than you might like, as doctors will want to monitor the babies carefully, and you have a statistically higher chance of intervention. However, it’s worth remembering that you are not ill, or stupid and that your preferences still count. You can negotiate about any proposed intervention and talk, in full, to your obstetrician about any issue that worries you. Finally, having a caesarean section is a real possibility (about half of all twin births are vaginal), so make sure you read Chapter 6: Surgical Birth.
The main advice for a twin or multiple pregnancy isn’t terribly technical – it’s SLOW DOWN. This pregnancy is going to put more strain on your body than a singleton pregnancy would. You will also gain more weight, and get significantly bigger, though twins are generally born earlier – on average around 37 weeks.
Where to go for help:
TAMBA (Twins and Multiple Births Association): 2 The Willows, Gardner Road Guildford, Surrey GU1 4PG. 0870 770 3305; information and listening service call Freephone 0800 138 0509, evenings and weekends. www.tamba.org.uk
Multiple Birth Foundation 020 83833519 www.multiplebirths.org.uk
Further reading:
Twins and Multiple Births: The Essential Parenting Guide from Pregnancy to Adulthood by Carol Cooper (Vermilion, UK, 2004)
The Twins Handbook by Elizabeth Friedrich and Cherry Rowland (Robson Books, UK, 1998)
Twins, Triplets and More by Elizabeth M Bryan (Penguin, UK, 1992)
Multiple pregnancy tip:
Peggy Fitzgerald, a doula and mother of one-year-old triplets says, ‘Expect to get big fast: buy maternity clothes early but not too many, because you will outgrow them and need to find bigger ones. (Even at 25 weeks, I outgrew most of the biggest maternity clothes I had – luckily I didn’t have many – but still needed SOMETHING for doctor’s visits….) Under the belly pants are more useful than ones that cover the belly – they just aren’t made the shape you’ll need. Also, make sure, early in pregnancy, that you stock up your freezer with meals: not just for the times when you can’t cook (or the possibility that you’ll be on bed-rest), but for your postpartum too.’
A few other worries
Here are a few common worries and what to do with them. The list is potentially endless, so here’s the rule: ask your health professional if something is worrying you, no matter how silly and embarrassing it sounds. They’ll have heard it before and even if they haven’t, they won’t be shocked: they’re here to help you.
WHAT YOU DRANK BEFORE YOU KNEW YOU WERE PREGNANT | Many of us drink too much alcohol in the early weeks of pregnancy before realizing there’s a zygote in there. That Hen night you went on when two weeks pregnant, however, is not something to worry about. The real worry is if you can’t stop now you know you’re pregnant (see drinking advice below). Drinking too much alcohol throughout pregnancy can lead to fetal alcohol syndrome (where your baby is damaged because you are drinking 40–50 units of alcohol every week, or binge drinking). Get reassurance from your midwife and doctor about your early pregnancy behaviour, then move on to no more than two units (i.e. a couple of small glasses of wine) a week. This is the current UK government recommendation.
AIR TRAVEL | There is no evidence that holiday or business air travel will do you any harm whatsoever when pregnant. However, if you have pregnancy complications do consult your doctor before flying. The best time to travel is probably in your second trimester – in the middle three months. You will be less sick, more mobile, energetic and not yet the size of Free Willy. Take a large bottle of water, a bag of healthy snacks and move around a lot to avoid any chance of deep vein thrombosis (potentially fatal blood clots). Most airlines have a policy about pregnancy and air travel; most say you should not travel after a certain point in your pregnancy, usually 28–36 weeks. It may be hard to find this on a website, so try phoning the airline. Many will take your word as to how many weeks pregnant you are, though some may require a letter from your doctor. If you’re considering stretching the truth, however, remember airline staff are generally not trained medical professionals. Giving birth 8,000 feet above the Atlantic would be less than ideal.
Where to go for help:
About.com has a list of airlines and their rules about pregnancy and flying: www.airtravel.about.com
The Royal College of Obstetrics and Gynaecology also have guidelines for air travel safety on their website: www.rcog.org.uk
Air travel tip:
Obstetrician Lucy Chappell says, ‘As a general rule, simply think about the health care system of the country you are going to and whether you would like to be in it, should any complications arise. Avoid islands – where you can’t easily get to a hospital – and developing countries where possible.’
VACCINATIONS | This is a legitimate worry. Some ‘live’ vaccines, like those against chickenpox are unwise to have when pregnant; others such as Hepatitis B, Hepatitis A, and tetanus are OK for pregnant women who are at risk of getting these diseases. Talk to your doctor about vaccinations if you’ve had them before you knew you were pregnant, or if you are thinking of having them before travelling.
AIR POLLUTION | Thousands of healthy babies are born each year in inner London, one of Europe’s most polluted areas. Books will warn you about lead in traffic fumes, but really, if you live in an urban area, there’s not much you can do about this short of ceasing to breathe or wearing a Michael Jackson mask. City life is not going to harm your unborn baby. If it did, half the babies in Hammersmith would have birth defects.
PESTICIDES IN FOOD | You will probably hear, at some point, that you should eat only organic food when pregnant or you will poison your unborn child with pesticides. Some women have the money to do this. Most of us, however, don’t. The vast majority of us eat normal supermarket food when up the duff and our babies emerge just fine. According to the UK Government’s 2002 Committee on Toxicity, pregnant or breastfeeding women are unlikely to be any more vulnerable to the ‘cocktail’ effect of low-level pesticides in food than anyone else. You should, however, wash fruit and vegetables thoroughly. If you peel fruit, by the way, you will reduce the vitamin and fibre content.
BENDING AND LIFTING | Your midwife or health visitor will be able to give you tips on how to avoid back strain, what you should and should not lift, and how to cope when you have to carry bigger children or toddlers. It’s handy to pretend that you can’t lift anything at all, so that your partner has to do all the supermarket shopping etc., but it is fine for a pregnant woman to lift moderate weights (i.e. a shopping bag or two) from the car to the house. The main problem is back strain, so bend from the knee rather than your back when lifting. Having said that, most mothers of more than one child have, at some point, been forced to wrestle a howling, kicking, 30lb toddler out of the toyshop/supermarket/playground while heavily pregnant with no bad consequences (other than to our mental health). The basic rule is: if it’s heavy, try to avoid lifting it, and if you have to lift it, try to lift it with a good posture and try not to lift it above waist level. A physiotherapist-run class at your hospital will give you tips for bending and lifting. You can also divide your shopping into smaller, lighter bags: more trips, in general, are better than heavier bags.
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