Health Care and Twins

According to the American Congress of Obstetricians and Gynecologists (ACOG) twins are born once in about every 41 births. Having twins can bring great joy and rewards to a family. Sometimes, however, it also can pose a risk to the mother and her babies. Complications can occur that require special care. Have you ever seen a mother with a stroller that looks like it was made by a limo company--extra seats? When having twins, your likelihood of having healthy births becomes riskier. So, that scene with a twofer is extra special, because both babies are a miracle of birth.

When a sperm meets an egg in the fallopian tube, fertilization—union of egg and sperm—can occur. If this happens, the fertilized egg moves down the fallopian tube to the uterus where it attaches and grows into a fetus, according to ACOG. During this process, twins can form. Twins can be either fraternal or identical. Most are fraternal twins—each develops from a separate egg and sperm. Fraternal twins each have their own placenta and amniotic sac. Because each twin develops from the union of a different egg and a different sperm, these twins may not look alike. The twins can be boys, girls, or one of each.

Identical twins are more rare. They occur when a fertilized egg splits early in pregnancy and develops into two fetuses. Identical twins may share a placenta, but each baby usually has its own amniotic sac. Identical twins are the same sex and have the same blood type, hair color, and eye color, and they look very much alike, according to ACOG. Some families are more likely than others to have fraternal twins. Women who take fertility drugs or have in vitro fertilization also have a greater chance of having twins.

According to BabyCenter.com, These days, about one in 32 births are twin births. This rate has gone up 65 percent since 1980, and it's more than double the rate among women who conceive without medical assistance — one in 89. The rise in triplets and quadruplets is even more dramatic. Between 1980 and 1998, the rate of triplets and higher-order multiple births shot up by more than 400 percent, but it's crept back down over the past few years as fertility treatments have become more refined. In 2003, one in 535 births resulted in triplets, quadruplets, or more. Meanwhile, the likelihood of having identical twins (when one fertilized egg divides in half) is about one in 250. This rate hasn't changed over the decades and is remarkably constant all over the world. While identical twins generally happen by sheer chance, there are several factors that influence your chances of having fraternal twins:

• Heredity: If you're a twin or if twins run in your family, you're slightly more likely to have a set yourself. Women who are fraternal twins have a one in 60 chance of bearing twins.

• Race: Twins are more common than average in African Americans and less common in Hispanics and Asians.

• Age: The older you are, the higher your chances of having fraternal twins or higher-order multiples. A 2006 study found that women over 35 produce more follicle stimulating hormone (FSH) than younger women. Ironically, increasing levels of this hormone are a sign of failing ovaries and declining fertility. But FSH is also the hormone that causes an egg to ripen in preparation for ovulation each month, and women with extra FSH may release more than one egg in a single cycle. So while older women are statistically less likely to get pregnant, if they do get pregnant, they're more likely to have twins.

• Number of pregnancies: The more pregnancies you've had, the greater your chances of having twins.

• History of twins: Once you have a set of fraternal twins, you're twice as likely to have another set in future pregnancies.

• Body type: Twins are more common in large and tall women than in small women.

Don't let anyone tell you differently -- having two babies at once is very different than having just one. And no, it's not twice as hard! Here is a site that gives you 17 things to know about having twins: http://www.ivillage.com/what-know-when-youre-having-twins/6-b-311544 . Lots of extra details on this site will help you when it comes to twins. Also, another site with significant info on twins is here:
http://www.having-twins.com/.

Most twins are diagnosed before delivery, according to ACOG. Your doctor may suspect that you are carrying twins if your uterus grows more quickly or is larger than expected. However, twins usually are diagnosed by using an ultrasound exam. Ultrasound also may be able to tell if the twins are identical or fraternal. You will need special prenatal care with twins if you are the expectant mother. You should see your doctor more often and you may need special tests. Plan to take childbirth classes during your 4th to 6th month of pregnancy. Ask your doctor about classes for parents expecting twins.

An important factor of twin pregnancies is the greater risk of premature delivery--on average, twins are born at 36 1/2 weeks instead of 40 to 41 weeks for singletons, according to PregnancyToday.com. If you find you're having twins, prepare to be on bed rest for the end of your pregnancy. That is a possibility for most twin births.

Also, one of the biggest concerns for couples having twins is the double hit to the pocketbook. The costs are definitely doubled, especially when it comes to things such as diapers and food. But there are also some advantages that can balance out the costs. Additionally, if twins bring double the happiness, they also double the stress; establishing a schedule eased a lot of the pressure. A routine is important. While the challenge of meeting the needs of two personalities seems daunting to many expecting parents, the rewards of parenting are increased exponentially. Twins can be daunting, particularly when budgets are tight. However, having multiple children at one time is unique, and can be rewarding as a parent.

Until next time.