Although multiple pregnancies and births are more likely to have complications, they are now safer than ever as advances in prenatal and postpartum care have dramatically improved the outlook for premature babies-the main concern with multiples.
You can prepare for the birth by getting plenty of rest. Putting your feet up, or even having a nap during the day, helps improve the blood flow to the placenta, which in turn helps your babies grow. Practicing Kegel exercises (see Start squeezing!) is important with a multiple pregnancy since your pelvic floor muscles are under additional strain.
Twins or more usually arrive earlier than singletons. Space in the uterus is one factor. In addition, with multiple pregnancies the placenta becomes less efficient toward the end of pregnancy. As a result, the average length of pregnancy is shorter: for twins 36 to 37 weeks is considered typical, for triplets the average pregnancy is 33 weeks, and for quadruplets pregnancy lasts about 30 weeks. The average birth weight for each twin is 5 lb 8 oz (2.5 kg) at full term.
You may deliver even earlier than this, since nearly 50 percent of twins are born prematurely. However, nowadays expert care for premature babies means that about 75 percent of babies weighing 3 lb 5 oz at birth, and 57 percent of babies weighing 2 lb 3 oz at birth, survive.
Even if your twins are identical they're individuals, and relating to them as separate people will help their development and your relationship with them. Even in pregnancy, some expectant moms notice how different their babies are from their different movement patterns in the uterus.
Often, expectant moms of twins or more worry about how they will bond with more than one baby. It's true that bonding can be harder with twins, and even more so with higher multiples. After all, it's hard to fall in love with more than one person at a time, especially when you're exhausted caring for two babies or more. Being aware of this and arranging extra help for after the birth may ease your anxiety. Also, accept additional offers of help that allow you to rest or spend time with one twin. If someone offers to take the twins out, you might consider one twin going and the other spending time with you.
In the final weeks, your babies will take up their positions for the birth. The most common position is with both babies lying vertically. With 75 percent of twins, the first is head down (cephalic); the second twin may be head down or breech, or one twin may lie across the uterus (transverse). You may suspect their position from the kicks, but only a scan confirms this.
A cesarean will be recommended if you have triplets or more, or your first twin is breech or transverse (25 percent of cases). A vaginal delivery is most likely if both twins are head down. If the first is head down and the second is transverse or breech, there are different opinions as to the best type of delivery, which you can discuss with your obstetrician.
Excerpted from Pregnancy Day by Day.
Copyright ©2009 Dorling Kindersley Limited.
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