Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

On this episode of the Double Happiness Multiplied podcast, we talk with Consultant Neonatologist Doctor Patricia Woods from King Edward Memorial Hospital in Western Australia about what to expect when you have babies in the Neonatal Intensive Care Unit (NICU).

Mum of quadruplets Jannelle Snaddon walks us through her NICU journey.

Psychologist Doctor Monique Robinson offers practical advice about taking care of your emotional wellbeing when you have babies in NICU.

I’ll share my NICU story with you and I’ll read a moving letter from a micro-premmie mum written to other parents of premature babies.

What does pre-term mean?

A Preterm or Premmie baby is defined as being born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, however, based on gestational age:

• Extremely preterm, or micro premmies, are born at less than 28-weeks’ gestation,

• Very preterm are those babies born between 28 and 32-weeks’ gestation,

• And, moderate to late preterm, which are babies born after 32 weeks and before 37-weeks’ gestation.

Why does preterm birth happen?

There are many reasons preterm births occur, the most common causes include multiple pregnancies, infections, and chronic conditions such as diabetes and high blood pressure. However, oftentimes no cause is identified but may be due to genetic influences.

Pre-term birth facts

• Worldwide, an estimated 15 million babies are born too early every year. That’s more than one in every 10 babies. Sadly, of these babies, approximately 1 million will die each year due to complications of their preterm birth.

• Prematurity is the leading cause of death in children under the age of 5 years, globally.

• In almost...]]>

   

  Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

  https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

   

   

   

  On this episode of the Double Happiness Multiplied podcast, we talk with Consultant Neonatologist Doctor Patricia Woods from King Edward Memorial Hospital in Western Australia about what to expect when you have babies in the Neonatal Intensive Care Unit (NICU).

  Mum of quadruplets Jannelle Snaddon walks us through her NICU journey.

  Psychologist Doctor Monique Robinson offers practical advice about taking care of your emotional wellbeing when you have babies in NICU.

  I’ll share my NICU story with you and I’ll read a moving letter from a micro-premmie mum written to other parents of premature babies.

  What does pre-term mean?

  A Preterm or Premmie baby is defined as being born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, however, based on gestational age:

  • Extremely preterm, or micro premmies, are born at less than 28-weeks’ gestation,

  • Very preterm are those babies born between 28 and 32-weeks’ gestation,

  • And, moderate to late preterm, which are babies born after 32 weeks and before 37-weeks’ gestation.

  
  

  Why does preterm birth happen?

  There are many reasons preterm births occur, the most common causes include multiple pregnancies, infections, and chronic conditions such as diabetes and high blood pressure. However, oftentimes no cause is identified but may be due to genetic influences.

  Pre-term birth facts

  • Worldwide, an estimated 15 million babies are born too early every year. That’s more than one in every 10 babies. Sadly, of these babies, approximately 1 million will die each year due to complications of their preterm birth.

  • Prematurity is the leading cause of death in children under the age of 5 years, globally.

  • In almost all countries with reliable data, preterm birth rates are increasing, with stark inequalities in survival rates around the world.

  • In low-income settings, half of all babies born at or below 32 weeks die due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties.

  • In contrast, babies born at or below 32-weeks in high-income countries will almost always survive.

  
  

  Where and when does preterm birth happen?

  Preterm birth is a global problem despite more than 60 per cent of preterm births occurring in Africa and South Asia. In lower-income countries, on average, 12 per cent of babies are born too early compared with 9 per cent in higher-income countries.

  There is also a dramatic difference in survival rates of premature babies depending on where they’re born. For example, more than 90 per cent of extremely preterm babies born in low-income countries die within the first few days of life; yet less than 10 per cent of extremely preterm babies die in high-income settings.

  These statistics are interesting and for some will offer reassurance and a glimmer of hope during this time of immense emotional turmoil, however, as Consultant Neonatologist Doctor Patricia Woods explains, it can be quite confronting.

  The Neonatal Intensive Care Unit (NICU)

  “I think the Neonatal Intensive Care Unit is a terrifying place for families. It’s extremely confronting to walk into, it’s very alien, parents have rarely experienced anything like this before, and we really recognise that struggle that some families might be coping with,”

  “Having babies born preterm can be an absolute crisis for many families, something they hadn’t expected or anticipated and sometimes we are meeting them on what could possibly be the worst day of their lives,” says Dr Woods.

  Having babies born preterm can be an absolute crisis for many families, something they hadn’t expected or anticipated and sometimes we are meeting them on what could possibly be the worst day of their lives.” ~Consultant Neonatologist Doctor Patricia Woods~

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  Dr Woods explains that in an intensive care environment babies are cared for in their own unique spot, where they have their own incubator and all the support they could possibly need in terms of breathing help, monitoring, infusion pumps, their own neonatal intensive care nurse, and little computers.

  “Even that on its own can be daunting when you’re looking at the equipment and incubators and the sound of alarms. It’s the sensory overload that some families might find frightening,”

  "You’ll hear a lot of terms that can be quite confusing, however, it’s important to understand that prematurity is a spectrum and babies born along that timeline have very different needs and vulnerabilities," Dr Woods explains.

  Be Prepared

  Dr Woods says it is essential for a woman carrying multiples to understand the risk of prematurity.

  “Just equipping yourself with the knowledge and the reality that your babies may well require intensive care, and this journey may well not be as smooth or straightforward as you might imagine,”

  “Doctors cannot always predict purely on gestation where your baby might need intensive care most,”

  “The default is really coming to the intensive care area so your baby can be assessed properly and be provided whatever support they need in those first few hours and take it from there,” Dr Woods says.

  NICU - The first few hours

  According to Dr Woods, a baby born, for example, at 28-weeks’ gestation will almost certainly need assistance in breathing, so CPAP is very common.

  CPAP is Continuous Positive Airway Pressure that delivers constant air pressure into the nose, which helps the air sacs in your babies’ lungs stay open and helps prevent apneas.

  “The skin system is also incredibly important and moisturisers such as coconut oil are wonderful for helping skin integrity and preventing infection,” says Dr Woods.

  Nutrition

  Dr Woods says from there the focus turns to nutrition.

  “Like everything, your baby’s systems are developing and maturing and breast milk is introduced slowly, as it takes a little bit of time for the baby’s gut to wake up and learn to absorb it and tolerate it properly,

  “In the meantime, we provide a thing called TPN, which is a balanced nutritional program that has the appropriate amount of protein and sugar for energy, and also some vitamins,” explains Dr Woods.

  Research also supports giving caffeine regularly to premature babies to support the respiratory drive for breathing. It’s used to regulate the breathing centres in the brain, so a baby is less likely to take long or dramatic pauses in their breath.

  Your New Normal

  Ask anyone, and they’ll tell you the Neonatal Intensive Care Unit is a confronting place. It can be stifling with an array of new sounds and smells, and you might even find yourself in a state of utter confusion.

  “Parents are often surprised when they come into the intensive care unit and their babies are at the opposite end of the room or in different pods and ask why aren’t they together?”

  “Particularly for a reducing of errors and not giving a baby the wrong medicine, a little bit of distance can help,” says Doctor Woods.

  Dr Woods also explains that individual care is really important. The focus of care on what the baby needs from NICU is an individual baby-led approach. Each baby is on a different trajectory and they will find their own groove, and curve. It may also be that one baby develops and grows at a different pace, so it can happen where you won’t be taking all two, three, or four babies home on the same day.

  Part of a daily NICU routine might include the following care or intervention:

  • Testing of blood at different times for various reasons.
  • X-rays
    
  • Ultrasound
    Preterm infants born less than 32 weeks will have cranial ultrasounds at the bedside as part of their standard care. The ultrasound is completed usually within the first 24-hours of being born, about a week later, and then a month after that.
  • Invasive procedures
    These include things such as a heel prick blood test. The NICU has pain score charts, which validate how to tell if a baby might be in pain or experiencing discomfort. Simple comfort measures such as swaddling, cuddling, breastfeeding, using oral sucrose with a dummy or a finger have been shown to act on pain receptors in the brain and are used to make the procedures less invasive.
  • Heart rate and breathing monitoring
    A pulse oximetry monitor, which is like a little sticky band, is placed around the baby’s right wrist or on the foot. This picks up the heartbeat and provides a real indication of the oxygen profusion to the tissues. Those are called ‘sats’ or ‘sats monitors’ and are measured continuously.
  • Temperature monitoring
    A little sticker and temperature probe that feeds directly back to the incubator so everything is completely smooth and titrated to what the baby needs.

  
  

  Skin-to-skin contact

  In the NICU, it can be daunting to see your babies with all the stickers wires, and tubes attached. However, it’s all part of intensive care.

  As Doctor Woods explains even with all the medical equipment and procedures, one of the most important things that offers incredible benefits to your babies is ‘kangaroo care’, or skin-to-skin contact.  This is where the baby or babies are placed onto the mum or the dad’s bare chest. This has shown to improve the baby’s breathing and they tend to get to go home sooner.

  “We observe trends in babies relaxing when they’re in that space,”

  “Their heart rates come down, blood pressure can come down, and it is a really unique physiological experience,” says Doctor Woods.

  Taking your babies home

  When it comes to making plans for taking your babies home, a baby-led approach is taken. A rough guide is to expect this to happen around their due date. However, Dr Woods explains there are several criteria they’ll need to meet before they’re ready to leave the security of the NICU.

  1. The babies need to be feeding well.
     Feeding can be exhausting for premature babies and it can take up to three weeks for a baby to build up their energy and endurance to be able to have a few feeds in a row. They will use a lot of energy learning to latch, breathe, swallow, and do everything on time. It’s a real maturity part of the brain that leads to that. As a guide, the baby needs to;

  
  

  • be sucking all breast or bottle feeds well for at least 48 hours;
  • having periods of sleep where they’re waking for feeds, and
  • be finishing most of their feed.

  
  

  2. The babies need to be able to maintain their normal body temperature.
     They need to be able to do this in normal baby clothes, in a normal cot.
  3. The babies need to be gaining weight.
     This is the real proof in the pudding. It needs to be obvious that they’re using the energy from the milk for growing, not just keeping warm or burning up all their energy because they are getting tired with their feeding.

  
  

  Preparing to take your babies home

  When your babies are in the NICU, you’ll often have times during the night when you’re worried about a certain aspect of your babies’ care and development. Dr Woods says it’s perfectly normal to pick up the phone at 3 am to check in on your babies. However, when it’s time to leave the safety and support of the NICU a whole new set of anxiety can hit.

  “It’s important to talk to people about your concerns or any anxiety that you may have,”

  “Don’t bottle things up, reach out and share your concerns and feelings, and know that this is all a normal part of the process,”

  “It might be a crisis today, or the worst feeling in the world, or even the worst day of your life but know that there are people in the NICU who can help you through this,” says Dr Woods.

  It might be a crisis today, or the worst feeling in the world, or even the worst day of your life but know that there are people in the NICU who can help you through this.” ~Consultant Neonatologist Dr Patricia Woods.

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  Janelle’s Story

  You’ll remember Janelle Snaddon's story from previous episodes, of turning to IVF in an attempt to conceive a baby, and she ended up with quadruplets. Of course, carrying four babies at the one time means they were certain to be born preterm. So, when they arrived at 30-weeks’ gestation Jannelle admits that no preparation could have equipped her for the emotions of seeing her babies in the NICU for the first time.

  “So emotional, it’s hard to even describe those feelings,”

  “So emotional. It’s hard to even describe those feelings. I just remember thinking that’s all I wanted to do, that whole time after having the babies a day later not knowing how they were and just having these four photos of them.”

  ~Jannelle Snaddon – Quadruplet mum~

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  “I just remember thinking that’s all I wanted to do, that whole time after having the babies, and a day later not knowing how they were and just having these four photos of them,”

  “I just wanted to see them and know how they were doing,” Jannelle says.

  Jannelle wasn’t well enough after the birth to see her babies and had to wait until the following day.

  “And, of course, having four, they were all spread out over the nursery, it’s not like they’re one, two, three, four,”

  “It’s complete and utterly uncontrolled,”

  “The one time I couldn’t control anything that was going on in there,” she says.

  Jannelle admits the hardest part of her NICU journey was just sitting beside her babies’ cribs, not being able to do anything to help them, and just hope that everything went well.

  Sally’s NICU story

  If you’ve been listening to this season of Double Happiness Multiplied you’ll remember that my identical girls were born at 28-weeks’ gestation. They spent 64 days in NICU. Those weeks and months were among the most joyous and heartbreaking of my life. Of course, I was extremely happy they were alive but they were so small and with every step forward there seemed to be five steps back.

  With each day, there would be another challenge, from chronic lung disease, constant infections requiring antibiotics, spinal taps, blood transfusions, heart complications, and hernias. Our NICU journey was completely and utterly overwhelming.

  I felt like a mere...]]>https://www.doublehappinessmultiplied.com/?p=1491Mon, 22 Jan 2018 11:36:01 -050024:05nofull18<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="../wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="../twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> &nbsp;<br /> &nbsp;<br /> &nbsp;<br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2018/05/Feet-NICU.jpg"></a>On this episode of the Double Happiness Multiplied podcast, we talk with Consultant Neonatologist Doctor Patricia Woods from King Edward Memorial Hospital in Western Australia about what to expect when you have babies in the Neonatal Intensive Care Unit (NICU).<br /> Mum of quadruplets Jannelle Snaddon walks us through her NICU journey.<br /> Psychologist Doctor Monique Robinson offers practical advice about taking care of your emotional wellbeing when you have babies in NICU.<br /> I’ll share my NICU story with you and I’ll read a moving letter from a micro-premmie mum written to other parents of premature babies.<br /> What does pre-term mean?<br /> A Preterm or Premmie baby is defined as being born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, however, based on gestational age:<br /> <br /> * <br /> Extremely preterm, or micro premmies, are born at less than 28-weeks’ gestation,<br /> <br /> * <br /> Very preterm are those babies born between 28 and 32-weeks’ gestation,<br /> <br /> * <br /> And, moderate to late preterm, which are babies born after 32 weeks and before 37-weeks’ gestation.<br /> <br /> <br /> Why does preterm birth happen?<br /> There are many reasons preterm births occur, the most common causes include multiple pregnancies, infections, and chronic conditions such as diabetes and high blood pressure. However, oftentimes no cause is identified but may be due to genetic influences.<br /> Pre-term birth facts<br /> <br /> * <br /> Worldwide, an estimated 15 million babies are born too early every year. That’s more than one in every 10 babies. Sadly, of these babies, approximately 1 million will die each year due to complications of their preterm birth.<br /> <br /> * <br /> Prematurity is the leading cause of death in children under the age of 5 years, globally.<br /> <br /> * <br /> In almost all countries with reliable data, preterm birth rates are increasing, with stark inequalities in survival rates around the world.<br /> <br /> * <br /> In low-income settings, half of all babies born at or below 32 weeks die due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties.<br /> <br /> * <br /> In contrast, babies born at or below 32-weeks in high-income countries will almost always survive.<br /> <br /> <br /> Where and when does preterm birth happen?<br /> Preterm birth is a global problem despite more than 60 per cent of preterm births occurring in Africa and South Asia. In lower-income countries, on average, 12 per cent of babies are born too early compared with 9 per cent in higher-income countries.<br /> There is also a dramatic difference in survival rates of premature babies depending on where they’re born. For example, more than 90 per cent of extremely preterm babies born in low-income countries die within the first few days of life; yet less than 10 per cent of extremely preterm babies die in high-income settings.<br /> These statistics are interesting and for some will offer reassurance and a glimmer of hope during this time of immense emotional turmoil, however, as Consultant Neonatologist Doctor Patricia Woods explains, it can be quite confronting.<br /> The Neonatal Intensive Care Unit (NICU)<br /> “I think the Neonatal Intensive Care Unit is a terrifying place for families.Sally Barker - HypnotherapistHow To Prepare for the Birth of Your Twins, Triplets, or Quads

   

  Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

  https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

   

  On episode seven of the Double Happiness Multiplied podcast, we explore birthing options for multiples.

  We talk to Maternal Fetal Medicine Specialist Professor Craig Pennell about the types of twins that will require a caesarean delivery and those that can be safely delivered vaginally.

  Founder of Rockstar Birth Magazine and Rockstar Birth Radio, Shalome Stone explains why a birthing plan is important.

  Hypnobirthing Practitioner and Birthing Doula Elysee Jamieson shares her experience of birthing breech fraternal twins.

  And, I’ll tell you why my girls were delivered by Caesarean section.

  By the end of this episode, you’ll be armed with all the information you’ll need to make educated decisions about the birth of your babies.

  Talking About Birth

  Birth. The topic can get as heated as bringing up politics, religion, or vaccinations at a dinner party. There are many people who have incredibly strong opinions on the matter, oftentimes formed on the basis of misguided information.

  You’ve probably heard people say things along the lines of, ‘women have been giving birth to babies in the open fields for centuries and they always did fine’, well they often didn’t and the mortality rate was exceptionally high.

  However, pregnancy and birth have become incredibly medicalised and it’s often difficult to find a middle ground as such.

  So, whether you’re someone who holds dear to your plans of a drug-free vaginal delivery or you surrender yourself to an attitude of going-with-flow, it’s important to be educated on the possibility that your ideal birth plans might need to be altered.

  Let’s face it, many multiples wouldn’t cope with the journey down the birth canal and without medical intervention those precious babies wouldn’t survive.

  On the other hand, if you have an uncomplicated multiple pregnancy, and under the guidance of a team with experience in multiple births, Professor Craig Pennell assures us that in most cases you can achieve a vaginal delivery.

  As Professor Pennell explains there are many things that need to be considered in planning the most appropriate form of delivery for a twin pregnancy.

  • Type of twins;

    • ...]]>

       

      Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

       

      On episode seven of the Double Happiness Multiplied podcast, we explore birthing options for multiples.

      We talk to Maternal Fetal Medicine Specialist Professor Craig Pennell about the types of twins that will require a caesarean delivery and those that can be safely delivered vaginally.

      Founder of Rockstar Birth Magazine and Rockstar Birth Radio, Shalome Stone explains why a birthing plan is important.

      Hypnobirthing Practitioner and Birthing Doula Elysee Jamieson shares her experience of birthing breech fraternal twins.

      And, I’ll tell you why my girls were delivered by Caesarean section.

      By the end of this episode, you’ll be armed with all the information you’ll need to make educated decisions about the birth of your babies.

      Talking About Birth

      Birth. The topic can get as heated as bringing up politics, religion, or vaccinations at a dinner party. There are many people who have incredibly strong opinions on the matter, oftentimes formed on the basis of misguided information.

      You’ve probably heard people say things along the lines of, ‘women have been giving birth to babies in the open fields for centuries and they always did fine’, well they often didn’t and the mortality rate was exceptionally high.

      However, pregnancy and birth have become incredibly medicalised and it’s often difficult to find a middle ground as such.

      So, whether you’re someone who holds dear to your plans of a drug-free vaginal delivery or you surrender yourself to an attitude of going-with-flow, it’s important to be educated on the possibility that your ideal birth plans might need to be altered.

      Let’s face it, many multiples wouldn’t cope with the journey down the birth canal and without medical intervention those precious babies wouldn’t survive.

      On the other hand, if you have an uncomplicated multiple pregnancy, and under the guidance of a team with experience in multiple births, Professor Craig Pennell assures us that in most cases you can achieve a vaginal delivery.

      As Professor Pennell explains there are many things that need to be considered in planning the most appropriate form of delivery for a twin pregnancy.

      • Type of twins;

        • Monochorionic Monoamniotic twins will always be delivered by caesarean section,

        • Monochorionic Diamniotic twins have a high rate of caesarean birth due to common complications,

        • Dichorionic-Diamniotic – more likely to achieve vaginal births.

        
        

      • Parity of the mother – delivery of twins is technically more difficult for a first-time mum than a woman who has had one or more vaginal births.

      • Complications in the pregnancy.

      • Gestation – delivering a set of twins at 24-weeks is very different from delivering twins at 37-weeks.

      • Location – smaller hospitals might not be equipped to cater for the vaginal delivery of twins.

      • And, the experience of your obstetrician.

      
      

      “If you are in the public hospital system in Australia or the United Kingdom, and you have an uncomplicated set of Dichorionic Diamniotic twins, and the first baby is coming head first, then it would be the normal approach to consider a vaginal delivery.”

      ~Maternal Fetal Medicine Specialist Professor Craig Pennell~

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      “To put all this in perspective, if you are in the public hospital system in Australia or the United Kingdom, and you have an uncomplicated set of Dichorionic Diamniotic twins and the first baby is coming head first then it would be the normal approach to consider a vaginal delivery,”

      “Similarly, in Australia and The United Kingdom if there was severe growth discordance, where the first twin was small and the second twin was large and the mother was unwell, in that situation it’s much more likely that you would have a caesarean delivery,” says Professor Pennell.

      When Do You Discuss Birthing Options?

      Professor Pennell goes on to say that the discussion about the type of birth you’d like should happen early on in the pregnancy, such that your obstetrician can present you the risks and benefits of each option.

      “What everybody’s afraid of is getting the first twin delivered and getting the second one stuck,

      “The chance of caesarean section for a stuck second twin is approximately one-to-two per cent, these are small numbers but they are very significant risks,”

      The easiest type of twins to deliver is where the first one is head first and the second one is head first, unfortunately once the first baby has come out the second baby’s position changes, which is why it’s always sensible to have an experienced person around with twins, even if they look like they will be straightforward to deliver, according to Professor Pennell.

      “If the first twin is breech and the second twin is head first then we would generally not deliver those twins vaginally, because of the risk of the heads getting locked,”

      “If both of the twins are breech then it is certainly possible to achieve two breech deliveries,” says Professor Pennell.

      Maternal Assisted Caesarean Section

      There is a growing trend for women to have as much involvement in their birth as possible and the maternal assisted caesarean delivery has started to be mentioned in multiple births circles. It’s important to consider that although relatively straightforward in a singleton pregnancy, a multiple pregnancy carries increased risks.

      As Professor Pennell explains with this procedure the mother is prepared for her caesarean section in the normal manner, however, her arms and hands are prepared with surgical scrub, gown, and gloves such that when the head comes out the mother can reach down and put her hands around the baby’s shoulders and complete the delivery by herself.

      “The important thing to realise is that in a twin delivery if the first baby is coming head first this procedure is certainly possible, but in terms of a breech delivery, these are technically challenging in caesarean and vaginal delivery,”

      “So, it’s not possible for a mother to bring her arms down and grab the baby’s legs and deliver that baby safely,” says Professor Pennell.

      Do your Research

      Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson did exactly what Associate Professor Pennell advises, she did her research and got a second opinion to find a birthing team she was happy with to deliver her non-identical twins.

      “So, for me, I was absolutely preparing for a vaginal birth of my babies if everything was safe for me and them,”

      “But I soon found when I turned up to my hospital in order to have that, there were a lot of protocols in place, things like having an epidural in place, which I wasn’t personally comfortable doing,”

      “I discussed that with the hospital I was preparing to birth at and felt that for me in the public system where you’re at the mercy of who’s on, on the day, it wasn’t the best option for me to stay in that system,” says Elyse.

      Elyse set out to do some research and found an obstetrician who was happy and comfortable for her to birth without the epidural. He was also skilled in twin births and skilled in breech birth, which worked out really well considering that both of Elyse’s babies ended up in the breech position at term.

      “I wouldn’t be going in willy, nilly or blind to a birth and expecting to have a vaginal breech birth without having a care team who were confident and skilled in that area.”

      ~Twin mum, Elsye Jamieson – founder of Somabirth~

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      “I wouldn’t be going in willy, nilly or blind to a birth and expecting to have a vaginal breech birth without having a care team who were confident and skilled in that area,”

      “The first baby came out frank breech, so he came our bum first,”

      “Twelve minutes later the next baby came out, he came out double footling with his arms over his head like Superman,” explains Elyse.

      Comparing births

      Elyse says although there were lots of people in the room for her twin birth, it felt a lot more calm, safe, and quieter than when she gave birth to her singleton. She believes the reason it went so well is that she trusted everyone in the room.

      “For me, it was a very straightforward double breech vaginal birth, which is uncommon but I am very, very grateful that it panned out in that way,”

      “There was no pressure after the first twin was out, he had delayed cord clamping and was put on my chest and we had a bit of a nuzzle and snuggle before I started bearing down for the second twin,” says Elyse.

      Now, Elyse did have a birthing plan and because she had already birthed a singleton she knew there were certain standards she’d accept the second time around. Although, a birth plan was part of her preparations for the birth of her twins she was also realistic about the outcome.

      This same approach is advocated by the founder of Rockstar Birth Magazine and Rockstar Birth Radio, Shalome Stone.

      “When we talk about birth plan there’s a sense of definitiveness about that as if you could write down your ideal birth wishes and that they would, therefore, all come true, and we all know birth is not like that,”

      “There are untold twists and turns in every birth journey because it’s a dance of two people, there’s you and there’s your baby and sometimes they decide how they want to be birthed,”

      “But what you do when you’re creating a birth plan is that you’re putting some thought into how you would like your birth to unfold,” explains Shalome.

      Shalome says it’s not about being prescriptive, it’s about putting some research into what’s available to you. And, asking yourself questions, such as;

      • What feels right to me?

      • How would I like my birth to unfold if it were to flow smoothly?

      • How would I like it to unfold if it doesn’t flow smoothly?

      • What interventions would I be happy with?

      • How mobile would I like to be?

      • What type and level of motoring would I be comfortable with?

      • Is delayed cord clamping important to me?

      • If a caesarean section is recommended, will I be interested in assisting the delivery?

      
      

      “It’s not about researching every medical paper and writing a ten-page birth plan, it’s about getting to the point that you feel comfortable with where you’re at.”

      ~Shalome Stone – founder of Rockstar Birth Magazine and Rockstar Birth Radio~

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      “It’s not about researching every medical paper and writing a ten-page birth plan, it’s about getting to the point that you feel comfortable with where you’re at,”

      “I’d encourage women when they are pregnant to feel into their intuitive side, there is a knowing that comes with pregnancy, there is a heightened sense of intuition,”

      “As you’re crafting your birth plan and you’re thinking about your options, really tap into what feels right to you,” says Shalome.

      Things to consider for your birth

      • How do you want it to feel?

      • What do want the room to look like?

      • Who do you want to be present?

      • How do you want to be supported?

      • Do you want the word pain excluded from your birth plan?

      
      

      Shalome suggests women explore the level and depth of the content they want in their birth plan, and also look at creating an alternate plan to turn to if things don’t unfold as expected.

      “So, you had hoped to birth your babes vaginally and something has taken a left turn when you thought it was going right, and now your team are talking about needing to do an unscheduled caesarean birth,”

      “Instead of fearing that as an outcome, and not wanting to put any attention to it for fear that you might actually manifest it, have a think about getting comfortable with that option,” says Shalome.

      Things to consider for your alternative birth plan

      • Would you want a gentle or family centred caesarean birth?

      • Would you want the drape to be dropped if possible?

      • Would you like to have a clear drape?

      • Would you like immediate skin-to-skin contact?

      • Do you want delayed cord clamping?

      
      

      Your birth plan should be short and easy to understand in the event that someone new to your team will be able to quickly scan it and know what you want.

      “So, you had hoped to birth your babes vaginally and something has taken a left turn when you thought it was going right and now your team are talking about needing to do an unscheduled caesarean birth. Instead of fearing that as an outcome and not wanting to put any attention to it for fear that you might actually manifest it, have a think about getting comfortable with that option.”

      ~Shalome Stone - founder of Rockstar Birth Magazine and Rockstar Birth Radio~

      Tweet This

      Sally’s Story

      There were no birthing plans, or in fact, any expectations for the birth of my twins. You see, the idea that I was actually having twins was still sinking in when it was discovered there were serious complications in the pregnancy. The Intrauterine Growth Restriction diagnosis meant that the girls wouldn’t survive a vaginal delivery. And it was very clear they would be born prematurely.

      So, at 28-weeks’ gestation when the sonographer informed us it was time to deliver the girls, I had no idea what would unfold.

      It turned out that the girls and I didn’t cope with the epidural and there were times when I remember feeling like my heart was stopping, and I was about to simply drift away. Also, I could tell there were significant concerns for my smaller twin, Aasha, with her vital signs dropping.

      Eventually, we were stabilised and I was wheeled into the operating theatre to be met by what seemed like such a large number of people.

      I could feel the pressure of the scalpel and I was trying so hard to be strong for what lay ahead. It was a complicated delivery. When twin one’s sac was ruptured to get her out, twin two’s sac also burst due to some kind of fusion between them.

      The girls weren’t well enough for me to hold, and one by one they were held up for me to see, Bella was a dark purple colour, which really shocked me even more so than her size, and Aasha, she was so tiny. They were both quickly whisked away by the Neonatal Intensive Care team.

      The girls weren’t well enough for me to hold,]]>https://www.doublehappinessmultiplied.com/?p=1489Mon, 22 Jan 2018 11:11:29 -050034:48nofull17<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="../wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="../twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> <br /> &nbsp;<br /> On episode seven of the Double Happiness Multiplied podcast, we explore birthing options for multiples.<br /> We talk to Maternal Fetal Medicine Specialist Professor Craig Pennell about the types of twins that will require a caesarean delivery and those that can be safely delivered vaginally.<br /> Founder of Rockstar Birth Magazine and Rockstar Birth Radio, Shalome Stone explains why a birthing plan is important.<br /> Hypnobirthing Practitioner and Birthing Doula Elysee Jamieson shares her experience of birthing breech fraternal twins.<br /> And, I’ll tell you why my girls were delivered by Caesarean section.<br /> By the end of this episode, you’ll be armed with all the information you’ll need to make educated decisions about the birth of your babies.<br /> Talking About Birth<br /> Birth. The topic can get as heated as bringing up politics, religion, or vaccinations at a dinner party. There are many people who have incredibly strong opinions on the matter, oftentimes formed on the basis of misguided information.<br /> You’ve probably heard people say things along the lines of, ‘women have been giving birth to babies in the open fields for centuries and they always did fine’, well they often didn’t and the mortality rate was exceptionally high.<br /> However, pregnancy and birth have become incredibly medicalised and it’s often difficult to find a middle ground as such.<br /> So, whether you’re someone who holds dear to your plans of a drug-free vaginal delivery or you surrender yourself to an attitude of going-with-flow, it’s important to be educated on the possibility that your ideal birth plans might need to be altered.<br /> Let’s face it, many multiples wouldn’t cope with the journey down the birth canal and without medical intervention those precious babies wouldn’t survive.<br /> On the other hand, if you have an uncomplicated multiple pregnancy, and under the guidance of a team with experience in multiple births, Professor Craig Pennell assures us that in most cases you can achieve a vaginal delivery.<br /> As Professor Pennell explains there are many things that need to be considered in planning the most appropriate form of delivery for a twin pregnancy.<br /> <br /> * <br /> Type of twins;<br /> <br /> * <br /> Monochorionic Monoamniotic twins will always be delivered by caesarean section,<br /> <br /> * <br /> Monochorionic Diamniotic twins have a high rate of caesarean birth due to common complications,<br /> <br /> * <br /> Dichorionic-Diamniotic – more likely to achieve vaginal births.<br /> <br /> <br /> <br /> * <br /> Parity of the mother – delivery of twins is technically more difficult for a first-time mum than a woman who has had one or more vaginal births.<br /> <br /> * <br /> Complications in the pregnancy.<br /> <br /> * <br /> Gestation – delivering a set of twins at 24-weeks is very different from delivering twins at 37-weeks.<br /> <br /> * <br /> Location – smaller hospitals might not be equipped to cater for the vaginal delivery of twins.<br /> <br /> * <br /> And, the experience of your obstetrician.<br /> <br /> <br /> <a href='https://twitter.com/share?text=%0A%E2%80%9CIf+you+are+in+the+public+hospital+system+in+Australia+or+the+United+Kingdom%2C+and+you+have+an...&url=https://www.doublehappinessmultiplied.com/?p=1489' target='_blank'><br /> “If you are in the public hospital system in Australia or the United Kingdom, and you have an uncomplicated set of Dichorionic Diamniotic twins, and the first baby is coming head first,Sally Barker - HypnotherapistHow To Keep Your Relationship On Track When Having Multiples

       

       

      Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

       

       

      On this episode, we discuss your couple relationship and why it’s important to nurture it before, during, and after your multiple pregnancy.

      We hear from Psychologist Dr Gretta Little, who offers some practical tips to help keep you on track, and warning signs to look out for that might indicate you need to get some outside help.

      Rebecca Perrie and Jannelle Snaddon share their stories of the ups-and-downs they had in their relationships while carrying their multiples, and after they were born.

      And, I talk about the pressure the complications in my twin pregnancy put on my couple relationship.

      Pressure

      It’s no secret that carrying more than one baby at a time puts enormous pressure on your couple relationship. And with multiples, there’s the increased risk of complications along with being concerned about how your family unit is going to operate when you take home more than one baby.

      Psychologist Gretta Little says it’s important to share your feelings about what’s happening and use your pregnancy to reflect on how you’d like things to be when you take the babies home.

      “If you can talk about how you want to be parents of multiples, how you were parented yourself, what you want to do the same, what you want to do differently, and how the two of you might have common ground in that and how you might support each other in going about that,”

      “That reflective capacity is really important, and that’s a way as a couple you can bond over the pregnancy as well,” says Gretta.

      Tweet This

      Dealing with complications

      When complications arise in your pregnancy, it’s important to be realistic about what’s achievable for your relationship and not having high...]]>

       

       

      Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

       

       

      On this episode, we discuss your couple relationship and why it’s important to nurture it before, during, and after your multiple pregnancy.

      We hear from Psychologist Dr Gretta Little, who offers some practical tips to help keep you on track, and warning signs to look out for that might indicate you need to get some outside help.

      Rebecca Perrie and Jannelle Snaddon share their stories of the ups-and-downs they had in their relationships while carrying their multiples, and after they were born.

      And, I talk about the pressure the complications in my twin pregnancy put on my couple relationship.

      Pressure

      It’s no secret that carrying more than one baby at a time puts enormous pressure on your couple relationship. And with multiples, there’s the increased risk of complications along with being concerned about how your family unit is going to operate when you take home more than one baby.

      Psychologist Gretta Little says it’s important to share your feelings about what’s happening and use your pregnancy to reflect on how you’d like things to be when you take the babies home.

      “If you can talk about how you want to be parents of multiples, how you were parented yourself, what you want to do the same, what you want to do differently, and how the two of you might have common ground in that and how you might support each other in going about that,”

      “That reflective capacity is really important, and that’s a way as a couple you can bond over the pregnancy as well,” says Gretta.

      Tweet This

      Dealing with complications

      When complications arise in your pregnancy, it’s important to be realistic about what’s achievable for your relationship and not having high expectations of your partner and what they’re going to be able to bring to the relationship.

      “It’s good to think about how you’re going to handle conflict together and how you’re going to be able to talk things through about that,”

      “But, realistically there may be times where that’s not always possible and that might just have to wait until the babies are a little bit older or more-well,”

      “I don’t think anyone ever really expects to have more than one baby, so it can be a bit of a shock,” says Dr Little.

      “I don’t think anyone ever really expects to have more than one baby, so it can be a bit of a shock.”

      ~Dr Gretta Little~

      Tweet This

      Dr Little suggests joining the Multiple Births Association where you get to meet other people who are parents with multiples, which can help normalise the experience and help you realise that people have done this before and that it is achievable.

      Warning signs your relationship is in trouble

      When you’ve been through months of the emotional upheaval of coming to terms with being the parent of multiples, you might have fallen into the trap of neglecting not only yourself but your partner. If issues aren’t addressed, your relationship could be headed for crisis point. Dr Little says there are some clear signs to look out for before you get to this point.

      “Warning signs would be increased conflict in the relationship or not talking to each other,”

      “And, if you’re having frequent feelings of anger or disappointment about your partner, that would be an indication that it would be good to get some help,” says Dr Little.

      If you’re having frequent feelings of anger or disappointment about your partner, that would be an indication that it would be good to get some help,” says Dr Little.

      Tweet This

      Rebecca’s Story

      Rebecca Perrie admits it took her a while to come to terms with being told she was having twins and that put a strain on her relationship with her husband.

      “It didn’t have an effect on the relationship at the beginning, I think it was more on myself. I really struggled to come to terms with it, I had a plan in place of what my life was going to be like,”

      “My first one was heading towards two, and in my mind, she could play or be sitting at a table and I could be happily holding the other baby,”

      “And when they told me I was having two, my whole plans for the future were not going the way I had envisaged,”

      “That’s where the toll on our relationship maybe came along as it went through the pregnancy, just me coming to terms with the fact I was having twins,”

      Rebecca says her husband Troy was very supportive of the idea of having twins from the beginning, which was a shock.

      “While I was reeling, he was like oh yeah, that sounds like fun,”

      “He’s always wanted three and I always wanted two, so he got what he wanted and I was still in shock,”

      “I think that was good because that allowed me to get swept up in his excitement of it,” admits Rebecca.

      During the pregnancy, Rebecca says her relationship with Troy was pretty good, and it wasn’t until they got home with the babies that they felt the pressures of being the parents of twins.

      “When we got home is when the reality set in and the shock of it continued,”

      “It put a lot of pressure on our relationship in the first six-month, it was exhausting,”

      “It put a lot of pressure on our relationship in the first six-month, it was exhausting, it was a time of where you make or break, we worked as a team, we still had our moments, and we got through it.”

      ~Rebecca Perrie – Twin mum~

      Tweet This

      “It was a time of where you make or break, we worked as a team, we still had our moments, and we got through it,” says Rebecca.

      When the twins had been home for about six-months, Rebecca and Troy enlisted the help of infant sleep specialists to help get the girls into a routine. Rebecca admits that helped not only the babies but steered her and her husband back in the right direction.

      Jannelle’s Story

      Jannelle Snaddon admits that she put her entire focus on her preterm quadruplets and failed to give the needs of her husband a priority.

      “I don’t deny that Matt loves them any bit less than me but I don’t know if other mums can understand, we’ve carried these little guys in our bellies and given birth to them, or had them taken out,”

      “They were my everything, and Matt, of course, is always going to be there and I love him to death, but these four people took the front seat and they jumped ahead of him,” says Jannelle.

      Jannelle remembers a time when Matt arrived home from work, sat her down, and very seriously asked her if she’d found someone else.

      “I just burst out laughing because I thought it was the most hilarious thing I’d heard,”

      “I’m not going to sugar coat it and say we just love each other so much and that’s how we made it through,”

      “I’m not going to sugar coat it and say we just love each other so much and that’s how we made it through, we just try and make it work the best we can.”

      ~Jannelle Snaddon - Quadruplet mum~

      Tweet This

      “Even now, it’s really hard but we respect each other and our family together is very important to each of us, so we just try and make it work the best we can,” says Jannelle.

      It was a long journey for Jannelle and Matt, which started with the decision to undergo IVF. Jannelle says she is extremely grateful that Matt put up with her all this time, especially with all those hormones and emotions while trying to conceive.

      “It did start at the IVF journey because I was all over the place with hormones and things like that and there’s so many times I think I don’t know how he put up with me,”

      “But he did and he stayed and dealt with all of those emotions at that time and then to the NICU,”

      “You go up down, up down, up down and we’re still there now,” admits Jannelle.

      Sally’s Story

      If I’m honest, I did exactly what Jannelle did. As you’ll remember from previous episodes, my pregnancy was fraught with anxiety, which laid the foundations for serious relationship problems.

      Finding out early on in the pregnancy that there were serious complications and then with the girls being born extremely early, a lengthy NICU stay, and then the realities of caring for two extremely tiny babies who just didn’t sleep, it all weighed heavily on that coveted couple relationship.

      Of course, there were times when we grew really close, and that was great to have that feeling of support. However, after the babies were born I guess I just couldn’t understand why he wasn’t as completely committed to the girls as I was. Don’t get me wrong, he clearly loved them immensely but not to the point where he pushed everything else away like I did.

      Little by little, as the years went by that connection you expect with your partner waned until there was absolutely no communication left. ~Sally Barker~

      Tweet This

      Little by little, as the years went by that connection you expect with your partner waned until there was absolutely no communication left. We never went out and did anything together as a couple, if we were invited anywhere I would stay at home with the girls and he would go, alone.

      You see, the advice that’s given is to ask for help or if help is offered accept it. But when you’ve got more than one baby, especially when they are premature, the help isn’t freely offered. I would have people say to me “If you get really, really, really stuck we might be able to help” I don’t blame them, they were probably terrified. You see, I had successfully positioned myself as the strong one who people would turn, so when I needed help I just don’t think they knew how.

      In the end, we were unable to rebuild our couple relationship.

      KEY POINTS:

      • Separation and divorce rates are significantly higher in couples with multiples.
      • Increased conflict in the relationship, or not talking to each other, are warning signs that your relationship is headed for trouble.
      • If you’re having frequent feelings of anger or disappointment about your partner, that would be an indication that it would be good to get some help.
      • It’s important to be realistic about what’s achievable for your relationship and not having high expectations of your partner.

      
      

      Coming up on Episode Seven, we explore birthing options for multiples.

      We hear from Maternal-Fetal Medicine Specialist Professor Craig Pennell about the types of twins that will require a caesarean delivery and those that can be safely delivered vaginally.

      Founder of Rockstar Birth Magazine and Rockstar Birth Radio, Shalome Stone explains why creating a birth plan is important.

      Hypnobirthing Practitioner and Doula Elysee Jamieson shares her experience of birthing breech fraternal twins.

      And, I’ll tell you why my girls were delivered by Caesarean section.

      Until next time…

      I wish you Double Happiness … Multiplied.

      RESOURCES:

      Double Happiness Multiplied Book

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

      Helping Little Hands

      https://www.facebook.com/helpinglittlehandsAustralia/

      http://www.helpinglittlehands.org

      hello@helpinglittlehands.org

      Dr Gretta Little

      Psychologist

      http://www.heliospsychology.com/

      Australian Multiple Birth Association

      https://www.amba.org.au/

      Perth & Districts Multiple Birth Association

      http://www.pdmba.org.au/

      Multiples of America

      http://www.multiplesofamerica.org/

      Twins & Multiple Births Association

      https://www.tamba.org.uk 

      The Multiple Births Foundation

      http://www.multiplebirths.org.uk/

      Irish Multiple Births Association

      http://www.imba.ie/

      Multiple Births Canada

      http://multiplebirthscanada.org/

      International Council of Multiple Birth Organisations (ICOMBO)

      http://icombo.org/

      Podcast music by:

      Catherine Ashley Harpist

      www.facebook.com/catherineashleyharpist

      www.catherineashleyharpist.com

      www.facebook.com/waharpcentre

      www.waharpcentre.com.au

      Produced by:

      Stuart James

      Soundfield Studio

      http://www.soundfieldstudio.com/

      Voiceover:

      Louise Rowe

      https://www.linkedin.com/in/louise-rowe-88aa5a95/

       

      ]]>https://www.doublehappinessmultiplied.com/?p=1485Mon, 22 Jan 2018 10:34:12 -050014:22nofull16<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> &nbsp;<br /> Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> &nbsp;<br /> &nbsp;<br /> On this episode, we discuss your couple relationship and why it’s important to nurture it before, during, and after your multiple pregnancy.<br /> We hear from Psychologist Dr Gretta Little, who offers some practical tips to help keep you on track, and warning signs to look out for that might indicate you need to get some outside help.<br /> Rebecca Perrie and Jannelle Snaddon share their stories of the ups-and-downs they had in their relationships while carrying their multiples, and after they were born.<br /> And, I talk about the pressure the complications in my twin pregnancy put on my couple relationship.<br /> Pressure<br /> It’s no secret that carrying more than one baby at a time puts enormous pressure on your couple relationship. And with multiples, there’s the increased risk of complications along with being concerned about how your family unit is going to operate when you take home more than one baby.<br /> Psychologist Gretta Little says it’s important to share your feelings about what’s happening and use your pregnancy to reflect on how you’d like things to be when you take the babies home.<br /> “If you can talk about how you want to be parents of multiples, how you were parented yourself, what you want to do the same, what you want to do differently, and how the two of you might have common ground in that and how you might support each other in going about that,”<br /> <a href='https://twitter.com/share?text=%E2%80%9CThat+reflective+capacity+is+really+important%2C+and+that%E2%80%99s+a+way+as+a+couple+you+can+bond+over...&url=https://www.doublehappinessmultiplied.com/?p=1485' target='_blank'>“That reflective capacity is really important, and that’s a way as a couple you can bond over the pregnancy as well,” says Gretta.</a><a href='https://twitter.com/share?text=%E2%80%9CThat+reflective+capacity+is+really+important%2C+and+that%E2%80%99s+a+way+as+a+couple+you+can+bond+over...+-+&url=https://www.doublehappinessmultiplied.com/?p=1485' target='_blank' class='spp-ctt-btn'>Tweet This</a><br /> Dealing with complications <br /> When complications arise in your pregnancy, it’s important to be realistic about what’s achievable for your relationship and not having high expectations of your partner and what they’re going to be able to bring to the relationship.<br /> “It’s good to think about how you’re going to handle conflict together and how you’re going to be able to talk things through about that,”<br /> “But, realistically there may be times where that’s not always possible and that might just have to wait until the babies are a little bit older or more-well,”<br /> “I don’t think anyone ever really expects to have more than one baby, so it can be a bit of a shock,” says Dr Little.<br /> <a href='https://twitter.com/share?text=%0A%E2%80%9CI+don%E2%80%99t+think+anyone+ever+really+expects+to+have+more+than+one+baby%2C+so+it+can+be+a+bit+of+a...&url=https://www.doublehappinessmultiplied.com/?p=1485' target='_blank'><br /> “I don’t think anyone ever really expects to have more than one baby, so it can be a bit of a shock.”<br /> ~Dr Gretta Little~<br /> </a><a href='https://twitter.com/share?text=%0A%E2%80%9CI+don%E2%80%99t+think+anyone+ever+really+expects+to+have+more+than+one+baby%2C+so+it+can+be+a+bit+of+a...+-+&url=https://www.doublehappinessmultiplied.com/?p=1485' target='_blank' class='spp-ctt-btn'>Tweet This</a><br /> Dr Little suggests joining the Multiple Births...Sally Barker - Hypnotherapist7 Common Complications of a Multiple Pregnancy

       

      Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

       

       

      On Episode Five, we discuss the seven most common complications that can arise in a multiple pregnancy.

      Maternal-Fetal Medicine Specialist Professor Craig Pennell explains certain conditions to be aware of, what to look out for, and what do when you receive a diagnosis you’re not expecting.

      Author Alexa Bigwarfe talks about twin-to-twin transfusion syndrome, and I share my story of intrauterine growth restriction.

      By the end of this episode, you’ll have an in-depth understanding of the many possibilities that could affect your pregnancy, but hopefully, you’ll be reassured that if you’re in the right hands those obstacles can be surmounted and you’ll be able to enjoy your pregnancy.

      The risks of having a multiple pregnancy

      Once you’ve been diagnosed with a multiple pregnancy, there is so much to learn that falls outside what you might already know about pregnancy. When you’re carrying twins, triplets, or quadruplet babies the risk for complications rises and depending on what type of multiples you have on board will determine the level of that risk, and what treatment options are available to you.

      Maternal-Fetal Medicine Specialist Professor Craig Pennell says even though there are increased risks involved with multiple pregnancies that doesn’t mean you can’t enjoy your pregnancy.

      “The things that can go wrong in multiple pregnancies are divided into those that can happen to all multiples and those that are specific to particular multiples,”

      “For example, Monochorionic Monoamniotic twins, also known as MoMos, account for just one-percent of identical twins and they’re the type of twins where cord entanglement can cause problems, which is associated with a loss rate in the pregnancy of up to 50 percent,”

      “In all the other types of twins where there is a membrane between them so those conditions can’t occur,” explains Professor Pennell.

      If we look at twins, in general, some of the things that can occur are:

      Hyperemesis

      Severe nausea and vomiting are very common in a...]]>

       

      Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

       

       

      On Episode Five, we discuss the seven most common complications that can arise in a multiple pregnancy.

      Maternal-Fetal Medicine Specialist Professor Craig Pennell explains certain conditions to be aware of, what to look out for, and what do when you receive a diagnosis you’re not expecting.

      Author Alexa Bigwarfe talks about twin-to-twin transfusion syndrome, and I share my story of intrauterine growth restriction.

      By the end of this episode, you’ll have an in-depth understanding of the many possibilities that could affect your pregnancy, but hopefully, you’ll be reassured that if you’re in the right hands those obstacles can be surmounted and you’ll be able to enjoy your pregnancy.

      The risks of having a multiple pregnancy

      Once you’ve been diagnosed with a multiple pregnancy, there is so much to learn that falls outside what you might already know about pregnancy. When you’re carrying twins, triplets, or quadruplet babies the risk for complications rises and depending on what type of multiples you have on board will determine the level of that risk, and what treatment options are available to you.

      Maternal-Fetal Medicine Specialist Professor Craig Pennell says even though there are increased risks involved with multiple pregnancies that doesn’t mean you can’t enjoy your pregnancy.

      “The things that can go wrong in multiple pregnancies are divided into those that can happen to all multiples and those that are specific to particular multiples,”

      “For example, Monochorionic Monoamniotic twins, also known as MoMos, account for just one-percent of identical twins and they’re the type of twins where cord entanglement can cause problems, which is associated with a loss rate in the pregnancy of up to 50 percent,”

      “In all the other types of twins where there is a membrane between them so those conditions can’t occur,” explains Professor Pennell.

      If we look at twins, in general, some of the things that can occur are:

      Hyperemesis

      Severe nausea and vomiting are very common in a multiple pregnancy, according to Professor Pennell.

      Professor Pennell reassures us that the condition usually goes away at the end of the first trimester, so around 13-or-14 weeks, however, in about 10 percent of women it continues throughout the pregnancy.

      Miscarriage

      According to Professor Pennell, the other thing that is more common in the first trimester of a multiple pregnancy is a miscarriage. He says the rate of miscarriage in twins is at least double, if not higher, than the rate in singletons. And, it’s often not noticed or simply missed depending on when you have your first ultrasound.

      “If you’re having scans from five-weeks, you may see what starts as a twin pregnancy that then ends as a singleton somewhere between six-and-12 weeks, whereas if your first scan is at nine-weeks, you may not realise that it started as a twin,”

      Not surprisingly, the rate of miscarriage in Higher Order Multiples is again higher. This is somewhere in the order of 30-50 percent where you would lose at least one of the embryos in the first trimester, according to Professor Pennell.

      Structural Anomalies

      All babies have the chance of having a structural problem (about five-percent), which includes such things as a clubbed foot, an extra finger, cleft-lip-and-palette, a hole in the heart, or an issue with the kidneys.

      “With Dichorionic twins, the rate is double that of a singleton,”

      “With Monochorionic twins, the rate is even higher than that because Monochorionic twins in itself is an anomaly,” says Professor Pennell.

      He goes on to explain that if you have an early blastocyst splitting into two embryos there’s an increased risk of issues in structural development.  The more severe anomalies can be picked up at the 11-13-week scan, however, most of them are detected during the 18-20-week anatomy scan.

      “When you have a multiple pregnancy, you want to go to a specialist centre who at a minimum specialises in pregnancy ultrasound, and preferably someone who specialises in ultrasound in high-risk pregnancies, because you need to have a lot of experience to do these types of scans well,” says Professor Pennell.

      Alexa’s story

      Alexa Bigwarfe agrees with Professor Pennell and admits that if she had been with a team that specialises in multiple pregnancies when she was diagnosed with an identical twin pregnancy, her life would be vastly different to what it is today. You see, Alexa has Systemic Lupus and Hashimoto's Disease, so when she discovered she was pregnant with her third baby, her doctor called her in straight away, despite being just 6-weeks’ pregnant, due to her classification of being High-Risk.

      “The doctor came in and confirmed, she said yep it’s definitely two,”

      “She said to come back in two weeks and we’ll just check and make sure there’s still two,” says Alexa.

      When they went back for the next ultrasound the doctor told them that the babies were identical and sharing a placenta.

      “I’ll never forget that day, it’s like burned into my mind because I remember the doctor very nonchalantly, very nonchalantly saying to me ‘sometimes with twins sharing a placenta like this, one of them will get too much of the placenta and one of them won’t get enough, and they’re not sharing the fluids and everything equally,”

      “And, then she was like but if that happens there’s stuff we can do and she said it like it’s no big deal,”

      “I constantly wonder how different my life would be today if she had said the words twin-to-twin transfusion syndrome if she had said anything to indicate that it would be something that we should follow closely.” Alexa Bigwarfe.

      Alexa says that over the next ten-weeks many mistakes were made, including not being scheduled for a 16-week ultrasound, and that was simply because she was with an obstetrician service where patients were rotated through doctors in the event that if you went into labour you’d be tended to by someone you knew.

      “I never had twins before, I wasn’t looking up twin-to-twin transfusion syndrome because she didn’t say anything about it,”

      “When we went in for the 20-week ultrasound they diagnosed us officially with twin-to-twin transfusion syndrome and we were already stage-3,”

      “This meant we were well on our way to one baby dying, if not both babies dying,” says Alexa.

      Alexa was then transferred to a Maternal Fetal Manager, which she says should have happened much earlier in her pregnancy. She had an amnioreduction, where the fluid is drained from the recipient baby’s amniotic sac. However, according to Alexa, her MFM wasn’t as up to speed on TTTS as he should have been.

      “There were some missteps taken along the way, some bad information, some procedures that probably could have happened that didn’t happen because of his lack of awareness and knowledge on the subject,” says Alexa.

      Several more amnioreduction procedures were carried out over the following weeks, and as a result, Alexa went into labour at 30-weeks-and-five-days gestation. She explains that Kathryn wouldn’t have survived a vaginal delivery so she underwent an emergency caesarean section.

      “Kathryn had to be resuscitated, she was the larger baby with hydrops, and when she was born she had so much fluid in her abdomen that it was swollen to the maximum extent,”

      “The little one we had just cleared viability with her, even though they were 30-weeks, she was about the size of a 24-25 weeker, one-pound-10-ounces,”

      “But she squeaked when she was born, it sounded like a little bird, and that was the most exciting sound,” says Alexa.

      Kathryn survived for two-days.

      Charis spent 84-days in NICU.

      What is TTTS?

      Twin-to-twin transfusion syndrome (TTTS) is a prenatal condition in which Monochorionic twins (identical) share an unequal amount of the placenta’s blood supply. This results in the fetuses growing at different rates. Around 70 percent of identical twins share a placenta and 20 percent of these pregnancies will be impacted by TTTS.

      “This condition typically occurs between 16-26 weeks and is due to an imbalance in the blood vessels that connect the twins across the surface of the placenta,”

      “This is usually a rapidly progressive condition and untreated can be associated with a loss rate of up to ninety percent. If it’s picked up and diagnosed, there are good treatments available now that give good outcomes in 80 percent of women,” says Professor Pennell.

      “If you are being managed by an experienced team and modern treatment, you can expect better outcomes now than were possible ten or twenty years ago.” Professor Craig Pennell.

      As Professor Pennell explains the baby with more of the blood supply is called the recipient and the one with less is called the donor. Because the donor has less blood flow, it will grow much slower and will be significantly smaller than the other twin. In contrast, the recipient twin has too much blood flow and grows fast and is much bigger.

      Stages of TTTS

      Stage 1: There is an imbalance of amniotic fluid, with a small amount (<2cm) around the donor twin and a large amount around the recipient twin (>8cm). The twins often have a 20% size discordance.

      Stage 2: The bladder of the donor twin is not visible, or it does not fill with urine, during an ultrasound exam.

      Stage 3: The imbalance of blood flow starts to affect the heart function in one or both babies. This is observed as abnormal blood flow in the umbilical cords or hearts of the twins.

      Stage 4: The imbalance of blood flow causes signs of heart failure in one of the twins.

      Stage 5: One or both of the twins has passed away from severe TTTS.

      For Stage 1 cases, observation may be all that is necessary, but for Stage 2 or higher cases, fetal surgery may be the best option.

      Symptoms of TTTS in the mother

      • Sudden weight gain.

      • Fundus appears large for dates (often will appear like a term pregnancy).

      • Abdominal pain and tightness.

      • Premature onset of contractions.

      
      

      Treatment options

      • Observation – weekly ultrasound assessment

      • Fetopic Laser Photocoagulation – in cases of stage 2 or higher, between 16-and-26 weeks surgeons insert a small laser fibre into the mothers’ uterus and laser energy is used to stop the blood flow between the twins. As a result, the placentas are separated, allowing each twin to develop independently.

      • Amnioreduction - this procedure removes the excess fluid from around the larger twin, reducing amniotic pressure and reducing the risk of preterm labour. This is usually performed with fetoscopic laser photocoagulation.

      
      

      “TTTS is a moving feast and it needs to be reviewed regularly as our ability to prognosticate beyond a week or so is very limited.” Professor Craig Pennell.

      Professor Pennell explains that twins with untreated advanced stages of TTTS during pregnancy usually don’t do well after delivery with a 90 percent fatality risk, and for those who do survive there’s a 15-50 percent risk of neurologic handicap.

      The good news is, according to Professor Pennell is that if TTTS has been successfully managed by an experienced team and treated during pregnancy, there is a much better chance that the babies will be healthy.

      Sally’s story

      There’s a common theme when I talk with people who have experienced a multiple pregnancy. There’s the initial shock when hearing the diagnosis and then there’s the steep learning curve while attempting to understand the type of multiple they’re carrying. And, then there are the complications.

      Looking back, I think I was in a state of shock for months because it seemed as though there were only a handful of weeks where I wasn’t faced with the prospect of losing one or both of my babies.

      Most people would shrug off my concerns about the discordance in size of the girls with comments like – ‘one twin is always bigger than the other’, even my private obstetrician dismissed my concerns before I decided he wasn’t the right person to guide me through my pregnancy.

      What these people didn’t realise was with my diagnosis of Intrauterine Growth Restriction or IUGR I was carrying a ticking time bomb. You see, IUGR in a twin pregnancy is a condition where one or both babies don’t grow in the manner that’s expected, due to an uneven share of the placenta, what that means is that these babies are much smaller than other babies of the same gestational age.

      “What these people didn’t realise was with my diagnosis of Intrauterine Growth Restriction, I was carrying a ticking time bomb.” Sally Barker.

      Fortunately, following the recommendation of the Sonographer at the specialised imaging centre I went to for my 12-week scan, I went to the local tertiary hospital in Perth Western Australia two-weeks later to have a follow-up assessment. It was then that I was placed in the care of the GOLD team, which is a group of highly skilled specialists who have extensive experience with multiple births.

      The management of my pregnancy was such that I was seen twice a week, and sometimes three times. I knew that the girls would be pre-term, there was no doubt about that. But just how early was a waiting game. During the scans, close attention was placed on the blood flow to my smaller baby, Aasha, who it turned out had a cord insertion at the lower edge of the placenta, which meant she was only getting about 25 percent of the nutrients she needed.

      At 24-weeks the blood flow to Aasha had slowed and showed signs of reversing. It was explained that the girls would need to be delivered and their chance of survival was slim, however, there had been cases where following a corticosteroid injection the condition could stabilise.  Thankfully, for us, that’s exactly what happened.

      We were hoping to get to at least 30-weeks’ gestation, and I was so certain we would get there, but when that blood flow stopped again at just 28 weeks’ gestation, this time there would be no intervention.

      The girls were so tiny, just 825 grams or 1.8 pounds and 1075 grams or 2.3 pounds. They came home together 64 days after they were born.

      Intrauterine Growth Restriction (IUGR)

      Professor Craig Pennell explains that IUGR can occur in both Dichorionic and Monochorionic twins, but it’s more common in Monochorionic twins, with an 80 percent chance the twins will share a placenta.

      https://www.doublehappinessmultiplied.com/?p=1483Mon, 22 Jan 2018 10:14:44 -050028:34nofull15<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> &nbsp;<br /> &nbsp;<br /> On Episode Five, we discuss the seven most common complications that can arise in a multiple pregnancy.<br /> Maternal-Fetal Medicine Specialist Professor Craig Pennell explains certain conditions to be aware of, what to look out for, and what do when you receive a diagnosis you’re not expecting.<br /> Author Alexa Bigwarfe talks about twin-to-twin transfusion syndrome, and I share my story of intrauterine growth restriction.<br /> By the end of this episode, you’ll have an in-depth understanding of the many possibilities that could affect your pregnancy, but hopefully, you’ll be reassured that if you’re in the right hands those obstacles can be surmounted and you’ll be able to enjoy your pregnancy.<br /> The risks of having a multiple pregnancy<br /> Once you’ve been diagnosed with a multiple pregnancy, there is so much to learn that falls outside what you might already know about pregnancy. When you’re carrying twins, triplets, or quadruplet babies the risk for complications rises and depending on what type of multiples you have on board will determine the level of that risk, and what treatment options are available to you.<br /> Maternal-Fetal Medicine Specialist Professor Craig Pennell says even though there are increased risks involved with multiple pregnancies that doesn’t mean you can’t enjoy your pregnancy.<br /> “The things that can go wrong in multiple pregnancies are divided into those that can happen to all multiples and those that are specific to particular multiples,”<br /> “For example, Monochorionic Monoamniotic twins, also known as MoMos, account for just one-percent of identical twins and they’re the type of twins where cord entanglement can cause problems, which is associated with a loss rate in the pregnancy of up to 50 percent,”<br /> “In all the other types of twins where there is a membrane between them so those conditions can’t occur,” explains Professor Pennell.<br /> If we look at twins, in general, some of the things that can occur are:<br /> Hyperemesis <br /> Severe nausea and vomiting are very common in a multiple pregnancy, according to Professor Pennell.<br /> Professor Pennell reassures us that the condition usually goes away at the end of the first trimester, so around 13-or-14 weeks, however, in about 10 percent of women it continues throughout the pregnancy.<br /> Miscarriage<br /> According to Professor Pennell, the other thing that is more common in the first trimester of a multiple pregnancy is a miscarriage. He says the rate of miscarriage in twins is at least double, if not higher, than the rate in singletons. And, it’s often not noticed or simply missed depending on when you have your first ultrasound.<br /> “If you’re having scans from five-weeks, you may see what starts as a twin pregnancy that then ends as a singleton somewhere between six-and-12 weeks, whereas if your first scan is at nine-weeks, you may not realise that it started as a twin,”<br /> Not surprisingly, the rate of miscarriage in Higher Order Multiples is again higher. This is somewhere in the order of 30-50 percent where you would lose at least one of the embryos in the first trimester, according to Professor Pennell.<br /> Structural Anomalies<br /> All babies have the chance of having a structural problem (about five-percent), which includes such things as a clubbed foot, an extra finger, cleft-lip-and-palette, a hole in the heart, or an issue with the kidneys.<br /> Sally Barker - HypnotherapistGestational Diabetes in Multiple Pregnancies

       

      Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

       

       

      On episode four, of Double Happiness Multiplied, we discuss Gestational Diabetes (GDM) and why it’s important for women carrying more than one baby to understand how it might impact their pregnancy.

      The good news is, with the right exercise and nutrition program you can avoid any adverse effects of the condition. More importantly, for 95 percent of women diagnosed with GDM the condition resolves once the babies are born.

      It’s a fact of life that pregnancy causes a diabetic state in every woman. About 90 percent of pregnant women can cope with it, while 10 percent can’t. It’s this latter group who get GDM.

      What is Gestational Diabetes?

      Diabetes Educator, Nurse Practitioner, and Midwife Marina Mickleson has spent more than twenty years explaining this to pregnant women. She says quite simply GDM is diabetes that is picked up for the first time in pregnancy.

      “What this means is that the woman hasn’t had a prior diabetes diagnosis and the condition has been picked up during routine testing, which shows the woman has glucose intolerance in the pregnancy,” explains Marina.

      What’s more, the percentage of women diagnosed with GDM varies depending on the population. On average, about 10 percent of the Caucasian population will get GDM, but if you add in the Indian, Asian, Indigenous, and African population, it can be up to 20 percent of the population who get GDM, according to Marina.

      “These women are more at risk just because of mainly the food they’re eating,”

      “Compared to what they’d be eating for three or four generations in their communities, it’s the Western diet their bodies aren’t able to cope with,” says Marina.

      Unfortunately, as Marina explains women who are carrying multiples are also at a higher risk of developing GDM due to the larger placenta, and GDM has a lot to do with placental hormones. So, the more babies you’re carrying, the more placental hormones you’ll be producing, which increases the chances of developing GDM.

      Testing

      There are two ways to be tested for GDM:

      1. A fasting blood glucose test, usually done in the first 12-weeks of pregnancy for women considered at high-risk of developing GDM. If this fasting level is elevated, then you will get a positive diagnosis and further testing isn’t required.
      2. The two-hour glucose tolerance test – this is where after an initial blood test you drink 75 grams of glucose syrup, which is followed by two more blood tests to see how your body reacts to the glucose load. This test is ideally given at 26-to-28-weeks’ gestation, however, if there has been a GDM diagnosis in a previous...]]>

          

         Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

         https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

          

          

         On episode four, of Double Happiness Multiplied, we discuss Gestational Diabetes (GDM) and why it’s important for women carrying more than one baby to understand how it might impact their pregnancy.

         The good news is, with the right exercise and nutrition program you can avoid any adverse effects of the condition. More importantly, for 95 percent of women diagnosed with GDM the condition resolves once the babies are born.

         It’s a fact of life that pregnancy causes a diabetic state in every woman. About 90 percent of pregnant women can cope with it, while 10 percent can’t. It’s this latter group who get GDM.

         What is Gestational Diabetes?

         Diabetes Educator, Nurse Practitioner, and Midwife Marina Mickleson has spent more than twenty years explaining this to pregnant women. She says quite simply GDM is diabetes that is picked up for the first time in pregnancy.

         “What this means is that the woman hasn’t had a prior diabetes diagnosis and the condition has been picked up during routine testing, which shows the woman has glucose intolerance in the pregnancy,” explains Marina.

         What’s more, the percentage of women diagnosed with GDM varies depending on the population. On average, about 10 percent of the Caucasian population will get GDM, but if you add in the Indian, Asian, Indigenous, and African population, it can be up to 20 percent of the population who get GDM, according to Marina.

         “These women are more at risk just because of mainly the food they’re eating,”

         “Compared to what they’d be eating for three or four generations in their communities, it’s the Western diet their bodies aren’t able to cope with,” says Marina.

         Unfortunately, as Marina explains women who are carrying multiples are also at a higher risk of developing GDM due to the larger placenta, and GDM has a lot to do with placental hormones. So, the more babies you’re carrying, the more placental hormones you’ll be producing, which increases the chances of developing GDM.

         Testing

         There are two ways to be tested for GDM:

         1. A fasting blood glucose test, usually done in the first 12-weeks of pregnancy for women considered at high-risk of developing GDM. If this fasting level is elevated, then you will get a positive diagnosis and further testing isn’t required.
         2. The two-hour glucose tolerance test – this is where after an initial blood test you drink 75 grams of glucose syrup, which is followed by two more blood tests to see how your body reacts to the glucose load. This test is ideally given at 26-to-28-weeks’ gestation, however, if there has been a GDM diagnosis in a previous pregnancy or there is a family history of Type 1 or Type 2 diabetes, the test will be done at around 20-22-weeks’ gestation.

         
         

         Deb Howe is an identical twin and just gave birth to identical twins. She invited us along to her Glucose Tolerance Test at 26-weeks’ gestation. Deb was considered a high-risk because her twin sister has Type 1 diabetes.

         After fasting for 10-hours, Deb had her first blood test and was given a 300ml bottle of liquid to drink, which contained the 75 grams of glucose syrup.

         Everything was going well until about 20-minutes after Deb consumed the sweet liquid, she started to feel a bit lightheaded, the babies were kicking a lot, and she felt a tiny bit of nausea.

         Deb admits she was worried that she had developed gestational diabetes because before falling pregnant she was following a low carb high-fat diet. When she started getting morning sickness, all she craved was carbohydrate foods and she gained a lot of weight in the first trimester.

         Another two blood tests later and Deb was given to all clear to go home and wait a few days for the results.

         The good news is, that apart from having low iron Deb appears to have passed the GTT, which means she doesn’t have gestational diabetes.

         Diagnosis

         However, if a woman is diagnosed with GDM, the next step is to be referred to a diabetes educator who will explain the condition and give instructions about blood glucose level checks, diet, and exercise.

         “For the majority of women Gestational Diabetes isn’t dangerous at all, it only becomes dangerous if women aren’t looking after themselves and are not controlling their blood glucose levels, and their levels are high,” Marina says.

         “For the majority of women Gestational Diabetes isn’t dangerous at all, it only becomes dangerous if women are not looking after themselves and are not controlling their blood glucose levels, and their levels are high.”

         ~Marina Mickleson~

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         Symptoms

         There are no specific symptoms and most women have no idea they have GDM. The first indication is usually that on ultrasound the babies are bigger for gestation than what is expected or you have a positive result on your glucose tolerance test.

         In fact, this is how Rachelle Lear found out she had GDM while pregnant with triplets. She was diagnosed with the condition at 26-weeks’ gestation, at the time she was still working full-time as a Treasury Analyst.

         Rachelle says that apart from having to do regular blood glucose testing and keeping a food diary the condition didn’t bother her at all. She found the GDM was quite easy to manage, it was just that she had to eat a lot and quite regularly, which was difficult because she didn’t have any room left for food.

         When Rachelle was admitted to the hospital, a few days before the boys were born, she realised just how much she was supposed to be eating.

         “They come around with breakfast, and then drop off a snack for morning tea, and then your lunch, and then another snack, and then dinner, and another snack after that even. It was just too much,” she laughs.

         All in all, Rachelle’s pregnancy was relatively uneventful and the boys arrived at 30-weeks’ gestation, and apart from the expected challenges that having babies in NICU presents, the boys continue to thrive. Rachelle and her husband have even added a little girl to their family.

          

         “I actually found Gestational Diabetes quite easy to manage, it was just the fact that you had to eat a lot and quite regularly, which I found difficult because I didn’t have any room.” ~Triplet mum - Rachelle Lear~

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         Nutrition

         When it comes to nutrition during pregnancy, Marina Mickleson recommends every woman, not just those who’ve been diagnosed with gestational diabetes, pay attention to what’s on their plate. And, for some, there might be a steep learning curve on the way.

         “A quarter of your plate should be carbohydrates, another quarter of the plate should be protein, and the rest leafy green vegetables, salad, and vegetables,”

         “Someone who has diabetes, Type 1, Type 2, or Gestational, the carbohydrates they’re having should be as low GI as possible,” explains Marina.

         According to Marian the simplest way to work out if something is low GI is to look for the least processed food. For example; a grainy piece of bread is going to be lower GI than a white piece of bread because your body is going to work a lot harder to break it down and it will break down more slowly.

         Beyond delivery

         As mentioned earlier, for 95 percent of women diagnosed with GDM the condition resolves once the babies are born.

         “In the cases where it doesn’t go, these women have come into the pregnancy with undiagnosed Type 2 Diabetes,”

         “And, because it’s picked up in pregnancy it’s referred to as Gestational Diabetes,” says Marina.

         Not only that, but if the mother’s blood glucose levels have been high during pregnancy, the baby or babies blood glucose levels will have also been higher in utero. What this means is that because the baby or babies are used to higher glucose levels when they are born their blood glucose levels can drop.

         “These babies can have problems with low blood glucose levels or Hypos for the first day or so of life,”

         “Because they’ve got low glucose levels, they may need some top ups with either breast milk or formula to bring those blood glucose levels up,”

         “Within a couple of days most babies are able to self-regulate their insulin and it doesn’t seem to be a problem,” explains Marina.

         All women who have had GDM, are encouraged to have a follow-up glucose tolerance test to ensure the condition has resolved. Marina suggests asking for a referral at your 6-week check-up, and have the test done at around the 8-10-week post-partum mark.

         GDM in future pregnancies

         As a result of having GDM, there is a high likelihood of developing the condition in subsequent pregnancies. The main reason for this is age.

         “As we have more children, we’re getting older, and unfortunately one of the risk factors of having gestational Diabetes is being 30 or older,”

         “Most of us are already 30 before we have our first pregnancy and each year we get older that risk is higher,”

         “Most of us are already 30 before we have our first pregnancy. Unfortunately, one of the risk factors for having gestational Diabetes is being 30 or older.”

         ~Marina Mickleson~

          

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         “So, if we’ve had gestational diabetes in one pregnancy, there is around a 40 percent chance of getting it in subsequent pregnancies,” Marina says.

         Educate yourself

         If you’re like most people you want to be informed about likely scenarios with your pregnancy, that’s why it’s important to understand what’s happening to your body, and that of your babies’, if you’ve been diagnosed with GDM.

         But what questions should you be asking your specialist?

         Marina suggests the following:

         1. Do I need to be monitored more closely?
         2. What can I do in terms of my diet to reduce the extra glucose going through to the babies?
         3. Who can I talk to about an appropriate exercise program?
         4. Who can show me how to test my blood glucose levels, and interpret what the readings mean?

         
         

         If you have a diagnosis of GDM and your doctor says not to worry about it, seek further help. It’s your right!

         Remember, if you’ve been diagnosed with GDM and you look after yourself by eating well, exercising moderately, and ensuring your blood glucose levels stay within the acceptable range, the condition isn’t dangerous

         Key Points:

         • Educate yourself about the condition.
         • Ask for a second opinion if your doctor says not to worry about a Gestational Diabetes diagnosis.
         • Ask questions. And, if you’re not satisfied with the answers, ask again.
         • Remember, for 95 percent of women diagnosed with GDM the condition resolves once the babies are born.
         • As a result of having GDM, you will need to have a follow-up glucose tolerance test about two-months post-partum.

         
         

         Until next time…

         I wish you Double Happiness… Multiplied.

          

         RESOURCES:

         Double Happiness Multiplied Book

         https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

          

         Gestational Diabetes Support Group

         https://www.facebook.com/GestationalDiabetesInformation/

         Gestational Diabetes UK

         https://www.facebook.com/GDUKMums/
         www.gestationaldiabetes.co.uk

          

         Australian Multiple Birth Association

         https://www.amba.org.au/

         Perth & Districts Multiple Birth Association

         http://www.pdmba.org.au/

         Multiples of America

         http://www.multiplesofamerica.org/

         Twins & Multiple Births Association

         https://www.tamba.org.uk

         The Multiple Births Foundation

         http://www.multiplebirths.org.uk/

         Irish Multiple Births Association

         http://www.imba.ie/

         Multiple Births Canada

         http://multiplebirthscanada.org/

         International Council of Multiple Birth Organisations (ICOMBO)

         http://icombo.org/

         South African Multiple Birth Association

         http://www.samultiplebirth.co.za/

         LINKS:

         Podcast music by:

         Catherine Ashley Harpist

         www.facebook.com/catherineashleyharpist

         www.catherineashleyharpist.com

         www.facebook.com/waharpcentre

         www.waharpcentre.com.au

         Produced by:

         Stuart James

         Soundfield Studio

         http://www.soundfieldstudio.com/

         Voiceover by:

         Louise Rowe

         https://www.linkedin.com/in/louise-rowe-88aa5a95/

          

      ]]>https://www.doublehappinessmultiplied.com/?p=1481Mon, 22 Jan 2018 09:35:36 -050019:47nofull14<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> &nbsp;<br /> &nbsp;<br /> On episode four, of Double Happiness Multiplied, we discuss Gestational Diabetes (GDM) and why it’s important for women carrying more than one baby to understand how it might impact their pregnancy.<br /> The good news is, with the right exercise and nutrition program you can avoid any adverse effects of the condition. More importantly, for 95 percent of women diagnosed with GDM the condition resolves once the babies are born.<br /> It’s a fact of life that pregnancy causes a diabetic state in every woman. About 90 percent of pregnant women can cope with it, while 10 percent can’t. It’s this latter group who get GDM.<br /> What is Gestational Diabetes?<br /> Diabetes Educator, Nurse Practitioner, and Midwife Marina Mickleson has spent more than twenty years explaining this to pregnant women. She says quite simply GDM is diabetes that is picked up for the first time in pregnancy.<br /> “What this means is that the woman hasn’t had a prior diabetes diagnosis and the condition has been picked up during routine testing, which shows the woman has glucose intolerance in the pregnancy,” explains Marina.<br /> What’s more, the percentage of women diagnosed with GDM varies depending on the population. On average, about 10 percent of the Caucasian population will get GDM, but if you add in the Indian, Asian, Indigenous, and African population, it can be up to 20 percent of the population who get GDM, according to Marina.<br /> “These women are more at risk just because of mainly the food they’re eating,”<br /> “Compared to what they’d be eating for three or four generations in their communities, it’s the Western diet their bodies aren’t able to cope with,” says Marina.<br /> Unfortunately, as Marina explains women who are carrying multiples are also at a higher risk of developing GDM due to the larger placenta, and GDM has a lot to do with placental hormones. So, the more babies you’re carrying, the more placental hormones you’ll be producing, which increases the chances of developing GDM.<br /> Testing<br /> There are two ways to be tested for GDM:<br /> <br /> * A fasting blood glucose test, usually done in the first 12-weeks of pregnancy for women considered at high-risk of developing GDM. If this fasting level is elevated, then you will get a positive diagnosis and further testing isn’t required.<br /> * The two-hour glucose tolerance test – this is where after an initial blood test you drink 75 grams of glucose syrup, which is followed by two more blood tests to see how your body reacts to the glucose load. This test is ideally given at 26-to-28-weeks’ gestation, however, if there has been a GDM diagnosis in a previous pregnancy or there is a family history of Type 1 or Type 2 diabetes, the test will be done at around 20-22-weeks’ gestation.<br /> <br /> Deb Howe is an identical twin and just gave birth to identical twins. She invited us along to her Glucose Tolerance Test at 26-weeks’ gestation. Deb was considered a high-risk because her twin sister has Type 1 diabetes.<br /> After fasting for 10-hours, Deb had her first blood test and was given a 300ml bottle of liquid to drink, which contained the 75 grams of glucose syrup.<br /> Everything was going well until about 20-minutes after Deb consumed the sweet liquid, she started to feel a bit lightheaded, the babies were kicking a lot, and she felt a tiny bit of nausea.<br /> Deb admits she was worried that she had developed gestational diabetes...Sally Barker - HypnotherapistHow To Eat Right When You’re Having Twins, Triplets, or Quads

       

       

      Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

       

      On this episode, we tackle the problem of hyperemesis in multiple pregnancies and explain how to maximise your nutrition when you’re too ill to keep anything down, or there’s simply no room left for food.

      Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell explains what happens to your body when you’re supplying nutrients to more than one baby at a time, and what supplements are required to ensure your vitamin and mineral needs are catered for.

      Pregnancy Dietician and Nutritionist Jessica Ruescher offers some practical advice on the types and amounts of foods you’ll need to eat, to maintain adequate weight gain during your pregnancy.

      Also, twin mum Elyse Jamieson and I talk about our experiences with hyperemesis, while mum of quadruplets Jannelle Snaddon shares her struggle with nutrition towards the end of her pregnancy when she was running out of room for food.

      Vitamin supplements

      As a woman carrying more than one baby, your energy and protein requirements are dramatically increased. This is because your resting energy expenditure is much greater than that of a woman carrying a singleton. What this means is that due to the increased maternal tissue you’re carrying you'll burn more calories at rest.

      And, this, of course, affects your vitamin and mineral levels, which have a significant impact on the growth and development of your babies.

      Maternal-Fetal Medicine Specialist Professor Craig Pennell explains that vitamin supplementation is a lot more important in twins than in singletons, and it’s actually not for the baby it’s more for the mother. He says the babies will take what they need from the mother almost always, which leads to the mother losing calcium from her bones. She will also lose iron because she’s making an extra litre-and-a-half to two-litres of maternal blood, plus two placentas, plus two baby blood volumes, all of which uses up iron.

      Professor Pennell advises all women carrying multiples to take a good pregnancy multivitamin, more folate than normal, iron, and calcium in a preventable manner at the very beginning of their pregnancy.

       

       

      Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

      https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

       

      On this episode, we tackle the problem of hyperemesis in multiple pregnancies and explain how to maximise your nutrition when you’re too ill to keep anything down, or there’s simply no room left for food.

      Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell explains what happens to your body when you’re supplying nutrients to more than one baby at a time, and what supplements are required to ensure your vitamin and mineral needs are catered for.

      Pregnancy Dietician and Nutritionist Jessica Ruescher offers some practical advice on the types and amounts of foods you’ll need to eat, to maintain adequate weight gain during your pregnancy.

      Also, twin mum Elyse Jamieson and I talk about our experiences with hyperemesis, while mum of quadruplets Jannelle Snaddon shares her struggle with nutrition towards the end of her pregnancy when she was running out of room for food.

      Vitamin supplements

      As a woman carrying more than one baby, your energy and protein requirements are dramatically increased. This is because your resting energy expenditure is much greater than that of a woman carrying a singleton. What this means is that due to the increased maternal tissue you’re carrying you'll burn more calories at rest.

      And, this, of course, affects your vitamin and mineral levels, which have a significant impact on the growth and development of your babies.

      Maternal-Fetal Medicine Specialist Professor Craig Pennell explains that vitamin supplementation is a lot more important in twins than in singletons, and it’s actually not for the baby it’s more for the mother. He says the babies will take what they need from the mother almost always, which leads to the mother losing calcium from her bones. She will also lose iron because she’s making an extra litre-and-a-half to two-litres of maternal blood, plus two placentas, plus two baby blood volumes, all of which uses up iron.

      Professor Pennell advises all women carrying multiples to take a good pregnancy multivitamin, more folate than normal, iron, and calcium in a preventable manner at the very beginning of their pregnancy.

      When the vast majority of women become iron deficient in pregnancy, and when we know it’s going to happen to all twins, the best thing to do is to start supplementing early.” ~Maternal Fetal Medicine Specialist Professor Craig Pennell~

      Tweet This

      “When the vast majority of women become iron deficient in pregnancy, and when we know it’s going to happen to all twins, the best thing to do is to start supplementing early,”

      “That way if you get side effects from the iron, missing a few days here and there isn’t an issue when you’re looking at it over a seven-or-eight-month period,”

      “Whereas if you’re trying to cram all of your iron in at 30-weeks to have it fixed before your delivery then it becomes a much bigger problem,” he says.

      Hyperemesis

      It’s no secret that vomiting and hyperemesis are much more common in multiple pregnancies because you have two, three, or even four times the pregnancy hormones.

      “Vomiting and hyperemesis are much more common in multiple pregnancies because you have two, three, or even four times the pregnancy hormones.”

      ~ Maternal-Fetal Medicine Specialist Professor Craig Pennell~

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      Professor Craig Pennell tells us that the first trimester is usually the most challenging and the best advice, if this is the case, is to keep down whatever you can and not be too worried about it, with water being the most important thing.

      Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson was hospitalised with hyperemesis in her first trimester and struggled to eat anything substantial for the first 18 weeks of her twin pregnancy. She even had a short stay in the hospital to get some intravenous fluids in.

      “The main thing for me was managing my life with the hyperemesis,”

      “I was fairly well bedridden for a large chunk of my pregnancy,” admits Elyse.

      Elyse says that simply keeping hydrated and trying to eat any food was a struggle and there was a period where she couldn’t even keep water down.

      “I’m the kind of person who eats organic food and eats the rainbow of vegetables and things but I couldn’t stomach most things for weeks at a time,” says Elyse.

      Despite being quite a small person Elyse didn’t lose any weight during the height of her hyperemesis. And, when she was able to eat again she says managed to maintain consistent weight gain by listening to her body and eating her usual diet.

      Carbohydrates and Protein

      Mum of quadruplets Jannelle Snaddon says despite being pregnant with quadruplets she didn’t struggle with eating as much as she expected.

      “The first two trimesters I found that I needed heavy foods, so I ate a lot of carbohydrates, I ate a lot of protein because I was told that that was good to give the babies a chance,”

      “I was definitely gonna have them early, so everything that I could give them was the best for them growing,” says Jannelle.

      “The first two trimesters I found that I needed heavy foods, so I ate a lot of carbohydrates, I ate a lot of protein because I was told that that was good to give the babies a chance.”

      ~Mum of Quadruplets, Jannelle Snaddon~

      Tweet This

      Jannelle believes eating all the heavy foods at the beginning of her pregnancy helped ward off the intense sickness that most other mums of multiples struggle with early on in their pregnancy.

      Heading towards the end of her pregnancy, Janelle went inpatient at 26-weeks’ gestation and the nurses started making her protein drinks to get enough nutrition in.

      “The hospital also had a resource juice drink, which was protein based, which made it a lot easier to fit everything in there amongst the four bambinos,” says Jannelle.

      When there is no room for food

      According to Professor Pennell the critical time for weight gain in multiples is from 16-to-30 weeks, and then it tends to plateau off at the end.

      “The problem is once you get past about 28-to-30 weeks there’s no room left in your abdomen, so even eating can start to become difficult,” he says.

      The Importance of Weight Gain in Multiple Pregnancies

      The other thing which some women struggle with is the concept of weight gain in pregnancy. In twin pregnancies, there’s very good data to show that the mother needs to gain 12-15 kilograms across the pregnancy, otherwise they will get growth restriction in their babies, according to Professor Craig Pennell.

      “For some women, weight gain in pregnancy is very easy,”

      “For other women, such as athletes or those who have jobs that require them to have a particular appearance, the concept of gaining 15 kilos goes against their habits and they will struggle greatly with the concept of gaining weight,”

      “For those women who struggle to gain weight, protein supplement drinks, sustagen, or protein milkshakes between meals can often help," says Professor Pennell.

      “In twin pregnancies, there’s very good data to show that the mother needs to gain 12-15 kilos across the pregnancy otherwise they will get growth restriction in their babies.”

      ~Maternal Fetal Medicine Specialist Professor Craig Pennell~

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      Where is the weight being gained?

      By the end of your pregnancy with twins you’re looking at:

      • Two extra litres of blood - 2kgs

      • a placenta – 1 kg

      • Two babies – 2.5kgs each

      • Breast tissue – 2kgs

      
      

      Total – Approximately 10kgs

      “If you’re gaining less weight than 12 kilos you’re actually losing your own weight and that usually comes from muscle,”

      “Diet in pregnancy is very complex so if there are any issues, it is worth seeing a good dietician,” suggests Professor Pennell.

      The Consequences of Inadequate Weight Gain in Multiple Pregnancies

      Professor Pennell explains that the harm of inadequate weight gain during multiple pregnancies almost exclusively is that the babies fail to reach their optimal weight.

      “If you’re a small baby that’s been small from the start, and you’re born small, you’ll be small later on, and that’s okay,”

      “If, however, you’re the child of two six-foot parents, and you don’t reach that potential, then your body is set up for a hostile environment and you’re more likely to get high blood pressure, diabetes, obesity, stroke, and all of the significant adult diseases,” warns Associate Professor Pennell.

      What you need to know about nutrition and weight gain in your multiple pregnancy

      There are no specific dietary guidelines for multiple pregnancies, however, as Pregnancy Dietician and Nutritionist Jessica Ruescher from Essence of Eating explains, the calories/energy needed each day depends on your pre-pregnancy weight, genetic makeup, and cultural background.

      Jessica says as a rough guide, recommendations for total calorie intake per day would be about 3500 calories or 14,700kJ, which is a lot of food.

      “You need to eat FIVE serves of vegetables/salad per day, TWO serves of fruit per day, eight-and-a-half serves of bread and cereals per day, three-and-a-half serves of protein per day, and two-and-a-half serves of dairy or dairy alternatives per day.

      This is what that looks like:

      Breakfast

      A bowl of rolled oats with cow’s milk, milk alternative, or yoghurt with nuts seeds and dried or fresh fruit.

      Or

      Two pieces of wholegrain toast with egg/avocado/ tomato/cheese.

      Morning Tea

      A piece of fruit with fruit toast or a small tub of yoghurt.

      Lunch

      Chicken, tuna, beef, tofu, or lentil patties with salad on a multigrain roll.

      Or

      Roasted vegetables/salad with nuts, cheddar cheese, brown rice, or barley.  Add extra virgin olive oil as a dressing to taste.

      Afternoon Tea

      Wholegrain Vita Weats with peanut or almond butter and banana.

      Or

      Veggie sticks with hummus, Greek yoghurt, or tomato salsa. Along with nuts and seeds or a piece of cheese.

      Dinner

      Red meat, chicken, fish, tempeh, tofu, or lentil patties with wholegrain carbohydrates such as quinoa, pasta, noodles, or rice with plenty of vegetables or salad.

      Ideally at least half of this meal should be veggies or salad.

      After dinner snack

      A glass of milk with Milo or Acta-Vite, a small tub of Greek yoghurt, a handful of nuts, or a piece of fruit.

      Third Trimester

      When it comes to trimester three, and you’re struggling to fit a large meal in you can break your plate up into smaller quantities.

      For example:

      6:30 am – Eat half the quantity of breakfast oats.

      [8:30]-9 am - Have the other half of your breakfast oats.

      [10:30] – One piece of fruit.

      12:30 pm – Half meat and salad roll.

      2:30 pm – Yoghurt.

      [4:30] – One piece of fruit or some nuts.

      [6:30] – Half dinner meal.

      [8:30] – 9 pm – The remaining half of your dinner.

      Jessica agrees with Associate Professor Pennell and says women carrying multiples should be aware that it’s quite difficult to get all the nutrients you’ll need from food alone. That’s why it’s crucial to supplement with good quality pregnancy vitamins before, during, and after your pregnancy

      Recommended Supplementation Guide

      	SINGLETON	MULTIPLE FETUS
      Iron	16-20mg/d (total 27mg/d)	30mg/day
      Folate	200ug/day	1mg/day
      Iodine	150ug/day
      Calcium		2000-2500mg/day
      Vitamin D		1000 IU/day
      Omega 3 fatty acids		300-500mg/day DHA/EPA

      “If you’re unsure what your individual nutritional requirements are, ask your doctor to recommend a dietician who specialises in nutrition in multiple pregnancies.”

      ~Jessica Ruescher~

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      Sally’s story

      You might remember my story of not realising my intense sickness was due to pregnancy, well as the weeks went by and my doctor sent me for more tests to establish what was wrong, my weight continued to drop significantly. In fact, by the time it was clear I was pregnant I weighed about 50 kilograms.

      Now, by this stage, I was about 11 weeks pregnant and all I could manage to keep down were those sickly red and blue sports drinks, which isn’t ideal nutrition for trying to grow healthy babies. My obstetrician prescribed medication for the hyperemesis but after talking with my pharmacist I decided against taking it.

      So, it wasn’t until I was about 17 or 18 weeks pregnant that my sickness started to subside and I could eat substantial meals again.

      By the time the girls were born at 28 weeks’ gestation I had gained weight, but I only weighed 64 kilograms. Looking back, I would have benefitted from the guidance of a pregnancy nutritionist or dietician.

      Key Points:

      • Vomiting and hyperemesis are much more common in multiple pregnancies because you have two, three, or even four times the pregnancy hormones.
      • In the first trimester, keep down whatever you can and focus on your water intake.
      • Trimester two is when you should maximise your nutritional intake and weight gain.
      • Women with multiple pregnancies should take a good quality pregnancy multivitamin, more folate than]]>https://www.doublehappinessmultiplied.com/?p=1479Mon, 22 Jan 2018 09:10:24 -050031:47nofull13<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> &nbsp;<br /> Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> &nbsp;<br /> On this episode, we tackle the problem of hyperemesis in multiple pregnancies and explain how to maximise your nutrition when you’re too ill to keep anything down, or there’s simply no room left for food.<br /> Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell explains what happens to your body when you’re supplying nutrients to more than one baby at a time, and what supplements are required to ensure your vitamin and mineral needs are catered for.<br /> Pregnancy Dietician and Nutritionist Jessica Ruescher offers some practical advice on the types and amounts of foods you’ll need to eat, to maintain adequate weight gain during your pregnancy.<br /> Also, twin mum Elyse Jamieson and I talk about our experiences with hyperemesis, while mum of quadruplets Jannelle Snaddon shares her struggle with nutrition towards the end of her pregnancy when she was running out of room for food.<br /> Vitamin supplements<br /> As a woman carrying more than one baby, your energy and protein requirements are dramatically increased. This is because your resting energy expenditure is much greater than that of a woman carrying a singleton. What this means is that due to the increased maternal tissue you’re carrying you'll burn more calories at rest.<br /> And, this, of course, affects your vitamin and mineral levels, which have a significant impact on the growth and development of your babies.<br /> Maternal-Fetal Medicine Specialist Professor Craig Pennell explains that vitamin supplementation is a lot more important in twins than in singletons, and it’s actually not for the baby it’s more for the mother. He says the babies will take what they need from the mother almost always, which leads to the mother losing calcium from her bones. She will also lose iron because she’s making an extra litre-and-a-half to two-litres of maternal blood, plus two placentas, plus two baby blood volumes, all of which uses up iron.<br /> Professor Pennell advises all women carrying multiples to take a good pregnancy multivitamin, more folate than normal, iron, and calcium in a preventable manner at the very beginning of their pregnancy.<br /> <a href='https://twitter.com/share?text=+When+the+vast+majority+of+women+become+iron+deficient+in+pregnancy%2C+and+when+we+know+it%E2%80%99s+going...&url=https://www.doublehappinessmultiplied.com/?p=1479' target='_blank'> When the vast majority of women become iron deficient in pregnancy, and when we know it’s going to happen to all twins, the best thing to do is to start supplementing early.” ~Maternal Fetal Medicine Specialist Professor Craig Pennell~</a><a href='https://twitter.com/share?text=+When+the+vast+majority+of+women+become+iron+deficient+in+pregnancy%2C+and+when+we+know+it%E2%80%99s+going...+-+&url=https://www.doublehappinessmultiplied.com/?p=1479' target='_blank' class='spp-ctt-btn'>Tweet This</a><br /> “When the vast majority of women become iron deficient in pregnancy, and when we know it’s going to happen to all twins, the best thing to do is to start supplementing early,”<br /> “That way if you get side effects from the iron, missing a few days here and there isn’t an issue when you’re looking at it over a seven-or-eight-month period,”<br /> “Whereas if you’re trying to cram all of your iron in at 30-weeks to have it fixed before your delivery then it becomes a much bigger problem,” he says.<br /> Hyperemesis<br /> Sally Barker - Hypnotherapist5 Things You Need To Know Right Now About Your Multiple Pregnancy

         

        Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

        https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

        Welcome to Season One, Episode Two of the Double Happiness Multiplied podcast.

        On this episode, we’re joined by Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell who will give us some tips on what you should be asking during your appointments with your Specialist or Obstetrician.

        Sonographer Sam Ward explains what to expect at your ultrasound appointments at each stage of your pregnancy.

        And, Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson offers guidance about choosing the right support team for your pregnancy.

        The shock

        Finding out your expecting multiples can be quite a shock and can throw you into a world of confusion and anxiety. Knowing what questions to ask your obstetrician, midwife, or sonographer and when you should ask specific questions isn’t easy to navigate, especially for a first-time parent.

        A few questions you’ll want to ask your obstetrician are:

        • What type of placentation do my babies have?

        • What tests and procedures will I have to have?

        • What is your philosophy on delivering twins?

        • How many multiples have you delivered in the past few years,

        • And, how do I get in touch with you if needed?

        
        

        To guide you further, Maternal-Fetal Medicine Specialist Professor Craig Pennell has this advice:

        The first question you should ask your Obstetrician is what do I have to do in a twin pregnancy that is different from a singleton pregnancy?

        There are many things that are different in multiple pregnancies than in a singleton pregnancy, for example:

        • You’ll be seen more frequently

        • You’ll have more ultrasound scans

        • The vitamin supplementation is a lot more important

        
        

        Professor Pennell says the second question you should ask is what type of placenta do my multiples have, which means are your twins identical or non-identical?

        “The risk in Dichorionic Diamniotic or non-identical twins, outside of prematurity, are very similar to singleton pregnancies,”

        “Whereas, if you have identical twins, depending on the type, those risks can go up from a few per cent up to 20 or 30 per cent of pregnancies having adverse outcomes.

        "So, you really want to know if you are a low-risk twin pregnancy, a...]]>

         

        Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

        https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

        Welcome to Season One, Episode Two of the Double Happiness Multiplied podcast.

        On this episode, we’re joined by Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell who will give us some tips on what you should be asking during your appointments with your Specialist or Obstetrician.

        Sonographer Sam Ward explains what to expect at your ultrasound appointments at each stage of your pregnancy.

        And, Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson offers guidance about choosing the right support team for your pregnancy.

        The shock

        Finding out your expecting multiples can be quite a shock and can throw you into a world of confusion and anxiety. Knowing what questions to ask your obstetrician, midwife, or sonographer and when you should ask specific questions isn’t easy to navigate, especially for a first-time parent.

        A few questions you’ll want to ask your obstetrician are:

        • What type of placentation do my babies have?

        • What tests and procedures will I have to have?

        • What is your philosophy on delivering twins?

        • How many multiples have you delivered in the past few years,

        • And, how do I get in touch with you if needed?

        
        

        To guide you further, Maternal-Fetal Medicine Specialist Professor Craig Pennell has this advice:

        The first question you should ask your Obstetrician is what do I have to do in a twin pregnancy that is different from a singleton pregnancy?

        There are many things that are different in multiple pregnancies than in a singleton pregnancy, for example:

        • You’ll be seen more frequently

        • You’ll have more ultrasound scans

        • The vitamin supplementation is a lot more important

        
        

        Professor Pennell says the second question you should ask is what type of placenta do my multiples have, which means are your twins identical or non-identical?

        “The risk in Dichorionic Diamniotic or non-identical twins, outside of prematurity, are very similar to singleton pregnancies,”

        “Whereas, if you have identical twins, depending on the type, those risks can go up from a few per cent up to 20 or 30 per cent of pregnancies having adverse outcomes.

        "So, you really want to know if you are a low-risk twin pregnancy, a moderate-risk twin pregnancy, or very high-risk twin pregnancy,” says Professor Pennell.

        “You really want to know if you are a low-risk twin pregnancy, a moderate-risk twin pregnancy, or very high-risk twin pregnancy. The care that you will get and your expectations will be very different depending on what group you are in.”

        Time of delivery

        With modern obstetric care and based on the most recent data, most twin pregnancies are delivered by the end of their 37^th week.

        “With Dichorionic Diamniotic twins, if the woman hasn't gone into labour by 37-weeks, then they will be induced or they have a planned caesarean section,”

        “The reason for that is the rate of stillbirth starts to increase dramatically.  That’s where that window of 37-weeks comes from,” says Associate Professor Pennell.

        Recommended times to deliver twins:

        • Dichorionic-Diamniotic twins – 37-weeks’ gestation.
        • Monochorionic - twins 36-weeks’ gestation.
        • Monoamniotic twins - 30-32 weeks or as early as 28 weeks’ gestation.

        
        

        Multiple pregnancy protocols

        Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson says after having a singleton pregnancy and birth, and then a twin pregnancy and birth she noticed a lot more protocols in place for multiple pregnancies, and oftentimes those protocols might not be relevant to you and your babies.

        “I think a lot of the time especially for multiple births, but also even just for singletons, we go into the hospital system and we’re put on a little conveyor belt and we just go through that system, travel through and all of the protocols are told to us and we just follow them along,”

        “So, I’d be asking what does that protocol mean to me and my babies, and is it appropriate for me to have this intervention, or have this scan, or have this test,” explains Elyse.

        Elyse says if you use this following list of questions, it can make the choice to have or not-to-have an intervention or a test much easier.

        What are the Benefits of this procedure or test?

        What are the Risks associated with it or what are the Risks if I don’t have it?

        What are the Alternatives to this?

        What’s my Intuition telling me about this?

        And what happens if we just do Nothing for the moment?

        Communication = Less Stress

        Another key part Elyse advocates for is creating minimal stress during your multiple pregnancy and the best way to go about this is to simply communicate your wishes to everyone on your team so they all can support your wishes.

        “When something crops up it’s so easy to move through it,”

        “That’s how I feel my birth and pregnancy went as smoothly as it did was that everyone knew what I wanted,” says Elyse.

        This all sounds very empowering; however, Elyse warns that if you’re challenging the norm, make sure you have researched the protocols first. Instead of making demands, try asking questions along the lines of,

        "I know this is your protocol, but what happens if we try it this way?"

        "Is that an option for me?"

        "Here’s all the research I’ve done on it, what do you think about that?"

        You’re more likely to find a sympathetic ear that way.

        “So, going in and asking the questions and finding out if your care team is supportive of that, or if there is someone down the road who is skilled in that or who does work in that way,”

        “Choosing those people you have around you is the most important thing,”

        “I would absolutely be recommending women who do have more than one baby on board to go out there and do their research, or go out there and find a childbirth educator, or a doula, or a midwife, or someone who can help you navigate all the protocols and systems in place,” says Elyse

        Your Sonographer

        Just as important as having a team that you’re confident with to guide you through your pregnancy, a sonographer who is skilled in multiple pregnancies is also crucial to not only your diagnosis but how the management of your pregnancy is handled.

        Samantha Ward is a sonographer who has worked with Multiple Births Specialists for more than a decade. She agrees that the more informed you are about what to expect during your pregnancy you’ll be more prepared for each milestone or hurdle.

        She says the most important thing is to check what type of twins you’re having or what type of higher order multiple you’re having because the obstetric care differs very greatly between Dichorionic (fraternal) and Monochorionic(identical) twins.

        “Dichorionic twins are the least complicated set of twins and Monochorionic twins can develop various potential complications because they actually share a placenta,”

        “So, knowing whether the twins are Dichorionic or Monochorionic will greatly change the obstetric care and the number of scans that the patient will have during their pregnancy,” says Samantha.

        Once it’s been established that you have Monochorionic twins on board, whether that’s part of a twin, triplet, or quadruplet pregnancy the schedule of scanning would look something like this:

        • Dating scan

        • 12-weeks’ gestation – to assess for chromosomal abnormalities, stages of early development, and cord insertion.

        • 15-weeks’ gestation - to assess for chromosomal abnormalities, stages of early development, and cord insertion.

        • 19-weeks’ – anatomy scan.

        • Then, every 2-3 weeks, if there are no complications.

        
        

        For Monochorionic Monoamniotic gestations:

        • Dating scan

        • 12-weeks’ gestation – to assess for chromosomal abnormalities, stages of early development, and cord insertion.

        • 15-weeks’ gestation - to assess for chromosomal abnormalities, stages of early development, and cord insertion.

        • 19-weeks’ – anatomy scan.

        • Then, bi-weekly progressing to daily with inpatient care at about 26-weeks’ gestation.

        
        

        For Dichorionic gestations:

        • Dating scan

        • 12-weeks’ gestation – to assess for chromosomal abnormalities, stages of early development, and cord insertion.

        • 15-weeks’ gestation - to assess for chromosomal abnormalities, stages of early development, and cord insertion.

        • 19-weeks’ – anatomy scan

        • Then, every four-weeks if there are no complications.

        
        

        With multiple pregnancies, there are things that are examined more closely than a singleton pregnancy. Equally, with a Monochorionic set of twins, there are some things that are looked at more closely than in a set of Dichorionic twins.

        “So, with the Dichorionic, or non-identical twins, we compare the babies’ growth to see if the babies are growing along the same centile, and are both the babies are growing along the centile that we’d expect for their gestational age,”

        “We also need to check to see if the fluid is equal in both of the sacs,"

        "Even though Dichorionic twins have their own placentas and don’t share any blood flow through the placentas, however, they are still at a higher risk of structural anomalies,"

        "So, even these least complicated twins are at risk of heart anomalies and various other structural anomalies,” says Samantha.

        What is being assessed?

        Dichorionic

        • Growth.

        • Fluid volumes.

        • Placental function.

        • Structural anomalies.

        
        

        With Monochorionic twins there are quite a few different tests that are required for each scan.

        • Growth.

        • Fluid volumes.

        • Bladders – does one baby have a full bladder and the other an empty bladder?

        • Examination of the dividing membrane to ensure it is floating freely.

        • Placental cord insertions.

        • Placental appearance.

        • Fetal Doppler studies – checking the blood flow through the cord of each baby, blood flow through the middle cerebral artery, and the blood flow through the Ductus Venosus.

        • Structural anomalies.

        
        

        “All of those components that we’re looking at add together to tell us the health of the baby,

        "It also tells us, are the babies sharing the placenta equally because Monochorionic twins are at risk of various complications due to the shared placenta, the most common one being twin-to-twin transfusion syndrome,” explains Samantha.

        What Does That Mean?

        Women are very informed about their pregnancies and come to ultrasound appointments prepared and often armed with a raft of questions. Some of the most common and useful questions you can ask your sonographer are:

        • Are my babies growing nicely?

        • Are they of equal size?

        • Is there a normal amount of fluid in the babies’ sacs?

        • Are the blood flows in the cord and the brain looking okay?

        • Is the placenta looking healthy?

        • Where is the cord inserting into the placenta?

        
        

        “I find it, as a Sonographer, very useful if patients ask me these question at the time because I like to show them as I’m scanning in real time the fluid around their babies, I like to show them the blood flows through the cord and to the brain,”

        “If there is a complication developing, I find that the patient has a better understanding if we can actually show them, for example, the difference in the fluid in both of the sacs,” says Samantha.

        It isn’t, however, the role of the Sonographer to diagnose or advise patients on available treatment options.

        Remember, whether you’re navigating the public or the private system, you have the right to have your questions answered. And, if you find yourself negotiating protocols, remember to approach the situation armed with plenty of research.

        KEY POINTS:

        • You will visit your obstetrician more regularly with a multiple pregnancy than with a singleton.

        • Knowing whether you have Dichorionic or Monochorionic gestations will greatly change the obstetric care and the number of scans you will have during your pregnancy.

        • Whether you’re navigating the public or the private system, you have the right to have your questions answered.

        • If you’re challenging the norm, make sure you have researched the protocols first.

        • Choosing people with experience in multiple births to be on your support team is crucial.

        
        

        NEXT EPISODE

        On episode THREE, we talk about the impact nutrition has at every stage of your multiple pregnancy.

        Maternal-Fetal Medicine Specialist Professor Craig Pennell joins us again, explaining the currently suggested supplementation required to provide adequate vitamins and minerals for multiple foetuses.

        Nutritionist and Dietician Jessica Ruescher from Essence of Eating tells us how to make the correct decisions about food to capitalise on your nutritional intake for the health of you and your babies.

        And, I’ll share my story of losing a significant amount of weight in my first trimester before realising I was pregnant and the battle to gain weight while suffering hyperemesis.

        Until next time…

        I wish you Double Happiness ... Multiplied.

        LINKS:

        Double Happiness Multiplied Book

        https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

        Double Happiness Multiplied 

        www.doublehappinessmultiplied.com

        Podcast music by:

        Catherine Ashley Harpist

        www.facebook.com/catherineashleyharpist

        www.catherineashleyharpist.com

        www.facebook.com/waharpcentre

        www.waharpcentre.com.au

        Produced by:

        Stuart James

        Soundfield Studio

        http://www.soundfieldstudio.com/

        Voiceover:

        Louise Rowe

        https://www.linkedin.com/in/louise-rowe-88aa5a95/

        RESOURCES:

        Helping Little Hands

        https://www.facebook.com/helpinglittlehandsAustralia/

        http://www.helpinglittlehands.org

        hello@helpinglittlehands.org

        Elyse Jamieson
        Hypnobirthing Australia Practitioner & Doula, Soma Birth

        http://www.somabirth.com.au

        elyse@somabirth.com.au

        Australian Multiple Birth Association

        https://www.amba.org.au/

        Perth & Districts Multiple Birth Association

        http://www.pdmba.org.au/

        Multiples of America

        http://www.multiplesofamerica.org/

        Twins & Multiple Births Association

        https://www.tamba.org.uk

        The Multiple Births Foundation

        http://www.multiplebirths.org.uk/

        Irish Multiple Births Association

        http://www.imba.ie/

        Multiple Births Canada

        https://www.doublehappinessmultiplied.com/?p=1475Mon, 22 Jan 2018 08:36:08 -050019:07nofull12<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> <br /> Welcome to Season One, Episode Two of the Double Happiness Multiplied podcast.<br /> On this episode, we’re joined by Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell who will give us some tips on what you should be asking during your appointments with your Specialist or Obstetrician.<br /> Sonographer Sam Ward explains what to expect at your ultrasound appointments at each stage of your pregnancy.<br /> And, Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson offers guidance about choosing the right support team for your pregnancy.<br /> The shock<br /> Finding out your expecting multiples can be quite a shock and can throw you into a world of confusion and anxiety. Knowing what questions to ask your obstetrician, midwife, or sonographer and when you should ask specific questions isn’t easy to navigate, especially for a first-time parent.<br /> A few questions you’ll want to ask your obstetrician are:<br /> <br /> * <br /> What type of placentation do my babies have?<br /> <br /> * <br /> What tests and procedures will I have to have?<br /> <br /> * <br /> What is your philosophy on delivering twins?<br /> <br /> * <br /> How many multiples have you delivered in the past few years,<br /> <br /> * <br /> And, how do I get in touch with you if needed?<br /> <br /> <br /> To guide you further, Maternal-Fetal Medicine Specialist Professor Craig Pennell has this advice:<br /> The first question you should ask your Obstetrician is what do I have to do in a twin pregnancy that is different from a singleton pregnancy?<br /> There are many things that are different in multiple pregnancies than in a singleton pregnancy, for example:<br /> <br /> * <br /> You’ll be seen more frequently<br /> <br /> * <br /> You’ll have more ultrasound scans<br /> <br /> * <br /> The vitamin supplementation is a lot more important<br /> <br /> <br /> Professor Pennell says the second question you should ask is what type of placenta do my multiples have, which means are your twins identical or non-identical?<br /> “The risk in Dichorionic Diamniotic or non-identical twins, outside of prematurity, are very similar to singleton pregnancies,”<br /> “Whereas, if you have identical twins, depending on the type, those risks can go up from a few per cent up to 20 or 30 per cent of pregnancies having adverse outcomes.<br /> "So, you really want to know if you are a low-risk twin pregnancy, a moderate-risk twin pregnancy, or very high-risk twin pregnancy,” says Professor Pennell.<br /> “You really want to know if you are a low-risk twin pregnancy, a moderate-risk twin pregnancy, or very high-risk twin pregnancy. The care that you will get and your expectations will be very different depending on what group you are in.”<br /> Time of delivery<br /> With modern obstetric care and based on the most recent data, most twin pregnancies are delivered by the end of their 37th week.<br /> “With Dichorionic Diamniotic twins, if the woman hasn't gone into labour by 37-weeks, then they will be induced or they have a planned caesarean section,”<br /> “The reason for that is the rate of stillbirth starts to increase dramatically.  That’s where that window of 37-weeks comes from,” says Associate Professor Pennell.<br /> Recommended times to deliver twins:<br /> <br /> * Dichorionic-Diamniotic twins – 37-weeks’ gestation.<br /> * Monochorionic - twins 36-weeks’ gestation.<br /> * Monoamniotic twins - 30-32 weeks or as early as 28...Sally Barker - HypnotherapistEverything you Need to Know about Higher Order Multiples

         

        Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

        https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

         

        On this episode of the podcast, we discuss Higher Order Multiples (HOM).

        We hear from Chair in Obstetrics and Gynaecology and Professor Fetal Medicine, Head of Discipline Obstetrics and Gynaecology at the University of Newcastle and John Hunter Hospital Professor Craig Pennell who explains the different types of Higher Order Multiples and what to expect from your pregnancy.

        Triplet mum Laura Sarubin talks about her experience of finding out she was having triplets and how she tried to normalise the pregnancy as much as possible.

        And, Jannelle Snaddon shares her story of infertility, her journey with IVF, and how she was hoping for one baby and ended up with four – Quadruplets.

        Types of HOMs

        Professor Pennell explains the three patterns of combinations with triplets.

        1. Three eggs that are fertilised by three different sperm known as a Trichorionic Triamniotic pregnancy.
        2. Monochorionic twins and a singleton, known as a Dichorionic Triamniotic pregnancy.
        3. Monochorionic triplets, known as a Monochorionic Triamniotic.

        
        

        For quadruplet pregnancies, most are where four eggs are fertilised by four different sperm, known as a Quadrachorionic Quadramniotic pregnancy, however, you can also have twins and two singletons. It’s also theoretically possible to have two sets of identical twins but it’s extremely rare, according to Professor Craig Pennell.

        Enjoy Your Pregnancy and Ask For Help

        The trick with HOMs is that you want to do as much as you can early on. You’ll want to sort out the type of HOM you’ve got, make sure you’ve got great care and great imaging, and that you’re optimising the situation in terms of your haemoglobin, so ensuring you have enough iron, calcium, and vitamins.

        Enjoy your second trimester and during that time take as much help from your friends as possible.

        “My advice is to buy a second or third freezer and whenever someone offers to help you say it would be great if you could make me a few frozen casseroles, and you just fill those freezers up such that you’ve got all these resources for later,”

        “If you’re in a good situation physically and metabolically by the time you get to 22-24 weeks, and you’re being cared for by a great team then you can feel confident that you will get through the situation,” says Professor Pennell.

        Professor Pennell insists that if you’re one of the unlucky people who starts contracting early, bleeding, or has some complications, seek medical help quickly. In this situation, you will be]]>

         

        Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

        https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

         

        On this episode of the podcast, we discuss Higher Order Multiples (HOM).

        We hear from Chair in Obstetrics and Gynaecology and Professor Fetal Medicine, Head of Discipline Obstetrics and Gynaecology at the University of Newcastle and John Hunter Hospital Professor Craig Pennell who explains the different types of Higher Order Multiples and what to expect from your pregnancy.

        Triplet mum Laura Sarubin talks about her experience of finding out she was having triplets and how she tried to normalise the pregnancy as much as possible.

        And, Jannelle Snaddon shares her story of infertility, her journey with IVF, and how she was hoping for one baby and ended up with four – Quadruplets.

        Types of HOMs

        Professor Pennell explains the three patterns of combinations with triplets.

        1. Three eggs that are fertilised by three different sperm known as a Trichorionic Triamniotic pregnancy.
        2. Monochorionic twins and a singleton, known as a Dichorionic Triamniotic pregnancy.
        3. Monochorionic triplets, known as a Monochorionic Triamniotic.

        
        

        For quadruplet pregnancies, most are where four eggs are fertilised by four different sperm, known as a Quadrachorionic Quadramniotic pregnancy, however, you can also have twins and two singletons. It’s also theoretically possible to have two sets of identical twins but it’s extremely rare, according to Professor Craig Pennell.

        Enjoy Your Pregnancy and Ask For Help

        The trick with HOMs is that you want to do as much as you can early on. You’ll want to sort out the type of HOM you’ve got, make sure you’ve got great care and great imaging, and that you’re optimising the situation in terms of your haemoglobin, so ensuring you have enough iron, calcium, and vitamins.

        Enjoy your second trimester and during that time take as much help from your friends as possible.

        “My advice is to buy a second or third freezer and whenever someone offers to help you say it would be great if you could make me a few frozen casseroles, and you just fill those freezers up such that you’ve got all these resources for later,”

        “If you’re in a good situation physically and metabolically by the time you get to 22-24 weeks, and you’re being cared for by a great team then you can feel confident that you will get through the situation,” says Professor Pennell.

        Professor Pennell insists that if you’re one of the unlucky people who starts contracting early, bleeding, or has some complications, seek medical help quickly. In this situation, you will be transferred to a tertiary centre, if you’re not already there, and you’ll be given steroids which optimises the outcomes for each of the babies.

        “The benefit of being administered corticosteroid at 23-weeks reduces the mortality by 50 percent,”

        It’s important to be realistic and understand that there will be tough times. You are going to have good days and bad days.

        "If you are showing signs of post-natal depression, get onto it, get it treated, seek help, see a psychologist, start taking medication if you need it,” urges Professor Pennell.

        Key Points

        • Monochorionic Triamniotic, or identical triplets, are delivered around 32-34 weeks.

        • In terms of quads and quins, the aim is to get as close to 30-weeks’ gestation as possible.

        • The benefit of being administered corticosteroid at 23-weeks’ gestation is that it reduces the mortality by 50 percent.

        • Between 8-and-12 weeks’ gestation is the best time to formally classify Higher Order Multiples.

        • There is a greater chance of miscarrying one or all of the babies in a HOM pregnancy than a twin pregnancy, simply because there are more embryos to lose.

        
        

        Remember, there are some great FREE downloads on the Double Happiness Multiplied website with diagrams that explain the types of Higher Order Multiples we’ve learned about in this episode.

        I hope you’ll join me on Episode Two where we hear from Professor Craig Pennell again who gives us some tips on what you should be asking your specialist, Sonographer Sam Ward walks us through what to expect during your ultrasounds, and twin mum Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson shines a light on your right to choose your care providers.

        Until next time…

        I wish you Double Happiness ... Multiplied.

        LINKS:

        https://www.doublehappinessmultiplied.com/blog/types-multiples-part-two-higher-order-multiples/

        Australian Multiple Birth Association

        https://www.amba.org.au/

        Perth & Districts Multiple Birth Association

        http://www.pdmba.org.au/

        Multiples of America

        http://www.multiplesofamerica.org/

        Twins & Multiple Births Association

        https://www.tamba.org.uk

        The Multiple Births Foundation

        http://www.multiplebirths.org.uk/

        Irish Multiple Births Association

        http://www.imba.ie/

        Multiple Births Canada

        http://multiplebirthscanada.org/

        ]]>https://www.doublehappinessmultiplied.com/?p=1469Mon, 22 Jan 2018 07:44:37 -050018:32nofull11<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> &nbsp;<br /> On this episode of the podcast, we discuss Higher Order Multiples (HOM).<br /> We hear from Chair in Obstetrics and Gynaecology and Professor Fetal Medicine, Head of Discipline Obstetrics and Gynaecology at the University of Newcastle and John Hunter Hospital Professor Craig Pennell who explains the different types of Higher Order Multiples and what to expect from your pregnancy.<br /> Triplet mum Laura Sarubin talks about her experience of finding out she was having triplets and how she tried to normalise the pregnancy as much as possible.<br /> And, Jannelle Snaddon shares her story of infertility, her journey with IVF, and how she was hoping for one baby and ended up with four – Quadruplets.<br /> Types of HOMs<br /> Professor Pennell explains the three patterns of combinations with triplets.<br /> <br /> * Three eggs that are fertilised by three different sperm known as a Trichorionic Triamniotic pregnancy.<br /> * Monochorionic twins and a singleton, known as a Dichorionic Triamniotic pregnancy.<br /> * Monochorionic triplets, known as a Monochorionic Triamniotic.<br /> <br /> For quadruplet pregnancies, most are where four eggs are fertilised by four different sperm, known as a Quadrachorionic Quadramniotic pregnancy, however, you can also have twins and two singletons. It’s also theoretically possible to have two sets of identical twins but it’s extremely rare, according to Professor Craig Pennell.<br /> Enjoy Your Pregnancy and Ask For Help<br /> The trick with HOMs is that you want to do as much as you can early on. You’ll want to sort out the type of HOM you’ve got, make sure you’ve got great care and great imaging, and that you’re optimising the situation in terms of your haemoglobin, so ensuring you have enough iron, calcium, and vitamins.<br /> Enjoy your second trimester and during that time take as much help from your friends as possible.<br /> “My advice is to buy a second or third freezer and whenever someone offers to help you say it would be great if you could make me a few frozen casseroles, and you just fill those freezers up such that you’ve got all these resources for later,”<br /> “If you’re in a good situation physically and metabolically by the time you get to 22-24 weeks, and you’re being cared for by a great team then you can feel confident that you will get through the situation,” says Professor Pennell.<br /> Professor Pennell insists that if you’re one of the unlucky people who starts contracting early, bleeding, or has some complications, seek medical help quickly. In this situation, you will be transferred to a tertiary centre, if you’re not already there, and you’ll be given steroids which optimises the outcomes for each of the babies.<br /> “The benefit of being administered corticosteroid at 23-weeks reduces the mortality by 50 percent,”<br /> It’s important to be realistic and understand that there will be tough times. You are going to have good days and bad days.<br /> "If you are showing signs of post-natal depression, get onto it, get it treated, seek help, see a psychologist, start taking medication if you need it,” urges Professor Pennell.<br /> Key Points<br /> <br /> * <br /> Monochorionic Triamniotic, or identical triplets, are delivered around 32-34 weeks.<br /> <br /> * <br /> In terms of quads and quins, the aim is to get as close to 30-weeks’ gestation as possible.<br /> <br /> * <br /> The benefit of being administered corticosteroid at 23-weeks’...Sally Barker - HypnotherapistEverything yo Need to Know about Different Types of Twins

        Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

        https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

         

         

         

        Welcome to Season One of Double Happiness Multiplied.

        On Episode One, Part One, we get clear on what type of multiple you’re carrying and what that means for your pregnancy.

        We hear from Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell who clears up some of the misconceptions surrounding whether your babies are identical or not, and how oftentimes your sonographer or obstetrician might give you a misdiagnosis.

        Rebecca Perrie shares her story of going through her twin pregnancy thinking she was carrying fraternal, or non-identical twins, to only find out later on that her girls are in fact identical.

        Jodie Wiren takes us on her journey with one of the rarest types of multiples – Monochorionic Monoamniotic twins or MoMos.

        Also, Hypnobirthing Practitioner and Doula Elyse Jamieson tell us how when she found out she was expecting fraternal twins, she was determined to learn everything she could in order to make confident decisions that were specific to her situation.

        And, I share my story about the shock of learning that I was carrying identical twins and that there were serious complications.

        On part two of this episode, we’ll focus on Higher Order Multiples. Laura Sarubin tells us about her journey with identical triplet girls and Jannelle Snaddon explains how she had to grow a uterus to have a baby and ended up with quadruplets.

        By the end of Episode One, you’ll be quite familiar with terms like Zygosity, Chorionicity, and Placentation so you’ll have the knowledge you’ll need to be proactive when attending your medical appointments.

         

        Key Points:

        • A zygote is a fertilised egg.
        • Fraternal twins are Dizygotic, which means two eggs have been fertilised by two sperm.
        • Monozygotic twins are where one egg is fertilised by one sperm and then that egg divides at some stage in the first two weeks after fertilisation.
        • You can get Dichorionic Diamniotic twins where some are identical and some are non-identical.
        • Monochorionic Diamniotic twins sharing a placenta are always identical.
        • The rate of identical twins is fixed across the world at 1-in-every 285 pregnancies.
        • Of those, just 1-percent are the rarest type, which is Monochorionic Monoamniotic.
        • Monochorionic Monoamniotic twins are also identical, however, they share the same amniotic sac, which poses increased risks during pregnancy and requires significant monitoring.

        
        

        Thank you for listening to Part One of Episode One, Season ONE of Double Happiness Multiplied. There are some great FREE downloads on the Double Happiness...]]>

        Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

        https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

         

         

         

        Welcome to Season One of Double Happiness Multiplied.

        On Episode One, Part One, we get clear on what type of multiple you’re carrying and what that means for your pregnancy.

        We hear from Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell who clears up some of the misconceptions surrounding whether your babies are identical or not, and how oftentimes your sonographer or obstetrician might give you a misdiagnosis.

        Rebecca Perrie shares her story of going through her twin pregnancy thinking she was carrying fraternal, or non-identical twins, to only find out later on that her girls are in fact identical.

        Jodie Wiren takes us on her journey with one of the rarest types of multiples – Monochorionic Monoamniotic twins or MoMos.

        Also, Hypnobirthing Practitioner and Doula Elyse Jamieson tell us how when she found out she was expecting fraternal twins, she was determined to learn everything she could in order to make confident decisions that were specific to her situation.

        And, I share my story about the shock of learning that I was carrying identical twins and that there were serious complications.

        On part two of this episode, we’ll focus on Higher Order Multiples. Laura Sarubin tells us about her journey with identical triplet girls and Jannelle Snaddon explains how she had to grow a uterus to have a baby and ended up with quadruplets.

        By the end of Episode One, you’ll be quite familiar with terms like Zygosity, Chorionicity, and Placentation so you’ll have the knowledge you’ll need to be proactive when attending your medical appointments.

         

        Key Points:

        • A zygote is a fertilised egg.
        • Fraternal twins are Dizygotic, which means two eggs have been fertilised by two sperm.
        • Monozygotic twins are where one egg is fertilised by one sperm and then that egg divides at some stage in the first two weeks after fertilisation.
        • You can get Dichorionic Diamniotic twins where some are identical and some are non-identical.
        • Monochorionic Diamniotic twins sharing a placenta are always identical.
        • The rate of identical twins is fixed across the world at 1-in-every 285 pregnancies.
        • Of those, just 1-percent are the rarest type, which is Monochorionic Monoamniotic.
        • Monochorionic Monoamniotic twins are also identical, however, they share the same amniotic sac, which poses increased risks during pregnancy and requires significant monitoring.

        
        

        Thank you for listening to Part One of Episode One, Season ONE of Double Happiness Multiplied. There are some great FREE downloads on the Double Happiness Multiplied website with diagrams that explain the types of Higher Order Multiples we’ve learned about in this episode.

        On Part Two of Episode One, we’ll explore Higher Order Multiples including a mum of triplets and a woman who had to grow a uterus to have a baby and ended up with quadruplets.

        LINKS:

         Double Happiness Multiplied

        www.doublehappinessmultiplied.com

        Elyse Jamieson
        Hypnobirthing Australia Practitioner & Doula, Soma Birth

        http://www.somabirth.com.au

        elyse@somabirth.com.au

        Mono-Mono Twin Support Group

        https://www.facebook.com/pg/momomommies/about/

        Helping Little Hands

        https://www.facebook.com/helpinglittlehandsAustralia/

        http://www.helpinglittlehands.org

        hello@helpinglittlehands.org

        Australian Multiple Birth Association

        https://www.amba.org.au/

        Perth & Districts Multiple Birth Association

        http://www.pdmba.org.au/

        Multiples of America

        http://www.multiplesofamerica.org/

        Twins & Multiple Births Association

        https://www.tamba.org.uk

        The Multiple Births Foundation

        http://www.multiplebirths.org.uk/

        Irish Multiple Births Association

        http://www.imba.ie/

        Multiple Births Canada

        http://multiplebirthscanada.org/

        International Council of Multiple Birth Organisations (ICOMBO)

        http://icombo.org/

        South African Multiple Birth Association

        http://www.samultiplebirth.co.za/

        ]]>https://www.doublehappinessmultiplied.com/?p=1465Mon, 22 Jan 2018 07:09:15 -050024:53nofull11<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2018/08/SB_doublehappiness_3Dimage.png"></a>Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, &amp; Quads HERE: <br /> <a href="../twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> &nbsp;<br /> &nbsp;<br /> &nbsp;<br /> Welcome to Season One of Double Happiness Multiplied.<br /> On Episode One, Part One, we get clear on what type of multiple you’re carrying and what that means for your pregnancy.<br /> We hear from Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell who clears up some of the misconceptions surrounding whether your babies are identical or not, and how oftentimes your sonographer or obstetrician might give you a misdiagnosis.<br /> Rebecca Perrie shares her story of going through her twin pregnancy thinking she was carrying fraternal, or non-identical twins, to only find out later on that her girls are in fact identical.<br /> Jodie Wiren takes us on her journey with one of the rarest types of multiples – Monochorionic Monoamniotic twins or MoMos.<br /> Also, Hypnobirthing Practitioner and Doula Elyse Jamieson tell us how when she found out she was expecting fraternal twins, she was determined to learn everything she could in order to make confident decisions that were specific to her situation.<br /> And, I share my story about the shock of learning that I was carrying identical twins and that there were serious complications.<br /> On part two of this episode, we’ll focus on Higher Order Multiples. Laura Sarubin tells us about her journey with identical triplet girls and Jannelle Snaddon explains how she had to grow a uterus to have a baby and ended up with quadruplets.<br /> By the end of Episode One, you’ll be quite familiar with terms like Zygosity, Chorionicity, and Placentation so you’ll have the knowledge you’ll need to be proactive when attending your medical appointments.<br /> &nbsp;<br /> Key Points: <br /> <br /> * A zygote is a fertilised egg.<br /> * Fraternal twins are Dizygotic, which means two eggs have been fertilised by two sperm.<br /> * Monozygotic twins are where one egg is fertilised by one sperm and then that egg divides at some stage in the first two weeks after fertilisation.<br /> * You can get Dichorionic Diamniotic twins where some are identical and some are non-identical.<br /> * Monochorionic Diamniotic twins sharing a placenta are always identical.<br /> * The rate of identical twins is fixed across the world at 1-in-every 285 pregnancies.<br /> * Of those, just 1-percent are the rarest type, which is Monochorionic Monoamniotic.<br /> * Monochorionic Monoamniotic twins are also identical, however, they share the same amniotic sac, which poses increased risks during pregnancy and requires significant monitoring.<br /> <br /> Thank you for listening to Part One of Episode One, Season ONE of Double Happiness Multiplied. There are some great FREE downloads on the Double Happiness Multiplied website with diagrams that explain the types of Higher Order Multiples we’ve learned about in this episode.<br /> On Part Two of Episode One, we’ll explore Higher Order Multiples including a mum of triplets and a woman who had to grow a uterus to have a baby and ended up with quadruplets.<br /> LINKS:<br />  Double Happiness Multiplied<br /> <a href="../">www.doublehappinessmultiplied.com</a><br /> Elyse Jamieson<br /> Hypnobirthing Australia™ Practitioner &amp; Doula, Soma Birth<br /> <a href="http://www.somabirth.com.au">http://www.somabirth.com.au</a><br /> <a href="mailto:elyse@somabirth.com.au">elyse@somabirth.com.au</a><br /> Mono-Mono Twin Support Group<br /> <a href="https://www.facebook.com/pg/momomommies/about/">https://www.facebook.com/pg/momomommies/about/</a><br /> Sally Barker - HypnotherapistAbout Season One

        Welcome to Double Happiness Multiplied – with host Sally Barker.

        Sally Barker is the mum of identical twin girls who were born at 28-weeks’ gestation due to Intrauterine Growth Restriction or IUGR. Needless to say, the journey was rough and full of many highs and plenty of lows, too.

        Over the next 12 episodes, Sally talks with experts in the fields of Maternal Fetal Medicine, Nutrition, Birthing, Mental Health, Breastfeeding, and much more. You’ll also hear from women who share their stories of having twins, triplets, and quads.

        The Book

        One of those experts you’ll learn from is Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell.

        Associate Professor Pennell has generously spent not only months working on this podcast with Sally, to ensure you receive the most up to date information, but for several years, she has been calling on him as the co-author of the book Double Happiness Multiplied – What You Need to Know About Having Twins, Triplets, or Quads. 

         

        Order your copy here: https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

         

         

        Different Journeys

        Throughout season one of Double Happiness Multiplied, we’ll hear about multiple pregnancies, types of delivery, time spent in the neonatal intensive care unit, and we honour those families who sadly didn’t get to take their babies home.

        Educate

        Sally's goal is to give you all the information you need to ask informed questions when you attend your medical appointments, so you can make decisions that are right for you, your family, and your pregnancy.

        You’ll notice that, throughout the podcast, Sally advocates finding a team that specialises in multiple births to manage your pregnancy, even when you’re searching for a doula or a hypnobirthing practitioner. Whether you’re in the public or the private system, you want to be with people who know what they’re doing and treat your pregnancy as an individual case, not merely a replica of some statistics that have been quickly read in a textbook.

        Low, Medium, or High Risk

        Having twins, triplets, or quadruplets is often referred to as High-Risk simply because having multiples is very different to having a singleton and each type of multiple carries its own set of variables and possible complications, often resulting in your babies spending the first weeks or months of their lives in the Neonatal Intensive Care Unit … or NICU…

        Your Pregnancy, Your Birth

        Every pregnancy is different, and some of you will have a relatively uneventful multiple pregnancy and will deliver your babies vaginally and without pain medication, however, many of you will have challenges throughout your pregnancy, which will lead to your babies being born via caesarean section much earlier than was hoped for.

        Many women aren’t...]]>

        Welcome to Double Happiness Multiplied – with host Sally Barker.

        Sally Barker is the mum of identical twin girls who were born at 28-weeks’ gestation due to Intrauterine Growth Restriction or IUGR. Needless to say, the journey was rough and full of many highs and plenty of lows, too.

        Over the next 12 episodes, Sally talks with experts in the fields of Maternal Fetal Medicine, Nutrition, Birthing, Mental Health, Breastfeeding, and much more. You’ll also hear from women who share their stories of having twins, triplets, and quads.

        The Book

        One of those experts you’ll learn from is Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell.

        Associate Professor Pennell has generously spent not only months working on this podcast with Sally, to ensure you receive the most up to date information, but for several years, she has been calling on him as the co-author of the book Double Happiness Multiplied – What You Need to Know About Having Twins, Triplets, or Quads. 

         

        Order your copy here: https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

         

         

        Different Journeys

        Throughout season one of Double Happiness Multiplied, we’ll hear about multiple pregnancies, types of delivery, time spent in the neonatal intensive care unit, and we honour those families who sadly didn’t get to take their babies home.

        Educate

        Sally's goal is to give you all the information you need to ask informed questions when you attend your medical appointments, so you can make decisions that are right for you, your family, and your pregnancy.

        You’ll notice that, throughout the podcast, Sally advocates finding a team that specialises in multiple births to manage your pregnancy, even when you’re searching for a doula or a hypnobirthing practitioner. Whether you’re in the public or the private system, you want to be with people who know what they’re doing and treat your pregnancy as an individual case, not merely a replica of some statistics that have been quickly read in a textbook.

        Low, Medium, or High Risk

        Having twins, triplets, or quadruplets is often referred to as High-Risk simply because having multiples is very different to having a singleton and each type of multiple carries its own set of variables and possible complications, often resulting in your babies spending the first weeks or months of their lives in the Neonatal Intensive Care Unit … or NICU…

        Your Pregnancy, Your Birth

        Every pregnancy is different, and some of you will have a relatively uneventful multiple pregnancy and will deliver your babies vaginally and without pain medication, however, many of you will have challenges throughout your pregnancy, which will lead to your babies being born via caesarean section much earlier than was hoped for.

        Many women aren’t mentally prepared for this to happen, so it’s to be aware of the possibility as many women beat themselves up because they didn’t get the birth they wanted. Sally even had a chap tell her she wasn’t a real woman and didn’t birth her babies because they entered the world via C-section. He went on to say his wife ACTUALLY gave birth to four babies, which made her a real woman. Of course, he didn’t know the story behind why Sally’s babies came into the world the way they did, but his comments made her feel pretty awful for a while, even though she knew the way they were birthed saved their lives.

        Breast or Bottle

        It’s no surprise that some of you will have no problem breastfeeding your multiples, while some of you will struggle. When Sally was expecting her girls, another twin mum, who was successfully feeding her twins, told her that the only reason women aren’t successful in this area is because they’re simply lazy. You can imagine the pressure she felt after this comment. It’s absolutely not true by the way, and it’s important to know that if you need to supplement with formula to grow healthy babies then that’s your choice. Go for it!

        Couple Bond

        Let’s be honest, your multiple pregnancy will put pressure on your couple relationship, especially if there are challenges to deal with. You’ll hear stories from others who have had relationship struggles and how they navigated them.

        It’s a fact of life, that when your focus is strongly on your babies your couple relationship is often forgotten and put on the back burner to sort out later on. Oftentimes, with a multiple pregnancy, later on never comes.

        Emotional and Mental Wellbeing

        We’ll hear from Psychologist Gretta Little, a twin mum herself, who offers some strategies to help guide you and your partner through your pregnancy and beyond in the hope to ease some of the pressures, which mum of quadruplets Jannelle Snaddon admits is part and parcel of your journey with multiples.

        It would be great to see you in the Double Happiness Multiplied Facebook group where you can share your story and ask for guidance whenever you need it.

        Until next time.

        I wish you Double Happiness … Multiplied.

        ]]>https://www.doublehappinessmultiplied.com/?p=1441Mon, 22 Jan 2018 05:26:51 -050006:45notrailer1<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> Welcome to Double Happiness Multiplied – with host Sally Barker.<br /> Sally Barker is the mum of identical twin girls who were born at 28-weeks’ gestation due to Intrauterine Growth Restriction or IUGR. Needless to say, the journey was rough and full of many highs and plenty of lows, too.<br /> Over the next 12 episodes, Sally talks with experts in the fields of Maternal Fetal Medicine, Nutrition, Birthing, Mental Health, Breastfeeding, and much more. You’ll also hear from women who share their stories of having twins, triplets, and quads.<br /> The Book<br /> One of those experts you’ll learn from is Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell.<br /> Associate Professor Pennell has generously spent not only months working on this podcast with Sally, to ensure you receive the most up to date information, but for several years, she has been calling on him as the co-author of the book Double Happiness Multiplied – What You Need to Know About Having Twins, Triplets, or Quads. <br /> <a href="https://www.doublehappinessmultiplied.com/wp-content/uploads/2019/02/Book-Cover-promo2.png"></a><br /> &nbsp;<br /> Order your copy here: <a href="https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/">https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/</a><br /> &nbsp;<br /> &nbsp;<br /> Different Journeys<br /> Throughout season one of Double Happiness Multiplied, we’ll hear about multiple pregnancies, types of delivery, time spent in the neonatal intensive care unit, and we honour those families who sadly didn’t get to take their babies home.<br /> Educate<br /> Sally's goal is to give you all the information you need to ask informed questions when you attend your medical appointments, so you can make decisions that are right for you, your family, and your pregnancy.<br /> You’ll notice that, throughout the podcast, Sally advocates finding a team that specialises in multiple births to manage your pregnancy, even when you’re searching for a doula or a hypnobirthing practitioner. Whether you’re in the public or the private system, you want to be with people who know what they’re doing and treat your pregnancy as an individual case, not merely a replica of some statistics that have been quickly read in a textbook.<br /> Low, Medium, or High Risk<br /> Having twins, triplets, or quadruplets is often referred to as High-Risk simply because having multiples is very different to having a singleton and each type of multiple carries its own set of variables and possible complications, often resulting in your babies spending the first weeks or months of their lives in the Neonatal Intensive Care Unit … or NICU…<br /> Your Pregnancy, Your Birth<br /> Every pregnancy is different, and some of you will have a relatively uneventful multiple pregnancy and will deliver your babies vaginally and without pain medication, however, many of you will have challenges throughout your pregnancy, which will lead to your babies being born via caesarean section much earlier than was hoped for.<br /> Many women aren’t mentally prepared for this to happen, so it’s to be aware of the possibility as many women beat themselves up because they didn’t get the birth they wanted. Sally even had a chap tell her she wasn’t a real woman and didn’t birth her babies because they entered the world via C-section. He went on to say his wife ACTUALLY gave birth to four babies, which made her a real woman. Of course, he didn’t know the story behind why Sally’s babies came into the world the way they did, but his comments made her feel pretty awful for a while, even though she knew the way they were birthed saved their lives.<br /> Breast or Bottle<br /> It’s no surprise that some of you will have no problem breastfeeding your multiples, while some of you will struggle. When Sally was expecting her girls, another twin mum,Sally Barker - Hypnotherapist