Two at a Time: Having Twins: The Journey Through Pregnancy and Birth

First Chapter

Chapter One: Precious Cargo

How did you find out you were carrying the most precious cargo of all? Many women I've talked to tell me they knew they were pregnant before a test confirmed it for them. Some just had a sort of sixth sense about it, others felt too edgy to believe they were simply premenstrual. One friend was certain she was coming down with the flu, she was so tired, until she realized she'd been "coming down with something" for weeks, and the "something" had never materialized — but neither had her period!

With my other pregnancies, there were always two infallible early signs: suddenly, strong smells were upsetting to me; I couldn't even bear the scent of my favorite perfume. But most of all, I was tired, a word that's not usually part of my vocabulary. Those symptoms always set me to wondering enough to go to the doctor for a pregnancy test.

When I got pregnant with our twins, because we were assisted by technology and I was closely monitored, I hardly had a moment to wonder what was happening. Before I had time to develop symptoms to wonder about, I knew not only that I was pregnant, but that it would be twins. I'd stepped immediately into a phase unique to women like you and me — that of wondering about how and why these two embryos, these twins, came to grow inside of us.

One Egg, or Two?

My boys have a strong family resemblance to each other, but they are fraternal. Still, people are forever asking me if they are identical. More to the point, they also ask me how I can be sure whether they're identical or fraternal. Usually, I simply smile and tell them to look a little more carefully at the boys, and they'll see the differences.

With closer friends I tell them I know because all babies conceived with help, as ours were, are fraternal. Fertility treatments — in all the forms that have to do with women's reproductive systems — simply encourage the ovaries to produce more eggs, not to make them split. And if you've been through fertility treatments, I don't have to tell you the details of how they work. When James and I were going through that process, we ended up feeling that we knew far more than we had ever dreamed we'd know (or honestly, wanted to know!) about conception. Suffice it to say that, no matter how they were produced, when two fertilized eggs implant in the uterus, you're having fraternal twins.

Identical twins are another matter altogether. Because they come from a single fertilized egg, identical twins have identical DNA, and of course, unlike my boys, they really do look alike. If your twins were conceived without medical help, "the old-fashioned way," you'll not likely be able to tell whether they are identical or fraternal unless you have amniocentesis (more on such tests in Chapters 2 through 4). Ultrasound sometimes offers clues, but not always.

If you're lucky, when your babies are born, the routine examination of the placenta will show that your babies had one of everything — one inner sac, one outer sac and one placenta — then you'll know they are identical. Any other combination for babies conceived without help means the decision, fraternal or identical, is up for further analysis.

You can have DNA tests done on your babies, but they are very expensive, and most doctors will tell you they're not worth it unless there's some medical problem you're trying to sort out. Or, you can simply wait and see how they look!

First Feelings

Immediately on the heels of the wild, incredible, unbelievable joy James and I felt on finding out we were pregnant, came fear. I was terrified I'd lose these babies as I'd lost two other pregnancies during our fertility treatments. One miscarriage had occurred very early on in the pregnancy, and was not much more than a heavy period when I knew I shouldn't be having one. The second was much more traumatic and frightening. It happened while I was on live national television, co-hosting the New Year's Day parade in New York. By the time I felt the cramping, it was too late. The moment we were off the air, James carried me to a nearby hospital where the doctor confirmed that I had miscarried. We were brokenhearted.

So this time, when I was told I was pregnant, I was afraid to move. Swing dancing was out — and James and I had fallen in love dancing, so even though it may sound unimportant, it was a kind of loss for us, but certainly one we could live with. At work on the set of Dr. Quinn, we made some alterations immediately. I could sit on a horse or in a wagon, but I wasn't going to jump up onto either of those, even though the story line routinely called for me to do that. So we got a body double for me, and she did the leaping, the jumping and the sliding into home plate as one episode required soon after my positive pregnancy test. I was happy and relieved we could do that, but it made me think of how hard it is for women who are not actresses, who never get a body double for hard work they have to do in normal life, difficult pregnancy or no. Wouldn't it be great if we could all have a body double to stand in for us when we're feeling especially fragile — or when we actually are especially fragile?

I have to admit that feeling so afraid and vulnerable early in my pregnancy was disconcerting. Perhaps you've felt that kind of fear and worry, too. I hope it will be comforting for you to know that for me — and I think for many women — the fear did pass, especially as I worked hard to do all I could to take care of myself and of my babies, and as I learned more about what was happening to me, and to them. And I tried to be philosophical. I'd psyche myself up by telling myself "I will do all I can to achieve my goal," and then in my mind I sort of let go of the end result, even while I'm trying my best to make sure it has every chance of happening. That's what I did early on in my twin pregnancy. I focused on what I could do rather than dwelling on what frightened me or on what I could not control.

I also tried to laugh as much as possible. It seemed to lighten the dire atmosphere I could so easily create for myself. Out of necessity, James and I began to find humor in some pretty strange situations. If you've had difficulty keeping a pregnancy, or if you've undergone fertility treatments, you'll be familiar with the progesterone injections (or suppositories) necessary to be sure the embryos implant in the wall of the uterus and stay there until the placenta (or placentas) can begin making enough progesterone on its (their) own. By that time I'd had so many injections, James and I often joked about feeling like junkies — always looking for a private place to "shoot up." I remember going to a certain glamorous black-tie Hollywood event and in my tiny jeweled evening bag I carried, not just a lipstick, but the syringe and medication I'd need to have that evening to remain on schedule. James had to "administer" the medication because it had to go in my backside, which I couldn't reach while I was wearing my elaborate gown. But where should we go for our needle party? I couldn't go into the men's room with him, and he couldn't go into the ladies' room with me. So we roamed the corridors of this fancy hotel, looking for a deserted corner. We finally found a small, out-of-the-way alcove. Crowding ourselves against the back wall, looking to the left, right and center, I lifted up the skirt of my huge ball gown and bent over. James, elegant in his tux, swabbed a spot on my backside with alcohol, quickly jammed in the needle, and squeezed out the medication. After I'd rearranged my dress, we walked out all smiles, as if nothing unusual had happened, although we did giggle to think of how many other couples were doing something similar, perhaps not in ball gown and tux, but definitely involving needles at inconvenient times.

Of course not all twin pregnancies are so delicate. By now you may have heard that about half of all twins are born early. That means, happily, that the other half are born at full term, which for twins is 36-38 weeks. Many women have complications in twin pregnancies, but just as many do not. You may be like a friend of mine who didn't even find out she was having twins until she was 28 weeks pregnant! She'd been blithely attending her ballet classes right up until the ultrasound that showed two babies occupying her previously unexplainably large belly. And there are still a few delivery-table surprises — births where the "placenta" turns out to be a second baby. The key to a healthy pregnancy, I believe, is to keep close track of what's happening in your pregnancy by having good prenatal care, eating well, and exercising appropriately. Keep yourself healthy, and you can be ready for what your pregnancy brings you.

The "Older Mother" Myth

If there's one thing I learned very early in my pregnancy, it's that there is a kind of myth or misunderstanding about those of us who are considered "older" mothers. I was 45 when our boys were born, and I have to admit that I had some questions about how my age would affect my babies. I'd heard somewhere — who knows where — that pregnancy was somehow perilous for women of my age. James and I had worked so hard to get pregnant, I hadn't really stopped to think about whether the pregnancy itself would be any more difficult for me because of my age than it would be if I were younger.

After the first few comments from well-meaning friends about my age and their concerns for my pregnancy, I went looking for more information. Here's the good news I found — the most recent thinking in much of the medical community is that in a sense, the risk associated with older mothers and their pregnancies has often been overstated. The fact is that if a woman is healthy and fit, her uterus is likely also to be healthy and fit. It's true that older eggs can mean a higher risk of genetic problems, but screening techniques continue to help in that area. And careful monitoring makes a difference, too. Women over 40 are at higher risk for hypertension, preeclampsia and gestational diabetes, but as I found out in my own pregnancy, thankfully there are many ways to monitor for and treat these conditions.

All this made a lot of sense to me. I think women in their 30s and 40s are far more responsible in lots of ways than they were when they were in their 20s. I know I am! All those years of life experience and the emotional preparation and planning that can go into getting pregnant can actually help older women have healthier pregnancies. I know my body and what it needs better now than ever before, and if you are an "older mother," too, I'm sure you feel that way as well. So when it comes to choosing healthy behaviors or fine-tuning your lifestyle for the sake of your babies, an older mom often knows just what to do. If she doesn't, you can bet she will find out, and do it!

That, of course, is not to say that younger moms are irresponsible. Youth, not to speak of stomach muscles that haven't been stretched to the limit by previous babies, are definite pluses where pregnancy is concerned! At the end of the day, whether you count yourself as a younger mom or an older mom, I believe it's the wisdom you bring to your pregnancy and the willingness to make healthy decisions for yourself and your babies that make all the difference.

Who Are You Going to Call?

Even though I was being closely monitored during our efforts to get pregnant, James and I had a home pregnancy test kit ready and waiting for the right moment. Haven't these simple little kits made an enormous difference for us? With my earlier pregnancies, I remember waiting until my doctor's office called to confirm my suspicions so that I could say that I was officially pregnant. Now it's often reversed: the woman calls the doctor to announce her pregnancy, and to make an appointment for her first prenatal visit. What a switch!

I have to admit that in our case, there was no romantic, candle-lit dinner, no handholding stroll along the beach near our home at sunset, no intimate tête-à-tête during which I quietly announced my long-awaited pregnancy to James. The spot we most likely first shared the news that I was pregnant was in our bathroom, over the home pregnancy test which we did on our own to confirm what we thought had happened. Not much romance to it, but quite a lot of excitement. I don't actually remember the details but I know we called the doctor immediately and went directly to his office.

It's funny how, when you're trying to get pregnant, you think you'll never forget all that you went through, or the moment you finally got that positive test result. Or, if you haven't had to try so hard for babies, how easy it is to think you'll never forget the moment you got the news you were pregnant, or the moment you told your husband. I've been surprised to find that so much is eclipsed by the enormous miracle of a twin pregnancy and the birth of those babies, that sometimes it seems all that came before their birth melts into a single entity, a single piece of time. I've thought more than once that there ought to be a special name for that time in the lives of parents of twins called BB — Before Babies.

Strange as it may sound now, I never really considered ahead of time that we'd have twins, although of course I knew it was a possibility. With all the testing associated with my pregnancy, we found out right away — we knew that more than one embryo had implanted. In fact, three had implanted; the doctor showed us on the ultrasound. We could see all three clearly, and we could also see that one embryo was a quarter of the size of the other two. My doctor explained that he didn't think that embryo would develop, and that it wasn't unusual for that to happen, even in non-assisted pregnancies. Sure enough, within a week or two after we saw the three embryos on my ultrasound, the smallest of them disappeared as if by magic. It had simply been re-absorbed by my body. That process, my doctor explained, is called vanishing twin syndrome — or maybe in my case it should be called vanishing triplet syndrome. Sometimes the embryo vanishes farther into the first trimester, and then there may be some cramping or maybe even some bleeding or tissue that's passed, just as there is in a miscarriage. In those cases, the pregnancy for the remaining twin most often carries on normally. In fact, my doctor said there are probably many more twins conceived than delivered. Because we can perform early ultrasounds, for the first time ever, we can know about some of those vanishing twins, or triplets, as the case may be.

So if you've just been given the greatest news on earth — not only that you are pregnant, but that you get two babies — do you shout it from the rooftops? Do you keep it under your hat for a while? Who do you call? How do you decide who shares the news of the gift you've been given? That can be a tough question. In my first two pregnancies with Katie and Sean, I told just about everyone I knew right away. After letting my husband in on the news I was on the phone with my closest girlfriends, with my parents, with my sisters, and I chatted casually about my pregnancy with co-workers. With my twins though, I found that I felt a bit more circumspect.

After losing two pregnancies, fear made me more than willing to wait a while to publicly announce the fact of the third pregnancy to the world at large. Each time, many people I worked with knew I was pregnant almost as soon as I did, because they were so aware we were trying and I was updating everyone on the set. And each time, it was particularly painful to return to the set and announce I wasn't pregnant any longer. I really didn't want to go through any of that again.

As I sorted out how to deal with news of this pregnancy, I remembered a conversation I'd had with a friend that helped guide me, and perhaps it will be helpful to you too. My friend and I had talked about the difference between private and secret, and that helped me define my own boundaries concerning who would know about the pregnancy and how much they would know. My pregnancy certainly wasn't a secret, it couldn't be even if I'd wanted that. After all, nearly 200 people on the set knew within days that I'd had a positive pregnancy test because suddenly I had to have a body double. And it would only have added to the stress of the time to try to keep secret something as momentous as this pregnancy. In fact, I did feel comfortable letting those I worked with — the "family" with whom I spent 12-hour days on the set — know about the day-to-day facts of the pregnancy.

Still, there was a part of me that felt that my pregnancy was also an important, intimate and very private part of my relationship with James. That deeper part of the pregnancy I did not share with the world. I held close to my heart doubts and fears that troubled me from time to time as well as the keen sense of contentment and commitment I felt. As I let the idea of the difference between private and secret settle in my mind, I found that I was no longer dithering and afraid about who to tell and who not to tell. No matter how many people knew that I was pregnant, the deepest meanings of the pregnancy could remain private. They belonged to James and me.

Copyright © 2001 by Jane Seymour