You are pregnant and feeling amaze that you are carrying two babies instead of one. After the excitement, you may start to have questions or concerns about your pregnancy. Generally, expectant mothers will discover their special condition at their 12-week scan.

The parents can expect identical twins when the fertilized egg splits into two. Non-identical twins will result when two separate eggs are fertilized by two sperms at the same time. Below are common questions from expectant mothers of twins.

#1: Will there be enough space for two babies?

Yes, the womb can stretch to accommodate two babies easily. Twin pregnancy is considered full term at about 38 weeks instead of 40 weeks as in a single pregnancy. During the first two trimesters, twins will grow about the same rate as a single baby. However, from weeks 26 to 28, the growth will slow down.

#2: Will the mom be bigger in size?

The expectant mother will not be twice the size but the bump will be bigger. The mom will also show earlier at about 11 weeks with twins compared to 13 weeks for a single baby.

#3: Will the mom have double the morning sickness?

Pregnant with twins may cause the mom to suffer the usual morning sickness and may be slightly worse and for longer duration.

#4: Will the mom need to eat for three?

Expectant mothers do not need to eat for three people like having three slices of cake, three servings of meat, etc. In the last trimester, the mother only needs about 600 more calories per day. It is important to eat nutritional foods like nuts and yoghurt instead of taking in empty calories only.

#5: Will the mom need a Caesarean section?

The delivery process depends on the position of the babies. If the babies are in breech or transverse position, i.e. lying across the uterus, normal vaginally delivery is difficult. Your doctor will monitor your condition and decide the best option for you.

photo credit: Organic Haus

In Part I, we covered the possible reasons for a scheduled induction or caesarean section (c-section). Instead of waiting for labor to start naturally, the doctor will initiate the induction process using several methods. When a doctor begins an induction, the goal is to have a vaginal delivery of the baby.

What are the potential risks?

There are potential risks involved when a woman opts for an induction. Some of the risks are:

• Fetal distress.

• There is an increase risk of infections to both the mother and baby.

• There is a risk where the umbilical cord comes out before the baby or it is compressed.

• There is a risk that the induction may fail resulting in going for surgery or c-section. There will be added risk from the anesthetic and the surgery itself.

• In rare cases, a circulatory failure may happen due to the flow of amniotic fluid into the circulation.

• Also rare is a possible prolapsed of the umbilical cord which may require an emergency c-section.

Hence, it is very important for a pregnant woman to consult closely with her doctor if she decides to go for an induction or planned labor. Her doctor will be the best person to monitor her condition to ensure the labor is smooth and that both the mother and baby are safe.

For my third pregnancy, I decided on a planned labor where I chose a fix date to have it. One of the reason is relating to work and the other is I did not want to be caught unawares. Therefore with my doctor’s advice and consent that I was healthy to go for a planned labor, I decided to go for it. There were no surprises and everything was prepared and carried out accordingly. I was happy with the whole process. I had no complications and I went home after spending two nights at the maternity medical center.

Do you have a “labor” story or advice to share?

Nowadays, with modern medicine and technology to assist us, we can choose how and when to give labor. A woman may choose to schedule her labor due to various personal or health reasons. She can choose to go for an induction or a caesarean section.

Of course, the doctor’s consent is necessary before the labor is induced. In cases involving health risks, the doctor will be the one to advice to induce or schedule a labor. An example of a health problem is if the mother has pre-eclampsia, a blood pressure problem or she has diabetes or other medical conditions; the doctor may advice to go for a planned delivery. If a pregnancy is overdue (over 42 weeks) and the placenta is observed to be not functioning well, then this is a good reason to have one.

photo credit: *clairity*

A woman may also request for a scheduled delivery for practical reasons. For example, her partner may be working long distance most of the time and therefore, a fix date for delivery is practical.

Choosing an auspicious date and time

The Chinese can be very particular about when to give birth. For example, they will try to avoid giving birth during the hungry ghost month. If they are believers of feng shui, then they may also tend to choose an auspicious date and time to give birth rather than waiting for nature to take its course.

What is the procedure for an induction?

An induction means the doctor starts the process of labor using superficial methods. The methods may include sweeping the amniotic membranes, breaking the water bag, applying prostaglandin gels or suppositories or by administering an oxytocin drip. There are also natural ways to induce labor according to housewives tales such as making love or having sex, consuming castor oil, drinking coconut water or raspberry leaf tea or by nipple stimulation.

There are risks involved when a woman decides to go for a planned induction or c-section. This will be covered in Part II of the same title.

photo credit: teresawer

When pregnant, there are a lot of things to take care off like your nutrition and health. There are 7 conditions or symptoms that a pregnant mom should pay attention to. They are:

1. Pre-eclampsia

The signs or symptoms are a rise in the blood pressure, protein in the urine, upper abdominal pain, vomiting, headaches and visual disturbances. It is caused by a defect in the placenta and there is a shortage of blood supply. Hence, the baby’s well-being is at risk as the placenta provides the oxygen and nutrients. Those most at risk are the following:
• You are a first time mom
• You are overweight
• Your age is over 40
• You have high blood pressure, diabetes or kidney disease
• You have a family history or pre-eclampsia
• You have a multiple pregnancy

2. Placenta praevia

There is usually no symptoms and it is diagnosed by scanning. In certain cases, you will notice some vaginal bleeding. The placenta covers or partially covers the cervix and when in labour, the cervix opens and the placenta may start to disconnect from the wall of the womb. Those most at risk are the following:
• You have more than one child
• You have a multiple pregnancy
• You have had previous surgery on the womb like a caesarean section

3. HELLP syndrome (Haemolysis, elevated liver enzymes, low platelets)

The symptoms include nausea, abdominal pain, headaches and blurred vision. You may be tested to have high blood pressure and there is protein in your urine. In addition, your blood test will show low platelets level.

This is actually another complication of pre-eclampsia and can cause kidney and liver problems as well as affect the ability of the blood to clot. Those most at risk are women who have pre-eclampsia which generally begins during the third trimester.

4. Placental abruption

About 80% of women with placental abruption will have vaginal bleeding. At the same time, there is abdominal pain and tenderness around the womb. This happens when the placenta has partially or completely separated from the uterus wall. Those most at risk are the following:
• You have high blood pressure
• You are above 35 years of age
• Have undergone distress or injury to the abdomen
• You smoke, drink or on drugs

5. Gestational diabetes

This is diabetes that develops during pregnancy. Pregnancy hormones can sometimes interfere with how the hormone insulin controls the glucose levels in the blood. The symptoms include feeling tired, extremely thirsty and wanting to pee constantly. Sugar is also detected in your urine. Although anyone is at risk, those most at risk are the following:
• Older moms
• You have a high body-mass index
• You have a family history of diabetes

6. Symphysis pubis dysfunction (SPD)

During pregnancy, the hormone “relaxin” relaxes the joints but when it softens too much, it can cause pain. The symptoms include feeling pain over the hip joints, pubic bone and lower back. SPD can happen to any pregnant women during any stage of the pregnancy. It is more common after the first trimester.

7. Obstetric cholestasis

The symptoms can include extreme cases of itching especially on the hands and feet. This is a liver disorder where the flow of bile is reduced. This can affect anyone and the risk is high if your mother or sister has had it before.

From the descriptions above, going for your regular antenatal checkups are important to enable the conditions or symptoms to be detected. It also helps to put your mind to rest if you suspect any irregularities during your pregnancy.