Rise in twin births

twin pregnancyEven as early as  the year 2000 many women were having the opinion that having twins was “glamorous”, “cute”, adorable and fun.  The reality is, it’s not, its hard work.  Your healthiest twin mom will tell you hands down the first year is a blur.  There’s double the work from conception to delivery and beyond.  And while double your pleasure double your fun might sound incredibly exciting experts will tell you that especially when undergoing IVF think hard about how many embryos a patient is contemplating on transferring back into her uterus.

Statistics show that twins accounted for about 1 in 30 births in the United States – or 3.3 percent. And 1 in 726 births resulted in triplets or higher-order multiples – this is as current as 2012.  If we compare statistics we see the twinning rate increasing – for instance in 2009, 1 in every 30 babies born in the USA was a twin compared to 1980 when 1 in every 53 babies were born a twin.  From 1980-2009 the twin birth rate rose a whopping 76%!  And oddly enough the twinning rates rose by at least 50% in most states.

Now this is a no brainer over the past three decades the twin birth rates almost 100% among the age group of 35-39 and more than 200% amongst those women 40 and over – Hello IVF!

IVF Abroad

If we take a look at Scotland the infertility experts in Scotland are warning their Scottish women who are traveling abroad for fertility treatment are actually putting their lives at risk.  Why you may ask?  Because many of these couples are traveling to countries like Russia, Greece, Turkey, Australia, Spain and the USA to speed up the wait times for IVF.

In Scotland single embryo transfers are the most preferred method of IVF.  The reason being that the Scots are concerned for their intended mothers and their health regarding multiple pregnancies because clinics in other countries are open to transferring up to three embryos at a time to maximize their chances of conception and live birth –and really who can blame them?

I remember when I was going through my own IVF treatment when the time came for my transfer I asked to have three placed back to my waiting uterus because frankly I’d been through hell and just wanted to become a mother in the worst way.

There’s lots to know and learn about being pregnant with IVF multiple Births and it’s important to become educated to when your turn comes you’ll hopefully be educated to know what’s coming down the pike.

What you should know

First of all, lots and lots of women have twins each year with no problem whatsoever.  Granted we aren’t meant to have many babies at once like puppy’s pigs, or cats.  We were designed to have one baby at a time.  However, as I said above lots and lots of women have successful twin pregnancies each and every year naturally and through IVF.

Where things can get dicey are when twin or high order multiple pregnancies occur in older women.  There are enough potential challenges for women in pregnancy when you are over 40; and so when you add a twin or more pregnancy to the mix the scales can tip and not necessarily in your favor.

Granted some of these risks are just a pain in the neck and not dangerous.  However, there are risks that can be life-threatening if they are ignored and not treated promptly.

Potential complications for older mom’s and twin or more pregnancy:

  • There is a condition called Pregnancy Induced Hypertension commonly known as PIH for short.  It’s simply high blood pressure during your pregnancy.  35+% of all twin pregnancy develop or involve PIH. This is by the way, three to four times higher than the rate of a singleton pregnancy even in a mom to be over 40.  If you leave this condition untreated, it can lead to premature labor, or something called IUGR (Intrauterine Growth Retardation) – the baby doesn’t grow like it’s supposed to – and in some cases sadly a stillbirth.  Last but not least the pregnancy mom can also suffer and this can be a serious threat to the mom’s health –as this can develop into preeclampsia which comes with a whole new set of issues.
  • Gestational diabetes:  This is a complication where your pancreas doesn’t work like it’s supposed to during pregnancy — Those women who were not diabetic before pregnancy become diabetic during pregnancy and can’t control their blood sugar.  GD as it’s commonly referred to occur in about 5% of singleton pregnancies, but women who are over 40 or who are pregnant with twins or more are twice as likely to develop this condition.  Left untreated GD can cause serious complications for your baby.  You can give birth to a too large of a baby called macrosomia which in turn can cause issues during delivery like injuries to your baby’s shoulders and your baby’s arms.  A baby that’s too big increases your risk for a C-section.  Babies that born to mom’s with GD can experience shortly after birth a sudden drop in their blood sugar and this requires treating the baby with IV with a sugar solution. Your newborn baby may also have a higher risk of developing jaundice (a condition that causes yellowing of the skin and whites of the eyes) and breathing problems.
  • Mom’s who are pregnant with twin or more pregnancies more than likely going to experience issues with bleeding before, during, and after their pregnancy.  Many times bleeding is benign and nothing to worry about, however, it’s scary to experience bleeding anytime during your pregnancy.
  • Those women who are pregnant with twins or more are often much more sick than those women who are carrying a singleton – sometimes this “morning sickness” develops into all day sickness and can develop into something more serious called hyperemesis gravidarum or HM.  If a pregnant mom develops this she’s almost always hospitalized.
  • Most pregnant mom’s (especially those going through IVF) experience constipation.  This occurs twice as often with mom’s who are pregnant with twins or more.
  • Bed rest occurs more often with pregnant moms of twins or more.
  • Seventy percent of IVF multiple births are born before their due date. With triplets, quadruplets and other higher order multiples, the odds are higher, nearly 100 percent. If premature labor begins, the pregnant Mom may need to take medications to stop labor and allow the babies more time in the uterus. These medications can have side effects, some mild and others more intense.
  • Most multiple pregnancies end up with a C-section because the babies are positioned weirdly in the uterus.  Like the first baby is not head down.  C-sections as you know are considered major abdominal surgery.
  • And last but not least mothers of multiples are most likely to develop and experience postpartum depression.

 

Affects on the baby

  • When you are pregnant with twins the rate of miscarriage is much higher.  There’s a phenomenon called the vanishing twin syndrome – one twin simply vanishes. Or one twin may actually miscarry.
  • Twin pregnancies are at risk for developing something called intrauterine growth discordance.  Basically one twin grows at a much slower rate than the other.  In identical pregnancies or those pregnancies where the babies share one placenta this is often a symptom of something serious referred to as twin-to-twin transfusion syndrome (TTTS), where one twin takes more than its share of blood flow from the placenta. TTTS occurs in 10% of monochorionic (identical twin) pregnancies. If left untreated, severe TTTS can lead to infant heart failure or death of one or both twins.
  • Twins are more likely to have low birth weights, even when they are born on time. Twins are also more likely to become jaundiced.

If your baby(s) are born premature the following can occur:

  • Stomach or digestive issues.
  • Central Nervous System issues – bleeding on the brain.
  • Feeding issues, having to learn how to nurse, and feed.
  • Immature lung issues which leads to problem with breathing.  Some premature babies are placed on ventilator until their little lungs mature.
  • Even with those babies who are born after 28 weeks and survive can sometimes develop something called Broncho pulmonary dysplasia (BPD).  This is a chronic lung condition that may require oxygen support for weeks or months after birth. Premature babies can also suffer just general respiratory issues, develop asthma and ongoing respiratory infections.
  • Premature babies can experience developmental delays as well as learning disabilities.  In severe cases retardation.  Some of these delays don’t show themselves right away.
  • Some premature babies suffer from Cerebral Palsy or experience vision problems or a hearing loss.

What about Mom and Dad

And let’s not forget about mature babies isn’t just a day – they are typically for weeks or months depending on how early their children were born and what kinds of complications they were born with.  Having to leave the hospital without babies in your arms stinks and is incredibly stressful and upsetting.  That coupled with seeing your little one hooked up to wires, machines, and other medical apparatus can be just devastating.

Talk to your doctor, talk to your partner, your family, your therapist, and last but not least have an honest talk with yourself. Talk about the risks to you and your particular situation.