Perinatal Mental Health and Twins: From Pregnancy, Birth and Postpartum

Author: Katrina Weynberg

Our Twin Pregnancy with Antenatal Anxiety 

“You’re having two babies!” the sonographer said as she re-scanned me at my dating scan. I walked into that appointment thinking that I was pregnant with one, yet there I was having two! I was told to return back in two weeks to find out what kind of twins they were. From that moment, my antenatal anxiety began and before I knew it, two weeks was my new norm, as we were deemed a high risk pregnancy!

At the following scan, I received the news that I was carrying MCDA Twins; identical twins with two sacs sharing ONE placenta. I was told that every two weeks, I would be undergoing checks and scans to ensure that my twins were not experiencing Twin to Twin Transfusion Syndrome (TTTS). Carrying this knowledge, had me researching, stressing and spiralling and I truly needed antenatal support. I felt so isolated not knowing anyone else that was a high risk pregnancy. Everything we thought we knew about pregnancy went out the window and my partner and I found ourselves feeling so alone… 

The closest thing we could describe our twin pregnancy experience was when we hiked Mt Everest. We were all walking on the same trail with our own load and baggage, yet no one actually saw the mental and physical load that one was carrying. Each week of the pregnancy felt like we were acclimatizing up to the next tea house in the Himalayas, sometimes gasping for air… So as each week went by, I became more anxious and I was very nervous about the birth…

Perinatal Mental Health and Twins: Birth Trauma

At 33 weeks; at my routine scan, my sonographer said “you have to wait in the waiting room…” Immediately after this was said, my heart dropped and I knew that something was wrong. My specialist called me in and she re-scanned me more times than I could remember. She told me that I would be giving birth within the next week. “Your babies are safer outside than in” is what was said. Nothing could prepare me for this moment. Mumford (Twin B) had developed a growth discrepancy. He stopped growing for two weeks and he was only circulating blood to his head and his heart. The doctors called him a miracle for this reason.

Before I could blink, I was on a hospital bed and steroids were being injected into me to help my babies’ lungs. After a restless night passed with no sleep, I was quickly wheeled away to the birthing unit. Mumford’s dopplers had dramatically dropped and we were going in for an Emergency C-Section…

When Murphy (1.7kg) and Mumford (1.4kg) were born, I thought that they were going to be placed on my chest (like what you see in films and books). This did not happen for me, instead they wrapped their tiny little fingers around mine before they were taken away to their shuttles for the Neonatal Intensive Care Unit (NICU). Helplessly, I looked to my left and I could see a twin receiving respiratory support but I could do nothing. Tears were streaming down my face and this was the onset of my Postpartum Psychosis. As tears flooded down, we had to choose for Donald to come with me or to follow our twins into the NICU. We chose for him to shuttle Mumford and Murphy into what they’d call home for 7 weeks.

NICU & Postpartum Psychosis 

I had to wait 8 long, painful hours before I was able to hold either of them. When I was eventually wheeled down, we were able to do skin-to-skin with a twin each. Sadly, our twins were separated by a wall so we did not get to share all our core moments together. This, along with birth trauma, no sleep, pressure to breastfeed, pumping, COVID, PCR testing, a premature birth, a CPAP on your baby’s face, no visitors allowed and leaving the hospital empty handed- sent me into a manic state

For 12 days, my mental health deteriorated and the next thing I know is I was being triaged into the Emergency Department for Postpartum Psychosis. Postpartum Psychosis occurs in every 1 in 1000 birthing mothers. It is a very serious but treatable mental health condition.

I was hospitalized for 33 days and for the entirety of this psychiatric stay, my twins were in the NICU. I had to learn how to be a new mum whilst bounded by walls of a psychiatric ward. Donald had to learn how to be a father to two in the NICU, while his wife was unwell receiving psychiatric care. This all happened all at once and to this day, we can’t believe that this was our reality. Once upon a time, I was handing EBM to Donald through the confined doors of a psych ward to send down to our children in the NICU. After a very long and traumatic month, I recovered from Postpartum Psychosis and together; we were discharged as a family… 

Postnatal Depression & Bipolar Disorder 

When we were finally all discharged from the hospital, I thought everything was over… Though this was not the case and this became the crux to our story. We left the hospital after 7 weeks. Weeks and weeks of hospital food, weeks of cafeteria coffee and weeks of being separated from my twins and Donald. We took the “happy discharge photo” and went along our way…

But when we got home, I was so depressed. It was like a tonne of bricks had fallen onto me and I could not breathe. Everything was foggy and there was no real clarity around why Postpartum Psychosis happened to me. Why was I the statistic?! How did I become so unwell?! The days were long and they felt like they would never end. After linking in with the Perinatal Infant Mental Health Services (PIMHS) at my birthing hospital, I was able to be referred to a Mother Baby Unit (MBU). 

Unfortunately, at the time of my crisis’ there was no public MBU available, so I suffered with Postnatal Depression for 6 months. Eventually, the first ever NSW public MBU opened in Sydney, and we were 1 of 4 piloting families to receive perinatal care. This hospitalisation became the crux to our story, as it was in this admission that I was diagnosed with Bipolar 1 disorder. Once the psychiatrist confirmed this diagnosis, we had to give up breastfeeding effectively- immediately due to medication. Although this no-choice decision broke my heart, we knew as a family that this was best. After being discharged from the MBU, I spent the next 6 months figuring out how to parent with a mental health condition..

Perinatal Mental Health and Twins: The First Five Years 

The first five years have been hard and humbling with a dreamlike haze. Although we’ve had our challenges with mental health, we’ve also had incredible milestones together. Watching their teeth come through, watching them crawl, walk and dance, to toilet training them both at the same time! It hasn’t been an easy journey, but it’s one we’re at least doing together. Fast forward five years, Mumford and Murphy are thriving in Pre-school; learning how to write their name. Donald and I have spent the last five years unpacking our experiences through therapy. Now, I am a mental health advocate writing articles like this one on perinatal mental health and twins to raise awareness!

If you or someone you know needs support:

• PANDA (national helpline Monday to Saturday) on 1300 726 306
• Red Nose Australia (24/7 bereavement support) on 1300 308 307
• Gidget Foundation Australia (perinatal mental health counselling support) on 1300 851 758
• SMS4Dads (free text support for fathers)
• LGBTQI Health Australia (LGBTIQ+ peer support and referral)
• 13 YARN (Aboriginal & Torres Strait Islander crisis support line. Available 24/7) 13 9276
• Lifeline Australia – Crisis Support. Suicide Prevention – 13 11 14

I wrote this poem about our experience with perinatal mental health and twins.

chest to chest by Katrina Weynberg

It's a hollow feeling
an emptiness inside
they were meant for my chest
heavy tears I cannot hide

with no one in my arms 
see their shuttles in sight
they’re about to leave
it was my passage, 
it was my rite

when they leave I wander
helpless thoughts here to stay
it was not like in films
I was really kept at bay

to the sadlands I go
I’m far enough by sea
an empty boat sailing
with silence echoing me

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