by Tracy Harper

So you have just found out that your partner is expecting twins, congratulations! 🙂

Finding out that you are expecting twins can be overwhelming and may come as a shock but there are a few things you can do to help support your partner and yourself through the process.

The first thing to do is establish the type of twins that your partner is carrying as this will greatly influence any future decisions you both make regarding the care your partner receives through pregnancy and the birth options she chooses to have for her birth. There are non-identical twins (otherwise known as fraternal, Dizygotic or DCDA) and identical twins (otherwise known as Monozygotic, MCDA or the rare MCMA). Most twin pregnancies will be placed under a high risk care plan and your partner will be offered additional scans and appointments which will often be overseen by an obstetrician to check on the growth, health and wellbeing of mum and babies.

If possible it would be beneficial to attend appointments with mum so that you can gather information together. My husband and I always found it helpful to note things down so that we could digest it and then on return take back any questions that we had. 🙂

Doctors will want to know that you fully understand the risks associated with your twin pregnancy and so it is important to research and understand the specific risks associated with the twins that your partner is carrying as this may greatly influence any decisions that you make throughout pregnancy and birth. Don’t be afraid to ask questions so that you feel able to make informed decisions. With this in mind it can be beneficial to seek support from a birth planning midwife, twin specialist midwife or even a Supervisor of Midwives. These midwives can help negotiate and facilitate your birth wishes with your medical team. Further support can be accessed via AIMS or TAMBA if you feel that you are coming up against barriers in your care plan.

Generally speaking the risks for non-identical twins are much lower for mum and babies, resulting in birthing options similar to that of a mum carrying a singleton – as long as mum and babies stay in good health throughout pregnancy and birth. J

You may wish to discuss the monitoring of your babies during birth – intermittent or continuous and the pain management options available to you, often you will be offered an appointment with an anaesthesiologist to discuss any concerns that you may have.

Although continuous monitoring and the citing of epidurals is often recommended for twin mums it isn’t always in tune with mum’s birth wishes and so you need to support her with the choices she wishes to make. For example, it may be that your partner wishes to decline continuous monitoring so that she can actively birth or she may decide the citing of an epidural or cannula would hinder her physiological process of birth.

Ultimately the positions of your babies will greatly affect the birth options available to you with most care providers looking for twin one in a head down position for a vaginal delivery. The key for birth planning is often negotiation between yourselves and your care provider. For example, mum needs to feel happy in her birth environment and safe and confident in the care of those around her. This will give her the most optimal birth environment and likelihood of a positive birth experience.

In the early days the overload of information may be quite an anxious time for yourself and your partner so it is important to give yourselves time to process the information so that you can make informed decisions that are right for your partner and your babies. This may be coupled with physical conditions such as morning sickness and lethargy which is highly common in twin mums due to the elevated HCG levels. Twin mums are also at risk of developing Hyperemesis Gravidarum and so it is worthwhile familiarising yourself with the signs and symptoms so that you know how to support your partner if this occurs.

You may also be entitled to paid leave to attend your local hospital with your birth partner. Here you can ask about their policies for twin birth so that you do not come up against any surprises on your partners birthing day. This will give you time to choose the right options together. You can also explore the birth environments available to you and ask any questions that you may have. For example – it may be that your hospital has a twin specific birthing room, how does your partner feel about this? If your partner decides she would like continuous monitoring it may be that mum wants to place herself in an optimal birth position before they are attached – will your care provider support you with this? Do they have a birth pool a twin mum can use? The more information you gather about the processes surrounding the birth options that your partner would like, the more in control and happy your partner will feel which will often result in a more positive birth experience for mum and babies. J

Twin specific antenatal classes and holistic approaches such as Hypnobirthing and pregnancy yoga or pilates may help mum release any anxieties and physical tensions during her pregnancy. This is most beneficial for mum and babies and will give you further advice and support on how to best support mum through the process of twin pregnancy and birth.

With identical twins it is often the case that you will have more regular appointments, sometimes fortnightly or more. Most identical mums will be offered a caesarean route for birth, especially the rare MCMA twins. It is common that MCMA twins will often be born prematurely via a caesarean due to the risks of cord entanglement or twin to twin transfusion. If you are expecting these twins you may wish to arrange a visit to your local NICU so that you can familiarise yourselves with the procedures, sounds and arrangements within your local unit. This can help yourself and mum to mentally and physically prepare for the journey ahead. You may also wish to discuss postnatal care and feeding options for your babies so that mum to be understands the options available to her post birth.

Did you know that there are gentle approaches to caesarean birth that you may wish to research such as a natural or gentle caesarean? 🙂

With postnatal care in mind you may wish to discuss extended paternity leave or save up some annual leave to extend the time you can be available to support mum and babies. The demands of a newborn can be high but with two babies this can be a particularly anxious time for yourself and your partner. Don’t be afraid to accept support from those around you and ask for help if you feel you need it.

There are charities such as HomeStart that can offer free weekly support meetings and they even have volunteers that can visit you at home. This can be further supported via your midwives, health visitors and breast feeding counsellors. Similarly your local colleges may have childcare students looking for placements for mums with newborn twins, this childcare support is often free and options like this can really benefit you as a new family and give you some respite periods within your home. Postnatal Doulas and those with specific twin experience can also offer some continuity of care for your family.

Overall don’t forget to enjoy the pregnancy and cherish your journey with photos and a journal. This is a unique and magical journey for all concerned and you’ve got this! 🙂