What to expect when you're expecting (162 page)

Fetal movement. Though every pregnant woman might feel at some point that she’s expecting an octopus, the eight limbs you’ll be carrying will really pack a punch. Make that many punches, and kicks.

Whether your pregnancy ends up bestowing you with double the discomforts or not, one thing’s for sure—it’ll also bestow you with twice the rewards. Not bad, for nine months’ work.

“I’m committed to eating well now that I’m pregnant with triplets, but I’m not sure what that means—eating three times as much?”

Belly up to the buffet table, Mom—feeding four means it’s always time to chow down. While you won’t literally have to quadruple your daily intake (any more than a woman expecting a single baby has to double it), you will need to do some serious eating in the months to come. Moms-to-be of multiples should indulge in an extra 150 to 300 calories a day per fetus, doctor’s orders (good news if you’re looking for a license to eat, not so good news if queasiness or tummy crowding has your appetite cramped). Which translates to an extra 300 to 600 calories if you’re carrying twins, an extra 450 to 900 calories for triplets (if you’ve started out with an average prepregnancy weight). But before you take that extra allotment as a free pass to Burritoville (extra guacamole for Baby A; extra sour cream for Baby B; refried beans for Baby C), think again. The quality of what you eat will be just as important as the quantity. In fact, good nutrition during a multiple pregnancy has an even greater impact on baby birthweight than it does during a singleton pregnancy.

So just how do you eat well when you’re expecting more than one? Check out the Pregnancy Diet (see Chapter 5) and:

Keep it small.
The bigger your belly gets, the smaller you’ll want your meals to stay. Not only will grazing on five or six healthy mini meals and snacks ease your digestive overload (and your tummy crowding), but it’ll keep your energy up—while delivering the same nutritional bottom line as three squares.

Make your calories count.
Pick foods that pack plenty of nutrients into small servings. Studies show that a high- calorie diet that’s also high in nutrients significantly improves your chances of having healthy full-term babies. Wasting too much of that premium space on junk food, on the other hand, means you’ll have less room for nutritious food.

Go for extra nutrients.
Not surprisingly, your need for nutrients multiplies with each baby—which means you’ll have to tack on some extra servings to your Daily Dozen (see
page 93
). It’s usually recommended that women carrying multiples get one extra serving of protein, one extra serving of calcium, and one extra serving of whole grains. Be sure to ask your practitioner what he or she recommends in your case.

Pump up the iron.
Another nutrient you’ll need to ramp up is iron, which helps your body manufacture red blood cells (you’ll need lots of those for the increased blood your multiple-baby factory will be using) and helps keep you from becoming anemic, which often happens in multiple pregnancies. Red meat, dried fruit, pumpkin seeds, and spinach are great sources of iron (you can find more iron-rich foods on
page 100
). Your prenatal vitamin and possibly a separate iron supplement should fill in the rest; ask your practitioner.

Keep the water flowing.
Dehydration can lead to preterm labor (something moms-to-be of multiples are already at risk for), so make sure you drink at least eight 8-ounce glasses of liquid a day.

For more information on eating well for multiples, check out
What to Expect: Eating Well When You’re Expecting.

“I know I’m supposed to gain more weight with twins, but just how much more?”

Get ready to gain. Most practitioners advise a woman expecting twins to gain 35 to 45 pounds and a woman expecting triplets to gain an average of 50 pounds (a little less if you were overweight prepregnancy; a little more if you were underweight). Sounds like a piece of cake, right? Or maybe two pieces of cake (or heck, maybe the whole cake). But the reality is, gaining enough weight isn’t always as easy as it seems when you’ve got two—or more—on board. In fact, a variety of challenges you may face throughout your pregnancy can keep the numbers on the scale from climbing fast enough.

Standing between you and weight gain in the first trimester might be nausea, which can make it difficult to get food down—and then keep it down. Eating tiny amounts of comforting (and, hopefully, sometimes nutritious) food throughout the day can help get you through those probably queasy months. Aim for a pound-a-week gain through the first trimester, but if you find you can’t gain that much, or have trouble gaining any at all, relax. You can have fun catching up later. Just be sure to take your prenatal vitamin and stay hydrated.

Use the second trimester (which will probably be your most comfortable one—and the easiest one for you to do some serious chowing down in) as your chance to load up on the nutrition your babies need to grow. If you gained no weight during the first trimester (or if you lost weight due to severe nausea and vomiting), your practitioner may want you to gain 1½ to 2 pounds per week during this period for twins or 2 to 2½ per week for triplets. (If you’ve been gaining steadily through the first trimester, you’ll only have to aim for 1½ pounds a week for twins or 2 per week for triplets.) That may seem like a lot of weight in a short time, and you’re right—it is. But it’s weight that’s important to gain. Supercharge your eating plan with extra servings of protein, calcium, and whole grains. Heartburn and indigestion starting to cramp your eating style? Spread your nutrients out over those six (or more) mini meals.

What to Gain When You’re Gaining for Two or More

Multiple Time Line

Already counting down your 40 weeks? You might not have to count that high after all. A twin pregnancy may be considered full-term a full 3 weeks earlier, at 37 weeks, which is certainly reason to celebrate (3 weeks less of puffiness, heartburn—and waiting!). But just as 95 percent of all singletons fail to arrive on their due date, multiples keep their moms and dads (and practitioners) guessing, too. They might just stay put until 39 weeks (or longer)—or they might make their appearance before they’ve clocked in the full 37 weeks. In fact, the average multiple pregnancy lasts 35½ weeks.

If your babies do end up overstaying their 37-week term, your practitioner may elect to induce at 38 weeks, depending on how they’re doing and how you’re doing, as well as his or her practice preferences. Be sure to have an end-game discussion with your practitioner long before the end is near, because many differ on how they typically handle the late stages of a multiple pregnancy.

As you head into the home stretch (aka, the third trimester), reach for a goal of 1½ to 2 pounds per week through your seventh month. By 32 weeks, your babies may be 4 pounds each, which won’t leave much room in your crowded-out stomach for food. Still, even though you’ll be feeling plenty bulky already, your babies will have to bulk up quite a bit more—and they’ll appreciate the nutrition a well-balanced diet provides. So focus on quality over quantity, and expect to taper down to a pound a week or less in the eighth month and just a pound or so total during the ninth. (This makes more sense when you remember that most multiple pregnancies don’t make it to 40 weeks.)

“I’m a runner, but now that I’m pregnant with twins, can I keep on exercising?”

Exercise can benefit most pregnancies, but when you’re staying fit for three, you’ll have to work out with care. If your practitioner green-lights exercise during the first and second trimesters (do be sure to ask), he or she will probably steer you toward more gentle options than running. You’ll definitely be advised to avoid any workout that puts a lot of downward pressure on your cervix or raises your body temperature significantly. ACOG recommends that moms-to-be of multiples stay away from high-impact aerobic exercise (which would include running) because it can increase the risk of preterm labor for them. This holds true for experienced runners, too.

Looking for a more sensible fitness routine for the three of you? Good options include swimming or pregnancy water aerobics, stretching, prenatal yoga, light weight training, and riding a stationary bicycle, all exercises that don’t require you to be on your feet while you do them. And don’t forget your Kegels, the anywhere-anytime exercise designed to strengthen your pelvic floor (which needs extra reinforcement when there are extra babies inside).

No matter what you’re doing during your workout, if the exertion is causing Braxton Hicks contractions or any other red flags listed on
page 223
, stop immediately, rest, drink some water, and call your practitioner if they don’t subside in 20 minutes or more.

“Everybody thinks it’s so exciting that we’re going to have twins, except us. We’re disappointed and scared. What’s wrong with us?”

Absolutely nothing. Prenatal daydreams don’t usually include two cribs, two high chairs, two strollers, or two babies. You prepare yourself psychologically, as well as physically and financially, for the arrival of one baby—and when you suddenly discover you’re having two, feelings of disappointment aren’t unusual. Neither is trepidation. The impending responsibilities of caring for one new infant are plenty daunting without having them doubled.

While some expectant parents are happy to hear they’re expecting more than one, others take some time getting used to the news. It’s just as common to feel initial shock as initial joy—to experience a sense of loss for the intimacy and normalcy of the one-on-one relationship you’d have with a single baby but can’t immediately see yourselves having with two. Instead of picturing yourselves rocking, feeding, and cuddling that one baby, you may have a hard time coming to terms with the thought of life with two newborns. You may also be flooded by conflicted emotions—first asking “Why us?” then feeling guilty about questioning your double blessing (especially if becoming pregnant was a struggle to begin with). All of these feelings (and the others you might be experiencing) are a completely normal reaction to the news that your pregnancy and your lives are taking an unexpected and very special turn.

So accept the fact that you’re ambivalent about the dual arrivals, and don’t saddle yourselves with guilt (since your feelings are normal and understandable, there’s absolutely nothing to feel guilty about). Instead, use the months before delivery to get used to the idea that you’ll be having twins (believe it or not, you will get used to it—and you will become happy about it!). Talk openly and honestly to each other (the more you let your feelings out, the less they’ll weigh you down and the faster you’ll work through them). Talk to anyone you know who has twins, and if you don’t know anyone, seek them out through groups and message boards. Sharing your feelings with others who’ve felt them, and recognizing that you’re not the first expectant parents to experience them, will help you accept and, in time, become excited about this pregnancy and the two beautiful babies you’ll be holding one day soon. Twins, you’ll find, may be double the effort at first, but they’re also double the pleasure down the road.

“I can’t believe it, but when I told my friends that we’re expecting twins, one of them said to me, ‘Better you than me.’ I thought she’d be happy for me—why would she make such a nasty comment?”

That might be the first insensitive comment you’ve been ambushed by during your multiple pregnancy, but it probably won’t be the last. From coworkers to family members to friends to those perfect (make that not-so-perfect) strangers in the supermarket, you’ll be amazed at the remarkably rude things people feel completely comfortable saying to an expectant mom of multiples, ranging from “Wow, you’re so huge—you must have a litter in there!” to “Boy, you’re in for it!” to “I could never manage more than one at a time.”

Multiple Connections

As a multiples mother-to-be, you’re about to join a special club already filled with thousands of women just like you—women who are also expecting double the delight and, no doubt, experiencing double the anxiety. Never been a joiner? Membership in this particular club does come with plenty of rewards. By talking to other moms-to-be of multiples, you’ll be able to share your fears, your joy, your symptoms, your funny stories (the ones nobody else would get) with women who know just how you’re feeling. You’ll also be able to score reassuring advice from other expectant moms who have more than one on the way (as well as from those who’ve already had their multistork delivery). Join a discussion group online (check out
whattoexpect.com
for a multiples message board) or ask your practitioner to hook you up with other pregnant-with-multiples women in his or her practice and start your own group. There are also national organizations that can provide you with contact information for local clubs, including the National Organization of Mothers of Twins Clubs,
nomotc.org
, or you can use an online search engine to find a local multiples chapter. You can also check out online sites that cater specifically to parents of multiples: mothersof
multiples.com
;
twinstuff.com
.