When You're Expecting Twins, Triplets, or Quads: Proven Guidelines for a Healthy Multiple Pregnancy

Chapter One Your Unique Pregnancy

Tamara: As I lay flat on the examining table, the radiology technician smeared my belly with greasy jelly, then turned the screen toward me. I was about to catch my first glimpse of the baby that had been growing inside me for 18 weeks.

But as she slid the probe across my abdomen, she began to frown. Pushing the screen to one side to block my view, she fiddled with the knobs. Then she stepped into the hall to summon a doctor. Together, they manipulated the dials of the ultrasound machine, whispering and pointing.

Trying to squelch a sudden rush of fear, I choked out the words: "What is it? Is something wrong with my baby?"

The doctor turned the screen to face me again and said, "Well, here's what we've got. This is a leg, and an arm, and this is the head. And now, over here, we see a foot, and a back, and "another head — twins! And they look just fine."

If you too have joined the ranks of expectant mothers of multiples — twins, triplets, even quadruplets or more — congratulations! You're now in a special group whose membership is swelling more and more each year. Between 1975 and 2000, twin births rose by 100 percent. During that same period, the birthrate of "supertwins" or "higher-order multiples" (meaning three or more babies born together) surged a whopping 587 percent.

You've probably got a thousand questions and concerns about your pregnancy, but chances are, you've had trouble finding the answers you need. "As soon as I found out that I was going to have twins, I read everything I could find on the subject. Yet most pregnancy books have only a page or two about multiples, and the books devoted to twins focus on taking care ofthe babies after they're born," says Judy Levy, mother of twin girls and an older daughter.

Or perhaps you succeeded in finding some material on multiple pregnancy but were put off by its gloom-and-doom tone. "Everything I read about having twins seemed so frightening, as if the writers were saying, 'You will definitely have all sorts of problems — and your babies will too.' I couldn't bear to read that scary stuff," says Stacy Moore, mother of twin boys. "What I really needed was some sensible advice on the specific steps I could take to avoid complications and give my babies the best possible start in life. And I found it — at a special clinic for expectant mothers of multiples, where I learned that many problems associated with multiple births are preventable. I did everything they told me to do, and my whole pregnancy went very smoothly. My twins were born big and healthy at full term, weighing 6 lb., 11 oz., and 6 lb., 1 oz."

Dr. Luke: Here's where I come in. As a professor of obstetrics and gynecology at the University of Michigan Medical School in Ann Arbor, and a researcher and nutritionist, I founded the clinic that Stacy Moore attended, and directed it for six years. This is the Multiples Clinic we refer to throughout the book, and many of the mothers quoted participated in this program.

I'm now a professor at the University of Miami School of Medicine in Miami, Florida, where I'm working with experts from renowned universities across the country, as the University Consortium on Multiple Births.

Our goal is to improve pregnancy outcomes — in other words, to help our patients have the healthiest pregnancies and the healthiest babies. To achieve that, we providespecial prenatal care, including patient education, risk screening, and intensive nutrition therapy.

The Multiples Clinic program works. Our clinical success proves it. Compared to the average mother of multiples, women who follow our guidelines experience significantly fewer complications before the birth of their children. For instance: Our expectant mothers develop fewer infections. They have less trouble with high blood pressure and preeclampsia. The moms in our program have a lower incidence of preterm premature rupture of the membranes. Our patients are hospitalized for preterm labor less frequently, and they spend fewer days in the hospital if they are admitted. For infants born to our moms, the results are even more impressive: Triplets born to mothers in our program weigh 35 percent more at birth, on average, than triplets typically do. That's very significant, given that the average birthweight for triplets nationwide is just half that of the average singleton. Our twins are generally born 20 percent heavier than the average twins delivered at the same gestational age. Two out of three of our newborns weigh more than 5½ pounds at birth, and one out of four is born weighing more than 6 pounds. These birthweight figures, which are significantly better than the average for infants of multiple-gestation pregnancies, prove that you can break the "rule" that says twins are always born small. Sixty percent of our mothers of twins deliver at 36 weeks or later, compared to only about 40 percent of twin moms nationwide. Our babies are healthier at birth, regardless of when they are born, because they have grown well right from the start of the pregnancy. Infants born to patientsin our program go home sooner than the average multiple-birth baby, spending only half as much time in the hospital. (Their hospital bills are only half the average too!)

A Clinically Proven Program for Women Pregnant with Multiples

Completely Updated, with 50 Recipes for Optimal Birth Weight

You're expecting more than one baby? Congratulations! In When You're Expecting Twins, Triplets, or Quads, Dr. Barbara Luke's practical, nutrition-based program has been proven to lower complications, resulting in much healthier babies. This revision offers more nutritional information, 50 recipes to maximize birth weight, and new guidelines on nutritional needs and vegetarian options. It also includes updated information that reflects the most current obstetric and pediatric practices, such as expanded safety information on exercise and reducing your risk for complications.

The revision includes updates on current medical research as well as more nutritional information and recipes. Written in a practical, user-friendly style, When You're Expecting Twins, Triplets, or Quads fills an important gap for families expecting multiples, with clear guidelines regarding physical activity, nutrition, monitoring fetal growth, as well as signs and symptoms of potential complications. Every aspect of pregnancy and postpartum is covered, including a chapter devoted to the emotional ups and downs to pregnancy, childbirth, breastfeeding and bottle feeding.

Barbara Luke, Sc.D., M.P.H., R.N., R.D., is a professor in the Department of Obstetrics, Gynecology, and Reproductive Biology at Michigan State University. She has published numerous research studies on multiple pregnancy through the University Consortium on Multiple Births, with colleagues from universities around the country. She is also the author of Every Pregnant Woman's Guide to Preventing Premature Birthand coauthor, with Tamara Eberlein, of Program Your Baby's Health.