Double Happiness Multiplied Sally Barker - Hypnotherapist

Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

 

 

 

Welcome to Season One of Double Happiness Multiplied.

On Episode One, Part One, we get clear on what type of multiple you’re carrying and what that means for your pregnancy.

We hear from Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell who clears up some of the misconceptions surrounding whether your babies are identical or not, and how oftentimes your sonographer or obstetrician might give you a misdiagnosis.

Rebecca Perrie shares her story of going through her twin pregnancy thinking she was carrying fraternal, or non-identical twins, to only find out later on that her girls are in fact identical.

Jodie Wiren takes us on her journey with one of the rarest types of multiples – Monochorionic Monoamniotic twins or MoMos.

Also, Hypnobirthing Practitioner and Doula Elyse Jamieson tell us how when she found out she was expecting fraternal twins, she was determined to learn everything she could in order to make confident decisions that were specific to her situation.

And, I share my story about the shock of learning that I was carrying identical twins and that there were serious complications.

On part two of this episode, we’ll focus on Higher Order Multiples. Laura Sarubin tells us about her journey with identical triplet girls and Jannelle Snaddon explains how she had to grow a uterus to have a baby and ended up with quadruplets.

By the end of Episode One, you’ll be quite familiar with terms like Zygosity, Chorionicity, and Placentation so you’ll have the knowledge you’ll need to be proactive when attending your medical appointments.

 

Key Points:



* A zygote is a fertilised egg.

* Fraternal twins are Dizygotic, which means two eggs have been fertilised by two sperm.

* Monozygotic twins are where one egg is fertilised by one sperm and then that egg divides at some stage in the first two weeks after fertilisation.

* You can get Dichorionic Diamniotic twins where some are identical and some are non-identical.

* Monochorionic Diamniotic twins sharing a placenta are always identical.

* The rate of identical twins is fixed across the world at 1-in-every 285 pregnancies.

* Of those, just 1-percent are the rarest type, which is Monochorionic Monoamniotic.

* Monochorionic Monoamniotic twins are also identical, however, they share the same amniotic sac, which poses increased risks during pregnancy and requires significant monitoring.



Thank you for listening to Part One of Episode One, Season ONE of Double Happiness Multiplied. There are some great FREE downloads on the Double Happiness Multiplied website with diagrams that explain the types of Higher Order Multiples we’ve learned about in this episode.

On Part Two of Episode One, we’ll explore Higher Order Multiples including a mum of triplets and a woman who had to grow a uterus to have a baby and ended up with quadruplets.

LINKS:

 Double Happiness Multiplied

www.doublehappinessmultiplied.com

Elyse Jamieson

Hypnobirthing Australia™ Practitioner & Doula, Soma Birth

http://www.somabirth.com.au

elyse@somabirth.com.au

Mono-Mono Twin Support Group

https://www.facebook.com/pg/momomommies/about/

 

Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

 

On this episode of the podcast, we discuss Higher Order Multiples (HOM).

We hear from Chair in Obstetrics and Gynaecology and Professor Fetal Medicine, Head of Discipline Obstetrics and Gynaecology at the University of Newcastle and John Hunter Hospital Professor Craig Pennell who explains the different types of Higher Order Multiples and what to expect from your pregnancy.

Triplet mum Laura Sarubin talks about her experience of finding out she was having triplets and how she tried to normalise the pregnancy as much as possible.

And, Jannelle Snaddon shares her story of infertility, her journey with IVF, and how she was hoping for one baby and ended up with four – Quadruplets.

Types of HOMs

Professor Pennell explains the three patterns of combinations with triplets.



* Three eggs that are fertilised by three different sperm known as a Trichorionic Triamniotic pregnancy.

* Monochorionic twins and a singleton, known as a Dichorionic Triamniotic pregnancy.

* Monochorionic triplets, known as a Monochorionic Triamniotic.



For quadruplet pregnancies, most are where four eggs are fertilised by four different sperm, known as a Quadrachorionic Quadramniotic pregnancy, however, you can also have twins and two singletons. It’s also theoretically possible to have two sets of identical twins but it’s extremely rare, according to Professor Craig Pennell.

Enjoy Your Pregnancy and Ask For Help

The trick with HOMs is that you want to do as much as you can early on. You’ll want to sort out the type of HOM you’ve got, make sure you’ve got great care and great imaging, and that you’re optimising the situation in terms of your haemoglobin, so ensuring you have enough iron, calcium, and vitamins.

Enjoy your second trimester and during that time take as much help from your friends as possible.

“My advice is to buy a second or third freezer and whenever someone offers to help you say it would be great if you could make me a few frozen casseroles, and you just fill those freezers up such that you’ve got all these resources for later,”

“If you’re in a good situation physically and metabolically by the time you get to 22-24 weeks, and you’re being cared for by a great team then you can feel confident that you will get through the situation,” says Professor Pennell.

Professor Pennell insists that if you’re one of the unlucky people who starts contracting early, bleeding, or has some complications, seek medical help quickly. In this situation, you will be transferred to a tertiary centre, if you’re not already there, and you’ll be given steroids which optimises the outcomes for each of the babies.

“The benefit of being administered corticosteroid at 23-weeks reduces the mortality by 50 percent,”

It’s important to be realistic and understand that there will be tough times. You are going to have good days and bad days.

"If you are showing signs of post-natal depression, get onto it, get it treated, seek help, see a psychologist, start taking medication if you need it,” urges Professor Pennell.

Key Points



*

Monochorionic Triamniotic, or identical triplets, are delivered around 32-34 weeks.



*

In terms of quads and quins, the aim is to get as close to 30-weeks’ gestation as possible.



*

The benefit of being administered corticosteroid at 23-weeks’...

 

Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/



Welcome to Season One, Episode Two of the Double Happiness Multiplied podcast.

On this episode, we’re joined by Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell who will give us some tips on what you should be asking during your appointments with your Specialist or Obstetrician.

Sonographer Sam Ward explains what to expect at your ultrasound appointments at each stage of your pregnancy.

And, Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson offers guidance about choosing the right support team for your pregnancy.

The shock

Finding out your expecting multiples can be quite a shock and can throw you into a world of confusion and anxiety. Knowing what questions to ask your obstetrician, midwife, or sonographer and when you should ask specific questions isn’t easy to navigate, especially for a first-time parent.

A few questions you’ll want to ask your obstetrician are:



*

What type of placentation do my babies have?



*

What tests and procedures will I have to have?



*

What is your philosophy on delivering twins?



*

How many multiples have you delivered in the past few years,



*

And, how do I get in touch with you if needed?





To guide you further, Maternal-Fetal Medicine Specialist Professor Craig Pennell has this advice:

The first question you should ask your Obstetrician is what do I have to do in a twin pregnancy that is different from a singleton pregnancy?

There are many things that are different in multiple pregnancies than in a singleton pregnancy, for example:



*

You’ll be seen more frequently



*

You’ll have more ultrasound scans



*

The vitamin supplementation is a lot more important





Professor Pennell says the second question you should ask is what type of placenta do my multiples have, which means are your twins identical or non-identical?

“The risk in Dichorionic Diamniotic or non-identical twins, outside of prematurity, are very similar to singleton pregnancies,”

“Whereas, if you have identical twins, depending on the type, those risks can go up from a few per cent up to 20 or 30 per cent of pregnancies having adverse outcomes.

"So, you really want to know if you are a low-risk twin pregnancy, a moderate-risk twin pregnancy, or very high-risk twin pregnancy,” says Professor Pennell.

“You really want to know if you are a low-risk twin pregnancy, a moderate-risk twin pregnancy, or very high-risk twin pregnancy. The care that you will get and your expectations will be very different depending on what group you are in.”

Time of delivery

With modern obstetric care and based on the most recent data, most twin pregnancies are delivered by the end of their 37th week.

“With Dichorionic Diamniotic twins, if the woman hasn't gone into labour by 37-weeks, then they will be induced or they have a planned caesarean section,”

“The reason for that is the rate of stillbirth starts to increase dramatically.  That’s where that window of 37-weeks comes from,” says Associate Professor Pennell.

Recommended times to deliver twins:



* Dichorionic-Diamniotic twins – 37-weeks’ gestation.

* Monochorionic - twins 36-weeks’ gestation.

* Monoamniotic twins - 30-32 weeks or as early as 28...

 

 

Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

 

On this episode, we tackle the problem of hyperemesis in multiple pregnancies and explain how to maximise your nutrition when you’re too ill to keep anything down, or there’s simply no room left for food.

Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell explains what happens to your body when you’re supplying nutrients to more than one baby at a time, and what supplements are required to ensure your vitamin and mineral needs are catered for.

Pregnancy Dietician and Nutritionist Jessica Ruescher offers some practical advice on the types and amounts of foods you’ll need to eat, to maintain adequate weight gain during your pregnancy.

Also, twin mum Elyse Jamieson and I talk about our experiences with hyperemesis, while mum of quadruplets Jannelle Snaddon shares her struggle with nutrition towards the end of her pregnancy when she was running out of room for food.

Vitamin supplements

As a woman carrying more than one baby, your energy and protein requirements are dramatically increased. This is because your resting energy expenditure is much greater than that of a woman carrying a singleton. What this means is that due to the increased maternal tissue you’re carrying you'll burn more calories at rest.

And, this, of course, affects your vitamin and mineral levels, which have a significant impact on the growth and development of your babies.

Maternal-Fetal Medicine Specialist Professor Craig Pennell explains that vitamin supplementation is a lot more important in twins than in singletons, and it’s actually not for the baby it’s more for the mother. He says the babies will take what they need from the mother almost always, which leads to the mother losing calcium from her bones. She will also lose iron because she’s making an extra litre-and-a-half to two-litres of maternal blood, plus two placentas, plus two baby blood volumes, all of which uses up iron.

Professor Pennell advises all women carrying multiples to take a good pregnancy multivitamin, more folate than normal, iron, and calcium in a preventable manner at the very beginning of their pregnancy.

When the vast majority of women become iron deficient in pregnancy, and when we know it’s going to happen to all twins, the best thing to do is to start supplementing early.” ~Maternal Fetal Medicine Specialist Professor Craig Pennell~Tweet This

“When the vast majority of women become iron deficient in pregnancy, and when we know it’s going to happen to all twins, the best thing to do is to start supplementing early,”

“That way if you get side effects from the iron, missing a few days here and there isn’t an issue when you’re looking at it over a seven-or-eight-month period,”

“Whereas if you’re trying to cram all of your iron in at 30-weeks to have it fixed before your delivery then it becomes a much bigger problem,” he says.

Hyperemesis

 

Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

 

 

On episode four, of Double Happiness Multiplied, we discuss Gestational Diabetes (GDM) and why it’s important for women carrying more than one baby to understand how it might impact their pregnancy.

The good news is, with the right exercise and nutrition program you can avoid any adverse effects of the condition. More importantly, for 95 percent of women diagnosed with GDM the condition resolves once the babies are born.

It’s a fact of life that pregnancy causes a diabetic state in every woman. About 90 percent of pregnant women can cope with it, while 10 percent can’t. It’s this latter group who get GDM.

What is Gestational Diabetes?

Diabetes Educator, Nurse Practitioner, and Midwife Marina Mickleson has spent more than twenty years explaining this to pregnant women. She says quite simply GDM is diabetes that is picked up for the first time in pregnancy.

“What this means is that the woman hasn’t had a prior diabetes diagnosis and the condition has been picked up during routine testing, which shows the woman has glucose intolerance in the pregnancy,” explains Marina.

What’s more, the percentage of women diagnosed with GDM varies depending on the population. On average, about 10 percent of the Caucasian population will get GDM, but if you add in the Indian, Asian, Indigenous, and African population, it can be up to 20 percent of the population who get GDM, according to Marina.

“These women are more at risk just because of mainly the food they’re eating,”

“Compared to what they’d be eating for three or four generations in their communities, it’s the Western diet their bodies aren’t able to cope with,” says Marina.

Unfortunately, as Marina explains women who are carrying multiples are also at a higher risk of developing GDM due to the larger placenta, and GDM has a lot to do with placental hormones. So, the more babies you’re carrying, the more placental hormones you’ll be producing, which increases the chances of developing GDM.

Testing

There are two ways to be tested for GDM:



* A fasting blood glucose test, usually done in the first 12-weeks of pregnancy for women considered at high-risk of developing GDM. If this fasting level is elevated, then you will get a positive diagnosis and further testing isn’t required.

* The two-hour glucose tolerance test – this is where after an initial blood test you drink 75 grams of glucose syrup, which is followed by two more blood tests to see how your body reacts to the glucose load. This test is ideally given at 26-to-28-weeks’ gestation, however, if there has been a GDM diagnosis in a previous pregnancy or there is a family history of Type 1 or Type 2 diabetes, the test will be done at around 20-22-weeks’ gestation.



Deb Howe is an identical twin and just gave birth to identical twins. She invited us along to her Glucose Tolerance Test at 26-weeks’ gestation. Deb was considered a high-risk because her twin sister has Type 1 diabetes.

After fasting for 10-hours, Deb had her first blood test and was given a 300ml bottle of liquid to drink, which contained the 75 grams of glucose syrup.

Everything was going well until about 20-minutes after Deb consumed the sweet liquid, she started to feel a bit lightheaded, the babies were kicking a lot, and she felt a tiny bit of nausea.

Deb admits she was worried that she had developed gestational diabetes...

 

Order your pre-launch copy of the book DOUBLE HAPPINESS MULTIPLIED - What you need to know about having Twins, Triplets, & Quads HERE: 

https://www.doublehappinessmultiplied.com/twins-triplets-quads-book/

 

 

On Episode Five, we discuss the seven most common complications that can arise in a multiple pregnancy.

Maternal-Fetal Medicine Specialist Professor Craig Pennell explains certain conditions to be aware of, what to look out for, and what do when you receive a diagnosis you’re not expecting.

Author Alexa Bigwarfe talks about twin-to-twin transfusion syndrome, and I share my story of intrauterine growth restriction.

By the end of this episode, you’ll have an in-depth understanding of the many possibilities that could affect your pregnancy, but hopefully, you’ll be reassured that if you’re in the right hands those obstacles can be surmounted and you’ll be able to enjoy your pregnancy.

The risks of having a multiple pregnancy

Once you’ve been diagnosed with a multiple pregnancy, there is so much to learn that falls outside what you might already know about pregnancy. When you’re carrying twins, triplets, or quadruplet babies the risk for complications rises and depending on what type of multiples you have on board will determine the level of that risk, and what treatment options are available to you.

Maternal-Fetal Medicine Specialist Professor Craig Pennell says even though there are increased risks involved with multiple pregnancies that doesn’t mean you can’t enjoy your pregnancy.

“The things that can go wrong in multiple pregnancies are divided into those that can happen to all multiples and those that are specific to particular multiples,”

“For example, Monochorionic Monoamniotic twins, also known as MoMos, account for just one-percent of identical twins and they’re the type of twins where cord entanglement can cause problems, which is associated with a loss rate in the pregnancy of up to 50 percent,”

“In all the other types of twins where there is a membrane between them so those conditions can’t occur,” explains Professor Pennell.

If we look at twins, in general, some of the things that can occur are:

Hyperemesis

Severe nausea and vomiting are very common in a multiple pregnancy, according to Professor Pennell.

Professor Pennell reassures us that the condition usually goes away at the end of the first trimester, so around 13-or-14 weeks, however, in about 10 percent of women it continues throughout the pregnancy.

Miscarriage

According to Professor Pennell, the other thing that is more common in the first trimester of a multiple pregnancy is a miscarriage. He says the rate of miscarriage in twins is at least double, if not higher, than the rate in singletons. And, it’s often not noticed or simply missed depending on when you have your first ultrasound.

“If you’re having scans from five-weeks, you may see what starts as a twin pregnancy that then ends as a singleton somewhere between six-and-12 weeks, whereas if your first scan is at nine-weeks, you may not realise that it started as a twin,”

Not surprisingly, the rate of miscarriage in Higher Order Multiples is again higher. This is somewhere in the order of 30-50 percent where you would lose at least one of the embryos in the first trimester, according to Professor Pennell.

Structural Anomalies

All babies have the chance of having a structural problem (about five-percent), which includes such things as a clubbed foot, an extra finger, cleft-lip-and-palette, a hole in the heart, or an issue with the kidneys.