Author: Stephanie Ernst
Identical twin parents will all nod their heads here when you ask them what one of the silliest questions they’ve ever been asked is.
“Is it a boy and a girl?” (I seriously heard all of you out there rolling your eyes right now!)
Here’s the tea, though: It can happen, but it’s super rare. We’re talking you’ve got more chance of winning the lottery rare! But it does happen, and it can occur in a few ways.
Author: Samantha Wolfe
“How many do you think are in there? One or two?” My wife asked me as we headed for our dating scan. 5 weeks prior to that I had had a double frozen embryo transfer. This was my 4th and final attempt at pregnancy. My wife and I did reciprocal IVF to conceive our children. She carried our first (master 3, biologically mine) and then we swapped.
“Maybe one?” I replied. Although I had a great HCG level, I didn’t feel pregnant in the slightest, the only symptom I had at that stage was no period.
As the ultrasound picture hit my uterus my eyes lit up. There sat two tiny little sacks, with a tiny little baby in each. Ecstatic is an understatement. I felt like I had waited a lifetime for this.
No gonna lie, I had a textbook pregnancy up to 32 weeks.
As I laid down in the examination chair for a quick ultrasound in my obstetricians rooms, he looks at my belly just under my belly button “…is that itchy?” Pointing to an itch that had started about a week earlier. “Yes actually, why? What is it?” Thinking it was just itchy stretch marks from my skin stretching. “You’ve got PUPPP, Pruritic-itchy, Urticarial-like mosquito bites, Papules- big lumps, Plaques- really big lumps, of pregnancy”
I left the rooms that day with my induction date. My obstetrician telling me that it doesn’t harm the baby, however it causes insanity in the mother with the itch. Pfft really? How bad could it be..? Let. Me. Tell. You!
Choosing names is a tough job at the best of time. But its even tougher when you have to choose more than one!
And then of course you have middle names. And what if you don’t know the gender – then you have to think of even MORE names!
You can read our blog on choosing names in general for twins or triplets HERE.
However, once you have FINALLY decided on the names, if you have same sex twins your job isn’t quite done. You still need to decide which baby gets which name!
Often parents get very bogged down in this, as they feel the pressure of getting several years down the track and maybe thinking that the names would have been better the other way around! Don’t panic though. You will find in most cases that babies seem to grow into their names, and you will (hopefully!) look back and think there is no way that Baby A could have been called Baby B’s name.
Nothing, and I repeat nothing will ever replace the multitude of emotions that you will experience when you first find out you are pregnant with twins or triplets. And that is perfectly normal.
You will spend the next few days…..or even weeks or months……..oscillating between excitement and fear, plus every other emotion in-between.
Twinfo is here, every step of the way, starting withy our online pregnancy course.
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Author: Sherrie Phelps
My pregnancy and birth story is almost like something out of a movie! We had possible TTTS, TAPS, preeclampsia, HELLP Syndrome and twins!
Easy smooth pregnancy until my ultrasound at 26+5 weeks at Dubbo Base Hospital. The doctor and MFM at Nepean were concerned about possible TTTS so they told me to go to the birthing unit and do at least 15 minutes of CTG monitoring to see how the babies were coping.
Because they don’t usually do CTGs until 28 weeks due to small babies being able to wriggle away from the monitors we were in there for a while. I started getting anxious and started having a panic attack. The midwives put electrodes on my ankles, wrists and chest for an ECG test and a cannula in my arm. My husband ran into the bathroom nearly throwing up cause he hates needles. Several hours later we went home.
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Congratulations you are pregnant! How exciting. Oh wait…there are two babies? Three babies????
Suddenly all the rules have changed. The panic sets in. The fact that you were never planning on finding out the gender of your baby may change now its TWO or THREE babies. Planning mode kicks in and you decide you now need to definitely find out the genders. But take a step back. You don’t HAVE to find out the gender just because there is more than one baby in there.
The desire to have a surprise at the end of the pregnancy means some people choose to not find out the gender. In todays technologically advanced world you may know the date of conception (from careful ovulation tracking to IVF), the date they are to be born (elective c-section or induction) and even what they look like (have you seen how clear the latest 4D cans are!!). So to find out the gender is really the last of the unknowns.
There aren’t that many surprises in life that can equate to this. That moment when you see them for the first time and find out their gender is equated to a moment time stands still. Plus you know what they are for the rest of their lives, those few months of not knowing is so exciting. And it is fun to keep everyone guessing.
Be warned though, you may face backlash from family and friends (and even strangers!). Be ready for comments like “I could never, how will you be prepared?” or “but you’re having two………”. Let me assure you, all the gender specific clothing in the world will never actually prepare you for having multiple babies!!
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Sonographer: And here is your baby. Oh, and here is your other baby. Congratulations it’s twins!!! Or if your extra lucky it’s triplets.
At some stage you are going to need to decide if you are going to find out the gender of twins (or more!).
Sometimes women who are pregnant with twins or triplets may spend some of their pregnancy on bedrest. This can be difficult at times. But it is so important, and with these easy tips you will find being pregnant with triplet or twins and bedrest a bit more bearable!
There are times in your life when you would love to be ordered to stay in bed. Being pregnant with twins, triplets or more isn’t really one of them. The idea of being pregnant on bedrest might sound nice, but the reality is much less pleasant.
If your doctor tells you that you need to stay in bed until the babies are born, this can be a mixed blessing. Any woman with a high-risk pregnancy should always follow the best advice of her doctor. But lying still when you have several tiny football players growing inside you is not so easy to comply with.
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You may already suspect you are pregnant, however that first scan and seeing the heartbeat is always a magical moment. Congratulations! You are definitely pregnant. There is the heartbeat. Oh wait, I think there is a second heartbeat. You are pregnant with twins! Oh, I think there is a third baby! Congratulations, you are having triplets!
Once you have recovered from the shock of finding out you are pregnant with multiples, your thoughts will soon turn to your pregnancy care. There are many options, all of which your GP can discuss with you.
One aspect of pregnancy care that you may not have thought of, is having a student midwife. A student midwife is a midwifery student that is partnered with you through your pregnancy, birth and postnatal period. The student is supervised by a registered midwife. There is a two-way benefit to this. For you, you may feel overwhelmed with all the information that you are presented with. A student midwife will be able to explain things and help you ask the right questions. It will also mean that you will have continuity of care, as the student midwife will attend all appointments with you. Oh, and I should mention, it is totally free.
In return, it is invaluable for the student to develop an intimate understanding of the process that pregnant women go through. And let’s face it, for a student midwife with twins or triplets, it is an amazing experience for them.
Twinfo asked in our closed Parents of Multiples group for some feedback from those who had used the services of a student midwife with twins or triplets.
Author: Stephanie Ernst
TAPS is a rare disease affecting twins sharing a placenta. There’s a lot of myths and misconceptions out there about it, which is something I want to try and “bust” for Twinfo readers!
As a TAPS mum myself, I know how scary and confusing this diagnosis can be. So I wanted to help you understand our disease and what is and isn’t true about it.
Twin Anemia Polycythemia Sequence is a rare disease affecting twins who share a placenta. (Note: We say twins who share a placenta because TAPS *has* been recorded in non-identical twins. It’s rare, but it has happened in some cases of fused placentas – which is why it’s important to say a shared placenta).
There are 2 forms of TAPS – the “more” common form is spontaneous TAPS, which happens in around 3-5% of monochorionic twin pregnancies. The second type happens after laser surgery for twin-to-twin transfusion syndrome, where connections in the placenta are not sealed properly or are missed on the edges of the placenta.
It’s caused by tiny connections in the placenta, less than a millimetre thick. Unlike TTTS, which can be rapid and happen in hours and days, TAPS is a long, slow transfer of red blood cells from the donor twin to the recipient. This causes the donor twin to become anemic with blood like a rosé wine, and the recipient twin with blood as thick as tomato sauce.
The anemia can cause some problems with the donor twin, like heart failure, and contribute to them not growing as well as their sibling. For recipient twins, their blood is so thick that it can cause problems for their hearts pumping it around. It can also lead to blood clots, causing severe problems like in-utero strokes and loss of limbs.
Before birth, this is using doppler readings on the mid-cerebral artery in the brain. It’s like a speeding test on the brain – soundwaves are bounced off the blood as it moves through the brain. If it’s moving too fast, this can be a sign of anemia and too slow, a sign of polycythemia.
These measurements are checked carefully (they should be checking them 3 times and taking the middle reading) and compared to each other. TAPS is diagnosed on the difference between the readings. If one is moving too fast and the other too slow, this can indicate that TAPS is developing. Remember that just like a speeding camera, the readings depend on the operator’s skill and getting the right angle. If you have one lousy reading, it’s a good idea to go back and get checked in 2-3 days to confirm the diagnosis.
It’s important to remember that there are other signs of TAPS on ultrasound as well. Your team should also be looking for these. Things like a bright appearance (echogenic) to the donor’s side of the placenta or an enlarged heart in the donor indicate TAPS. Recipients can also have something called a “starry sky” liver.
Even though there are other TAPS signs, you do need to have MCA dopplers done every 2 weeks, starting no later than 20 weeks. These are still the most reliable way to detect TAPS in utero.
After birth, TAPS is diagnosed through blood testing, where they check the number of reticulocytes (or young, mature red blood cells). TAPS donors have high numbers of these, as their bone marrow is constantly creating red blood cells to compensate for all the ones they’re sending to their sibling. They’re also going to have low haemoglobin, meaning they may need some transfusions to kickstart their own red cell production.
Recipient twins might also need to have a procedure done called a partial exchange transfusion, where they will thin out the baby’s blood with saline, and take some out.
One of the important things to remember is that both forms of TAPS have different outcomes, but that’s why it’s so important to screen for it.
Post-laser TAPS has a higher rate of mortality for donor twins before, and just after birth. However, long term effects are very similar to TTTS cases, with donors and recipients equally impacted.
But spontaneous TAPS is very different. The long-term effects of spontaneous TAPS are quite shocking, with donors at risk of a specific type of deafness (around a 15% chance) and are 4 times more likely than recipients to have some form of cognitive delay.
This is why we advocate so hard for routine screening for TAPS and twins. Early intervention is vital, and there are treatment options available for TAPS patients.
So now, why is there a foundation for TAPS? Back in 2013, when I was diagnosed with TAPS, there wasn’t a lot of information out there about it. A couple of journal articles, and a Wikipedia page, and really that was it.
Over the years it’s been hard to find a community that understood our TAPS diagnosis, and many doctors failed to recognise it as a different disease to TTTS. There’s still a myth out there that it’s a form of TTTS, (it’s not!) and this means that some doctors will not take it seriously or do followup testing.
We started the TAPS Support Foundation to help raise awareness of TAPS, but also to help fund research into it. In 2021, we’ve taken on our biggest project yet and are trying to raise the money to help put a part time TAPS researcher on at a university for 12 months.
Because of our close association with researchers, we also have access to the latest research as it happens, and we even do some writing ourselves to raise awareness of the complications of twins!
We also provide open access resources on our website TAPSSupport.com. And we do have a Facebook group, which is open to researchers, doctors, families and caregivers who either had, or think they may have had a TAPS diagnosis. We call it our family, because it’s a place where you can go where everyone had been down a similar path, and understands the frustration of the diagnosis.
If you’re facing a TAPS diagnosis, or you want to learn more – get in touch with us! We’re here to help you navigate that diagnosis, and advocate for care before and after birth.
Stephanie Ernst is a freelance writer and self-proclaimed TAPS Nerd. She’s the TAPS Support Foundation‘s founder and spends her free time raising awareness of the issues facing parents of twins. Her own experience with Twin Anemia Polycythemia Sequence (TAPS) and feeling the isolation of this diagnosis drives her determination to change screening protocols worldwide, support twin research, and raise the profile of multiples’ rights.
