was done across I think 60 different countries with close to 1400 different twin moms. It’s pretty expensive.

They’re looking out to see what’s the overall outcome of twin pregnancy C Section versus vaginal. Is there a benefit to having a C Section? It came out that it was eventually essentially the same when it came to morbidity rate.

I’ll turn it over to our expert today. Do you have any comments about what types of recommendations that you might make to your patients or what does this mean for you?

JOANNA ADAMCZAC: Sure, thanks. It’s wonderful that a study like this got published in The New England Journal of Medicine; a very reputable journal for us in medical community is concerned. The fact that they show basically information that we have known that: “Vaginal delivery is absolutely safe in twin pregnancies.”

I think it should be highlighted that: “Yes, it doesn’t apply to all twins.” It really matters what the Baby A – so, the first baby isn’t a head-down position. If Baby A is in a head-down position then absolutely, vaginal delivery is always in my opinion safest from mom and safest for baby.

CHRISTINE STEWART-FITZGERALD: That’s great news. I know some moms and I know we’re going to get into this later on but often we’re under the impression that if we have twins, it’s not even an option a vaginal birth.

JOANNA ADAMCZAC: Yeah, unfortunately I get a lot of patients in the office who kind of come in with this preconceived notion that: “I have to have a C Section.” It’s good that we’re here to kind of set the story straight. I know that you really don’t.

CHRISTINE STEWART-FITZGERALD: Yes, so I’m going to go now to our panellists. Now, I know some of us have had C Sections. Knowing that there isn’t I mean with the recent news that if there’s a really no difference, would that influence your decision knowing what you know now? If you were having twins and maybe throw this out to Sunny – does that affect your decision making at all?

SUNNY GAULT: It doesn’t really affect me so much because I am going to have a C Section, it’s already been scheduled. But the reason we did that, my first baby, my first boy was a vaginal birth but we’ve had some complications from that. They basically said: “You could be damaged for a long time beyond repair really if you have more vaginal births.”

So, my second was a caesarean. It was a tough call. Obviously, I didn’t want to get more injured. So, it really wasn’t too much of a decision for me to make. It was more like: “Okay, I just need to do this.” But, I think the process for me of letting go of the vaginal birth because it was such a good experience. I didn’t know that all of those complications were happening until after. So, the actual experience of having a vaginal birth was so good for me.

The process of understanding and coming to terms with having a C Section really happened between Baby One and Baby Two. So, with the twins; if it were in the cards, if it were something that I haven’t had that with Baby One, the whole issue – I definitely would be going for a vaginal birth.

In fact last night, it’s so funny that we’re talking about this today because I was actually on YouTube; I’m just going to Google like vaginal birth. Something came up for vaginal birth with triplets and it was fascinating. I’m sure you could just Google: “Vaginal triplets on YouTube.”

Baby A came out, head-down so everything was fine with that. Baby B was breached but they were able to bring the baby out. Baby C was head-down as well. I’m just watching this happening going: “Gosh, she can do this. We could do this with twins.”

CHRISTINE STEWART-FITZGERALD: Exactly, she can push three babies out; what’s two?

SUNNY GAULT: It was amazing. It just refreshed my memory about how amazing our bodies are to produce not just one baby, two babies, and three babies whatever. It’s just unreal.

CHRISTINE STEWART-FITZGERALD: Yeah, I just think that is personally I mean such a great thing I know overall. Here in the United States, our C Section rate is somewhere in the neighbourhood of 30%. It’s been rising. So, there are a lot of efforts to just try to reduce that overall. I think it’s great within the twin community just to give that incentive. Even just the idea: “Hey, you can do it. This is a viable option and just consider that.”

I think building the support within the medical institutions in the birthing community to put it out there. So, I think that’s encouraging. Today’s topic is: “Debunking myths about twin pregnancy.” We’re talking about Joanna Adamczac, a perinatologist at the San Diego Perinatal Centre and she’s helped many pregnant twin mamas over the years.

So, I knew that we were just talking about some of the different myths including that women have to have C Section. So, I’m going to go through this list that we have here. Look at some of the things that we’ve maybe even told or maybe we read on the internet. We’ve gotten these some pieces like misinformation.

So, first thing I have is as soon as we hear that a lot of twins and triplets, they tend to hideout and they’re not actually discovered until pretty late I mean second or third trimester, is that true?

JOANNA ADAMCZAC: No, not really true especially in this day and age with the quality of ultrasound machines that we have. Maybe if you’re, let’s say five or six weeks pregnant, it may be difficult to really appreciate if there is a twin or even a triplet gestation.

But, the further along you get especially anytime after 10 weeks of pregnancy; a good old ultrasonographer or radiology centre where UNR Centre will be able to pick up twins. So, they don’t really hide.

CHRISTINE STEWART-FITZGERALD: They don’t really hide.

SHELLY STEELY: Where are they going to go?

SUNNY GAULT: Although, I really have to say though – this was about eight weeks from me, to my first prenatal appointment. They didn’t see the twins. They just saw one baby.

BRANDI WALLACE: Same here. First pregnancy

CHRISTINE STEWART-FITZGERALD: So, how far along were you when they discovered the second one?

BRANDI WALLACE: Well, I was eight weeks when I went for my initial ultrasound. We saw a heartbeat; tear shed, a lovely moment. Then, four days later – had mild spotting according to the doctor, it was nothing to be concerned with but being a first time mom, she knew that I was a little stressed about the situation.

She said: “Come on in and I’ll prove to you everything’s okay.” What she ended up proving was there was a second baby.

SUNNY GAULT: Wait was your husband with you when that happened?

BRANDI WALLACE: Okay, he was there for the first visit where we saw the one heartbeat, a happy day. Then, for the second one, he says: “Well, I’ll take off work and can go with you.” I said: “No, I’m not going to be that girl.” You don’t need to come for every little hiccup and thing along the way. No big deal, I’ll go and I’ll come back until it rings fine.

So, he was not there and I have to say: “I have to compose myself about half an hour on the park bench before I could drive way back home safely.” When I got home, I told him. He said: “He was smiling.” He says: “Very funny, nice joke.” I said: “No, I’m not kidding.” He said: “He’s face dropped.” He lost all expressions. I want to see pictures.

SHELLY STEELY: So, would it be more common for them to not find if they’re sharing a placenta, I would think because so, like mine – I went on eight weeks, the ultrasound measured me seven weeks, five days and almost exactly. But, there were two circles very clearly right next to each other. But, I know that Sunny and Brandi both have identical that share one. So, would that be

JOANNA ADAMCZAC: To be honest with you, when they share one some identical twins are easier to spot because they’re approximately with each other is much closer where di-twins is non-identical twins, they can have one placenta that attaches at the top of the uterus; one placenta that attaches on the bottom of the uterus.

So, those are actually sometimes challenging to find especially like you said at eight weeks, I can understand how that was probably missed considering you’re not really looking specifically.

SUNNY GAULT: We’re not expecting it.

BRANDI WALLACE: But those are identical.

SHELLY STEELY: Yeah, those two both have identical.

SUNNY GAULT: Where were they hiding? Where were they; behind one another apparently.

SHELLY STEELY: That’s why we recommend 20 week ultrasounds. You’re like 11 week Nuchal Translucency seal ultrasounds.

SUNNY GAULT: That’s how I found mine out.

JOANNA ADAMCZAC: Exactly, that’s usually when we find them and because also understanding that when you do your Nuchal Translucency ultrasound, you’re doing it at a centre that has very good ultrasound machines, the quality of the images and the resolution is so fantastic. Not to undermine general OB GYN offices but, the ultrasound machines are just simple.

They’re just little ultrasound machines like you see if there’s a heartbeat and that’s it. You’re not looking for the detail, for the real anatomy. So, when you come to like a perinatal centre or a radiology centre, they’re just detail.

CHRISTINE STEWART-FITZGERALD: So, hopefully they get that referral early on.

JOANNA ADAMCZAC: Exactly.

SUNNY GAULT: I try to make sure that everybody goes to their Nuchal Translucency.

JOANNA ADAMCZAC: I do, there is a woman I know she saw midwives and she only had the 20 –week ultrasound and that’s when she found her twins.

CHRISTINE STEWART-FITZGERALD: Dr. Adamczac, another common misperception that we have I know, when we’re out in public – a lot of us twin moms; we get the question. So, did you use fertility treatments, IBF? It seems like there’s this big assumption that if you have twins, you must have use fertility treatments. So, is that true?

JOANNA ADAMCZAC: Well, the weight of twinning has significantly increased. So, while twins are definitely associated with assisted reproductive technologies either IBF or ovulation induction, so on and so forth. Let’s remember that this technology is not all pretty new in 10 or 15 years maybe let’s say. But, we have to use twins before IBF as well.

So, not all twins are IBF clearly. There are definitely other factors that lead to twinning, genetics, age so on and so forth.

SUNNY GAULT: Honeymoons.

CHRISTINE STEWART-FITZGERALD: That’s all right. I think as far as identical, the identical rate has remained fairly consistent – there’s no really genetic component to that.

JOANNA ADAMCZAC: There’s not. That’s just the egg splitting and you being lucky. We should probably go in the Super Lotto together.

CHRISTINE STEWART-FITZGERALD: There you go and here’s another myth. We’ve heard that if you’re going to be pregnant with twins, you’re going to have much more intense pregnancy symptoms like:

• Morning sickness
• Swollen feet and the whole bit.

So, how true is that?

JOANNA ADAMCZAC: Yes and no. Morning sickness and swelling – I think all of that is so individualized. Everybody approaches a pregnancy very differently. Their bodies react very differently. It is kind of true with a twin pregnancy, the amount of hormones that you have. The amount of Beta ECG which is the hormone that your body first makes during the early part of the pregnancy is elevated because you got two babies and usually two placentas.

So, morning sickness can be a little bit more intense with twins. But, just with singletons, it does subside. It doesn’t necessary always have to be as bad.

CHRISTINE STEWART-FITZGERALD: Now, I’m going to throw this over to Sunny since she’s had experiencing both. Have you found it to be different as far as symptoms go between singleton pregnancies?

SUNNY GAULT: Okay, so I have to practice this spicing that today, I’m 34 weeks so I still have another four weeks to go before I deliver. Hopefully, fingers crossed. But, I have to say: “Up to this point, I actually think the pregnancy is a bit easier.”

This pregnancy has been easier than the other two which sounds crazy because everyone’s looks at me and they’re like: “I was on bed rest. I was this and I was that.” The amount of weeks you are. I’m just like: “I don’t know if it’s a mental thing.”

In my head because my perinatologist, she’s like: “By the time you hit your C Section, you’re going to be 38 weeks.” That’s pretty far. It’s like you can have that as a goal. Let’s kind of be realistic here.

I said: “In my head, that’s when they’re coming.” I have to think that way. I think it’s kind of the same thing. I already have two little boys at home. My life isn’t just going to stop because I’m producing two babies right now. It’s just not so I think a lot for me is a mental thing. I did a little bit of a scare. I don’t know.

I think I was right about the mid-point of my pregnancy. I did, I was feeling some cramping. I went in to triage and they basically said: “I was dehydrated.” They gave me some Tylenol and it went away. So, I did have a little bit of the scare there but other than that, I was drinking more water now. I’m taking more preventative measures to make sure that that doesn’t happen.

It’s just over all; my last baby I had gestational diabetes. I don’t even have gestational diabetes with this. I thought for sure, if I had with a singleton, I was going to get it with twins, not at all.

CHRISTINE STEWART-FITZGERALD: You bit the odds.

SUNNY GAULT: I’m totally fine. I totally beat the odds.

CHRISTINE STEWART-FITZGERALD: Good for you.

SUNNY GAULT: Everything’s going well now. I don’t know this is a question for Dr. Adamczac like these our girls. I don’t know if it’s the gender thing.

JOANNA ADAMCZAC: If it place into the Cholestasis; absolutely, the gender thing does. It’s much more problem if you have boys. It’s much more problem in boys – as far as girls, no.

SUNNY GAULT: Even my heart burn isn’t as bad and there are two in there.

CHRISTINE STEWART-FITZGERALD: That’s actually not fair.

SUNNY GAULT: That’s something because they’re going to come out bald. It’s a hair thing. So, they’re going to come out bald in a few months.

CHRISTINE STEWART-FITZGERALD: That’s cool. That’s awesome. In my twin pregnancy versus my singleton, I really didn’t see that much difference. I mean surprisingly my weight gain was pretty close.

SUNNY GAULT: So, was mine.

CHRISTINE STEWART-FITZGERALD: I think that the only difference because I think with my twins, I do have a little bit more edema in my ankles. But, that was pretty much it. So, I was thankful.

SUNNY GAULT: My belly is bigger but I am actually a little bit bloat the way I was with my last two pregnancies. So, it’s a really weird thing. I don’t know and I’m also not as hungry; maybe that’s a part of it too. Well, because there’s less room in there. There a sac on your stomach.

SHELLY STEELY: I didn’t gain very much. I assume I will just balloon up but I only gain maybe 40 pounds about. I had every side effect in the book though but that’s just kind of how I am. My parents are convinced that’s how I end up with identical twins because if something weird can happen, it will happen to me.

BRANDI WALLACE: But, in terms of morning sickness, I was nauseous. The heart burn was the worst though. I think and that’s because it starts earlier with twins because they have more hormones. They move up faster and so I had throwing up from reflex for months.

I don’t know I haven’t had a singleton yet. So, but I mean I didn’t I was on bed rest, it was really hard for me to move towards the end.

SUNNY GAULT: That’s kind of what I’m experiencing. It’s hard to move.

BRANDI WALLACE: Just no energy and I didn’t have toddlers to chase after so I could sit on my couch with ice cream and Greys Anatomy.

SUNNY GAULT: It’s about luxury.

CHRISTINE STEWART-FITZGERALD: Strangely no.

BRANDI WALLACE: Well, as far as my pregnancies at the first pregnancy I did get morning sickness around the sixth week mark. I only threw up maybe three times total the entire pregnancy. Mine’s was just constant nausea. It lasted about five months. The second pregnancy with the fraternal twins, the morning sickness was much more intense. I actually had to take medication for it.

Again, didn’t actually throw up; just constant nausea. Again, lasted about five months before I could go up the medication; I didn’t have a heart burn the first time. Second time, definitely did; I was even on medication for that too. Not a lot of swelling first time. I was full time working the first time but I made it a point to put my feet up under my desk as much as I could.

Second pregnancy, I was not working. I was able to put my feet up a lot more with help at home.

CHRISTINE STEWART-FITZGERALD: So, can we modify for the second one. So, we went so to Dr. Adamczac. It almost sounds like I mean looking at both the twin pregnancy and singleton pregnancy; there are a lot of different factors. I mean lifestyle, age and maybe the fact that we absolutely learned something from previous pregnancies and we modify that.

JOANNA ADAMCZAC: Great and I think with your first pregnancy, you’re probably more hyper about everything and kind of like Sunny said with her second, with her pregnancy now. She’s kind of like: “She’s used to it. She’s been through it. She’s expecting the nausea and the swelling and this, that and the others.”

I think it just all goes back to each pregnancy is so unique. You can never compare one to the other.

CHRISTINE STEWART-FITZGERALD: Yes. Okay, when we come back, we’re going to debunk more unsettling myths about twin pregnancy including a look on bed rest.

[Theme Music]

CHRISTINE STEWART-FITZGERALD: Welcome back. Today, we’re with Dr. Joanna Adamczac tackling myths you may heard about twin pregnancies.

Our discussion continues as we discuss whether twin moms should be expect to be on bed rest. So, I think that was something when I first found out I was having twins: “I’m going to be on bed rest.” So, tell me how often does that happen? Should new expectant moms expect that?

JOANNA ADAMCZAC: No, I don’t think you should go into a twin pregnancy expecting to be on bed rest. Sometimes you may have to be but recommendations for bed rest are very controversial in the medical community. They’re going to be some adapters that strongly advocate for bed rest.

Others kind of say: “Listen, you could be on kind of what’s called modified bed rest. So, kind of decreasing your activities but you don’t actually have to be “in bed” for however many months or weeks.”

Twins are at a higher risk of preterm delivery because the cervix shortens faster. Nobody really knows why but we just know that twins at higher risk. So, some people think that bed rest actually prevents a preterm delivery and again, that’s very controversial.

SUNNY GAULT: I did hear something though; so if the twins are sharing a placenta and they’re in the same sac; so is that a mano-a-mano? It’s a mano-a-mano. Okay, so if that’s the case though then

CHRISTINE STEWART-FITZGERALD: That’s off.

SUNNY GAULT: Okay, that’s what I thought.

JOANNA ADAMCZAC: I don’t even think we should even talk about mano-a-mano twins because they’re so rare.

SUNNY GAULT: Okay.

JOANNA ADAMCZAC: Yes, when a woman is pregnant with mano-a-mano twins are very, very high risk and absolutely those twins, we usually like to admit to the hospital at around 28 weeks of pregnancy on average. It could be a little bit more, a little bit less depending on how you bargain with your perinatologist.

But, yes those twins unfortunately do have to be on bed rest. It’s not really bed rest, it’s just intense monitoring.

BRANDI WALLACE: Out of all the patients you see, how many of them end up in bed rest?

JOANNA ADAMCZAC: With twins, maybe 30%

BRANDI WALLACE: Okay.

SUNNY GAULT: Is that bed rest at home or bed rest in the hospital?

JOANNA ADAMCZAC: It depends again on the OB. I prefer personally, bed rest at home kind of been what I usually always recommend to my patients and again, I’m not speaking for all my partners – just for me personally is kind of modified bed rest.

If I feel that a patient is compliant, they’re going to be listening to kind of the signs and symptoms of preterm labour or preterm labour precautions then I think it’s reasonable to maybe be evaluated in the hospital for a few days to see if there’s any evidence of preterm labour. If there’s not, I feel that it’s safe to be able to go home.

BRANDI WALLACE: That’s great.

SHELLY STEELY: Say, I wouldn’t want to stay on the hospital because I’d feel like: “If I go home, I’ve got two toddlers.”

JOANNA ADAMCZAC: That goes into the bartering with your perinatologist. Those are questions that we ask to patients.

BRANDI WALLACE: I would be fine at home.

JOANNA ADAMCZAC: Hey listen, if you go home; are you going to be on bed rest? Are you going to be chasing around kids and cooking and doing this and the other. I think moms are very honest with us, I hope. We do get a lot of moms say: “Listen, it’s impossible for me to be on bed rest at home.” If that’s the case then yes, it will be on bed rest at the hospital.

CHRISTINE STEWART-FITZGERALD: Okay, so let’s see. Let’s move to the next one: “Having twins means you can’t have a vaginal birth.” So, now we did.

SHELLY STEELY: We squashed that one.

CHRISTINE STEWART-FITZGERALD: All right. I liked that. Another myth we’ve heard is that: Twins never go full term to 40 weeks.”

JOANNA ADAMCZAC: That one I probably will agree with a little bit about full term. Full term for a singleton is considered 40 weeks. For twins, it really depends on what type of twins you have – identical twins or fraternal twins. Since you have fraternal twins essentially it’s a brother and a sister or a sister and a sister just kind of sharing a home; sharing a uterus for a few months.

Those types of twins when the pregnancy’s progressing well – both babies are growing appropriately and there are no other risk factors. Diabetes, high blood pressure, studies have shown that delivery between 38 by 38 weeks maybe a little bit a 38 to 39 weeks is really the safest.

That’s one kind of the morbidity and mortality rate equals that of the singleton at 40 weeks. Then, when you’re going to mono/di twins so identical twins – those twins share a placenta. So, towards the end of the pregnancy when you’re sharing a placenta, a lot of the blood supply, a lot of the vascular supply will diminish a lot.

So, when mono/di twins now, what we recommend is delivery between 36 and 37 weeks with very close monitoring twice weekly what’s called [inaudible 00:26:19:20] monitoring non-stress test because again, the risks are much different than for identical twins.

SUNNY GAULT: I start those non-stressed tests on Monday.

JOANNA ADAMCZAC: I’m sorry.

SUNNY GAULT: Well, I have to have it with my singleton my last singleton because I had gestational diabetes. So, I’ve been there and done that.

JOANNA ADAMCZAC: So, you’re used to it now.

SUNNY GAULT: Yes.

BRANDI WALLACE: I quite enjoyed it.

SUNNY GAULT: It is kind of nice.

BRANDI WALLACE: There was a lovely recliner and a dim lit room.

SUNNY GAULT: Yes, it’s true.

CHRISTINE STEWART-FITZGERALD: So, twins almost always end up in the NICU, what would you say to that?

JOANNA ADAMCZAC: Well, if you’re pregnant with twins and you happen to get Cholestasis then, yes they may end up in the NICU. But, look at Brandi here, I’m assuming

BRANDI WALLACE: They actually weren’t. They went straight home with me.

JOANNA ADAMCZAC: Excellent.

CHRISTINE STEWART-FITZGERALD: Awesome.

JOANNA ADAMCZAC: I’m assuming Brandi here is we’re not in the NICU because she made it to a great gestational age, full term. So, it really is – if you make it to full term and babies are growing well throughout the pregnancy then they don’t need to go to the NICU. But if they’re premature then, yes. That’s why we have the NICU there.

We have our NICU colleagues that are always part of twin deliveries. They will assess the kidos and see what’s going on and see if they need a little bit more extra TLC.

SHELLY STEELY: So, it really has more to do with the prematurity than the twins.

JOANNA ADAMCZAC: Absolutely. I’m not positive about this but I think that at our hospital, less than 36 weeks always goes to the NICU for observation; and maybe it’s 35 weeks but I think they do like little closer observation at least for the first 24 hours to see kind of what the transition is.

CHRISTINE STEWART-FITZGERALD: I think a lot of twin parents; they have these visions of these tiny little babies like you can barely hold it. So, I think it sounded like: “Hey, especially for all of us who’ve had within these 37, 38, and 39 weeks. These are full term babies.

JOANNA ADAMCZAC: If they have a good weight, then there’s no need to go to the NICU. The regular postpartum nurses can really help you out and asses the babies perfectly well. It’s not to say full term babies don’t go to the NICU but that’s why the nurses are there to kind of asses and monitor the kidos. See if they needed specialized care.

CHRISTINE STEWART-FITZGERALD: How awesome.

SUNNY GAULT: I’ve been having this 35 week number like in my head for a while. I mentioned earlier: “I’m now 34 weeks.” I asked my perinatologist this question: “What really makes the difference between going to the NICU or not?”

I heard a long time ago, they used to be like: “Okay, babies have to be four pounds at least four pounds so they’re going to the NICU.” They were different ways to diagnose this. She said: “It was the 35 week mark.”

Every baby is different because babies could have complications even like you said. Full term babies could have complications. But, she said: “She notices a big drop-off from a mother coming in at 34 weeks and then coming in at 35 weeks for some reason between.”

It’s something about the lungs or some sort of maturity going on. So, I’m on the 34 week mark and I’m like: “At least, one more week.” We can do this and then hopefully the NICU’s out of sight.

CHRISTINE STEWART-FITZGERALD: Okay, 35 weeks keep them in there.

SUNNY GAULT: Yes, I know.

CHRISTINE STEWART-FITZGERALD: Thanks so much Joanna for joining us today and for more information about Debunking myths about twin pregnancy or for more information about any of our expert or panellists, visit the episode page on our website.

This conversation continues for members of our Twin Talks Club. After the show, Dr. Adamczac will talk about: “How we can handle those crazy myths we hear.” For more information about the Twin Talks Club, visit our website TwinTalks.com.

Here’s a question for one of our experts, it comes from Jamie of Pennsylvania. Jamie writes:

“The hospital I’m delivering at offers a multiple’s class. Is this the best type of preparation for having twin babies? Would you recommend taking a twin class like this or is there another way to better prepare?”

-Jamie

JONAROSE FEINBERG: Hi Jamie, this is JonaRose Feinberg. I’m an IBCLC, mom of twins and editor of BreastfeedingTwins.org. I definitely recommend taking a multiple class at the hospital if it’s available. These classes are generally a good source of basic information about the multiples pregnancy and what to expect after your babies arrived.

Many classes provide experience to parents of multiples pack to class to answer question for the expected parents. Class content can vary widely. Some of these classes are more focused on pregnancy related topics such as diet and preventing pre-term labour. Some provide an overview of hospital policies and practices around the multiples delivery at fast facility. Some educate parents of postpartum issues such as breastfeeding a new born care.

Depending on the contents of your class, you may want to supplement with other classes on specific topics such as:

• New born care
• Breastfeeding or
• Hospital tour.

You can also reach out to an IBCLC in your area for a private customized prenatal breastfeeding preparation, if that’s not part of the class. Twins Clubs and online groups are another great resource. You can join your local twins club or reach out to other moms of multiples online.

Local groups often have expectant on new mom’s meeting if you can attend now to get advice from mom’s who have recently been to the adventure of twin pregnancy; making usually offer local resources and referrals. Different groups have different personalities. So, be on the lookout for a good fit for your needs.

You can also supplement the class offerings with some of the many books about twins that are available. I often suggest Mothering Multiples by Karen Gromada as a great overview with both pregnancy and postpartum information. This is also the best book in the market for information about breastfeeding multiples.

Your local twins club, they have a lending library or a club sale where you can pick up some other books about twin pregnancy and parenting. Everyone has their own say with a few books and see what’s seems most helpful.

Again, congratulations on your pregnancy. Take it easy, keep them cooking and enjoy this new adventure. Come visit me online at BreastfeedingTwins.org for more information and tips.

CHRISTINE STEWART-FITZGERALD: So, that wraps up our show for today. We appreciate you listening to Twin Talks. Join in on the discussion by posting your comments on the Twin Talks Facebook page or you can call 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
• Parent Savers an online support group for the new parents.

Next week, we’re going to learn: “What to expect in the NICU.” 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.

ROBIN KAPLAN: New Mommy Media is expanding our line-up of shows for new and expecting parents. If you have an idea for a new series or if you’re a business or an organization interested in our network of our shows through a cobranded podcasts, visit NewMommyMedia.com.

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