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Excerpt from Chapter 1: Getting Them Close to Term
In my twin travels since having our boys, I have met so many families with multiples who have moving, sometimes tragic, sometimes nearly heroic stories about childbirth: the setting is usually the NICU, and the protagonists, two or three tiny babies who come much too early. Neonatal care has become astoundingly effective, and many of these stories now end happily after a frightening start and much arduous effort. But even when all seems well after the crisis period of weeks or months in the hospital, the lingering tragedy of the hidden harm produced by an early birth remains, and the eventual emergence of these problems is a slow drip of agonized worry and coping over years, whether the problems are as mild as slight learning differences or as severe as cerebral palsy.
It is a difficult project for a woman's body, be it twenty-four years old or forty-three years old, to grow more than one baby at once and take them to term. Actually, it's a pretty tall order to do so with one baby. As common as having multiples is becoming, it is tempting for us to think that because everyone seems to be doing it, it must be a reasonable proposition. But in spite of the numbers of us having twins or more, it remains a daunting task right from the first trimester. While it obviously can be done, it is worthwhile to bear in mind that we weren't truly designed to make two at a time. We cannot simply assume that our bodies will figure out what needs to be done and obligingly provide, regardless of the level of our more conscious efforts.
Dr. Barbara Luke's book, When You're Expecting Twins, Triplets, or Quads (coauthored with Tamara Eberlein, published by Harper Collins, 1999), is a great resource for helping to ensure a healthy multiple pregnancy and delivery. When I was pregnant, we read it, re-read it, highlighted it, re-re-read, and marked important passages with stickies. It was completely dog-eared by the end of my pregnancy. In a nutshell, the author, who is a prominent researcher in prenatal nutritional issues, argues for the importance of substantial maternal weight gain in order to bring multiples to term. But please don't be contented with the nutshell version. Go get the book.
Eat More and Slow Down
The truth is that you can do a lot to increase your chances of getting your babies to term. Ironically, the most important elements to success are two ideas that have become completely counterintuitive for the modern western woman: to eat more and to slow down. Very quickly, you need to reorient your thinking so that you can see weight gain and rest as good things, even if they have been your tacit enemies since adolescence. The concept of needing more rest when gestating two babies would seem self-evident at some level, and yet most of us are so accustomed to catapulting ourselves through hectic, overscheduled days and into evenings of re-grouping, bill paying, housecleaning, and scheduling tomorrow's madness that "rest" or "slowing down" means doing all that except, perhaps, the dishes. It's difficult for us to imagine how life would proceed if we truly eliminated or lessened the activities that fill our days. The dry cleaning can't get itself. That disgusting bathtub won't self-clean. One ought to pay one's bills. Right? Sort of.
Yes, life goes on. But your contributions to operations of the household must, must, must be diminished, and this is true even if you love being pregnant and have never felt better in your life. This is not simply a remedy for the suffering. It is a preemptive measure that will help ensure the babies' health. You need to rest every day, and at times of the day that would normally embarrass you as indulgences. This means a nap after lunch, or as soon as you get home from work, and an earlyas in right after dinnerbedtime, even if you lie in bed and read for hours before sleeping. Even if you feel capable of pushing harder and getting more done, don't. If you wait until you are totally beat and aching to rest, you have waited too long. It's like getting an oil change for the car: if you can feel a difference in your drive afterward, you waited too long. This is preventative rest, not restorative rest. And someone else will simply have to pick up the slack on everything else from bathtub scrubbing to board meetings. You will probably be surprised to see how much more adaptable others are to your new status as a slug, compared to you yourself. Give yourself permission to give these babies the best chance they can have, knowing that it involves some sacrifices.
Research points repeatedly to rest and nutrition as crucial in determining the health of twin babies. Yet as convinced as I was by the logic of this research, I still struggled with the notion of pursuing a substantial weight gain. That is, at the same time that I was willingly and healthfully gaining seventy pounds over thirty-nine weeks, I was simultaneously sickened by the thought that perhaps I would only lose, say, eleven pounds of it. I had a hard time believing faithfully in my being able to lose that much, having struggled with my weight in the past. This was a strange emotional position to occupy: half of my brain saying, "Eat. Eat!" and the other half saying, "Oh Lord, will I weigh over two hundred pounds for the rest of my life?" The answer for me was no; in fact, I weigh less now than I have since high school. (My high school friends will tell you that this isn't terribly impressive, which is just one of the many reasons I no longer hang out with them…but you see my point, right?) Gaining more weight than your entire body weighed in fourth grade needs to become a goal, not a dread.
Eat as much healthful, protein-filled, vitamin-packed food as you can manage. And then eat more. And then take a nap. There are all sorts of reasons that multiples sometimes come early, so it is simply incorrect and unfair to surmise that a mother of preemies didn't do everything she could to get those babies to term. At the same time, eating and sleeping are two behaviors that you can control that will help to give your babies the best possible chance they have to stay where they belong until they are fully cooked. As we used to say during my third trimester: in spite of the aching back and sleep disturbances, they are much, much easier to take care of while they're still inside you.