So you just found out you're having identical twins! If you're anything like me this news could be met with a little excitement, and a lot of fear, confusion and anxiety. And if you’ve stumbled upon this post you may have gone down the google rabbit hole of all the possible complications ahead of you. So I’m going to offer a gentle congrats, and share a bit of our story with the hopes it will give you more information and peace of mind.
If you’ve been following my social media accounts for awhile, you may know we struggled with secondary infertility after trying to extend our family a year after our first son was born. I’m not going to go into detail on that in this post, but if you’d like to read more about our infertility journey you can read about that here.
In May of 2020 we decided to go ahead with IVF due to difficulty conceiving and carrying a baby to term (two miscarriages). After our first transfer failed my anxiety was an all-time high. Our second transfer was a frozen embryo, and seemed to take right away. Like most TTC (trying to conceive) mamas, I started testing only a few days past transfer. Six days after our 5 day transfer (11dpo) those two little lines showed up on my first response pregnancy test. And it wasn't even one of those squinty lines that you have to find the right light to see. It was a glaring two lines staring back at me no question! I kept testing every day (cause, loss mom) and those lines kept getting darker. The day before I went in to get my blood drawn to test my hCG levels, those lines were very dark. It was at that time I suspected I might be having twins.
Of course being the researcher and worrier I am, I started googling all about the possibility of having twins with one embryo transfer. And of course I was met with all the risks and possible complications that come with an identical twin pregnancy. When I received my hCG results and they were quite a bit higher than average (864 to be precise) it made my suspicions even stronger. I was thrilled to be pregnant and that I had such a great numbers, but I was starting to worry that there might be two babies in there. Not because twins aren't an amazing double blessing, but because that would mean I was having a very high risk pregnancy, and after my history of losses, that was something I just simply wasn't prepared for at the time. I so badly wanted an easy, uncomplicated, "normal" pregnancy.
Just a week later I started feeling some severe nausea. And only a few days after that I started bleeding. Of course given that I have had miscarriages in the past I started to spiral into anxiety. Because I was so early in my pregnancy I really didn't have any options for an ultrasound or intervention. I was six weeks along and my ultrasound was in a weeks time. Thankfully, I had a midwife who was able to get me in for another hCG blood draw to give me some more information. My numbers came back so high that we I felt a little better, however my bleeding was very heavy and I was paralyzed in fear that those numbers were already dropping. I took another blood draw two days later to confirm that it was continuing to double, and it was! In fact, it was growing at an incredibly fast rate.
When it finally came time to do my ultrasound, I was a wreck. All I wanted was to see that little blinking light and hear all was ok. My husband and I sat in the room silently holding our breath waiting for the ultrasound tech to tell us if there was in fact healthy baby in my uterus.
It felt like an eternity until I saw that blink. And then somehow, as if I already knew, I saw a second one.
As soon as she said "I see another heartbeat", I started crying uncontrollably.
I immediately thought back to the conversation we had with our fertility doctor about our options when preparing for a second transfer. He told us to increase our chances of a healthy pregnancy we could transfer more than one embryo, however we had to be OK with the "risk of twins". Because we already had a three-year-old son at home, and we had only planned to have two children, we opted to only transfer one. Well, I guess I was truly destined to be a twin mom... especially since the chances of having identical twins is less than 1%.
It took me a long time to come to terms with the fact I had two babies in my uterus, and that those two babies would make it home with me 9 months later. And even though there are so many positive stories of healthy identical twin pregnancies and babies, I was unable to hear any of that at the time. All I could focus on was the negative. I was paralyzed with fear, constantly waiting for the shoe to drop. Because of this, I felt like the joy was robbed of my last pregnancy.
Somehow, even though we had a couple scares early on, the babies made it to 36 weeks exactly for my scheduled c-section. Both babies were just over 5 pounds and able to come with me directly to postpartum without the need for the NICU (other than a couple hour stay on day two to monitor blood sugar for Hayden). We were discharged on day three, when they got to go home to meet their proud big brother. You can read more about my birth story here.
Looking back on my twin pregnancy, there are some things I would have done differently, and some key information I wish I would have known from the beginning. I hope by sharing five of these things below, I can spare another twin mama some of that fear and anxiety.
WHAT I WISH I WOULD HAVE KNOWN
1. There are different types of identical twins. The type of twins you have is determined by when the embryo implants into the uterus. Some twins have their own amniotic sac and placenta (didi), some share both the same placenta and amniotic sac (momo) , and the third type shares the placenta but are separated in the sac by a thin membrane (modi). Each type has different risks and possible complications. My twins are monochorionic diamniotic (modi) twins. You can read more about the different types of identical twins and the possible complications here.
2. Just because you can't see the membrane, it doesn't mean that it isn't there. One of the biggest differences in risks associated with mono (modi or momo) twins is whether or not the fetuses are in the same gestational sac or not. As mentioned above, monochorionic diamniotic (modi) twins share a placenta, but have a small membrane separating them in the amniotic sac. Most times the membrane is hard to find until past 14 weeks gestation. Having this membrane helps eliminate several complications, making the pregnancy slightly less risky.
3. The importance of being referred to a maternal fetal medicine (MFM) specialist as soon as possible. Having a MFM who you trust early on in your pregnancy is so important. The number one thing you can do to lessen the risks that come with mono twin pregnancies is to have regular scans to check on the babies. I was seen every 2-4 weeks starting at 14 weeks. While it was stressful being seen so often, it did give me peace of mind to have as much information as possible. Be sure to ask a lot of questions. Listen to your body, and always get checked if you feel like something is off. In high risk pregnancies, its always better to error on the side of caution.
4. There is an amazing online community for moms of multiples. I wish I would have joined a mono twin pregnancy group on Facebook (like this) sooner in my pregnancy. It is so helpful to be able to connect with others who have been through similar twin pregnancies that can provide you with advice and support along the way. Instagram is another excellent way to connect with moms of identicals. The best part of being a twin mom is you are automatically a part of this amazing twin mom tribe. Through this online community of twin moms, I have met some of the most supportive and kind (not to mention strong as hell) woman.
5. Your mental health is just as important as your physical health. Twin pregnancies are extremely difficult on your body, soul and mind. And while it is easy to understand the importance of eating properly, getting lots of rest and changing other lifestyle habits to stay healthy while pregnant, cutting back on stress and anxiety is just as important. I am so grateful that I had a doctor who recognized how much I was struggling with my pregnancy after my miscarriages. He encouraged me to take time off work to focus on my health and eliminate stress. As part of that time away, I saw several mental health specialists including a bereavement coach, therapist, and support group. I also leaned into digital art as a type of therapy to keep my hands and mind busy while I was resting at home. Other types of self-care I did to manage my anxiety included outdoor walks, journaling, meditation, acupuncture, yoga nidra and massage.
Navigating an identical twin pregnancy can be very overwhelming. I hope reading about my experience and the points above will help. As always, please reach out if you have any questions or if there is anything I can do to help you in your twin mom journey.
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