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Striving for a Healthy Pregnancy
Prenatal Care for Moms of Multiples By Lisa Marie Metzler
More and more women today are pregnant with twins or higher order multiples. Delayed childbearing and techniques to treat infertility have brought an increase in multiple births and with multiple babies comes special care for the expectant mom.
A multiple birth automatically puts a pregnant woman in the "high-risk" category, but that doesn't necessarily mean there will be problems during pregnancy. Obstetricians will watch for potential complications such as preterm labor, hypertension, gestational diabetes, loss of one or more babies or other difficulties. With conscientious prenatal care, both Mother-to-be and Babies can thrive.
If you are pregnant with multiples, you will see your doctor more frequently than a mother carrying one baby. This close monitoring of you and your babies will help a physician detect potential problems and help to ensure you carry your babies as long as possible.
"The most important thing we watch for is preterm delivery," says Dr. Michael Pluvial, physician of maternal-fetal medicine at Brown Medical School's Women and Infant's Hospital in Providence, R.I. According to Dr. Pluvial, if moms-to-be of multiples deliver at 32 weeks or later, the babies have a greater chance for survival and fewer complications in general. The goal is to reach 36 weeks for a twin pregnancy, 34 weeks for a triplet pregnancy and 30 weeks for a quadruplet pregnancy.
Kimberly Clayton of Jamesburg, N.J., gave birth to healthy twins in March. "I was very worried about having a high-risk pregnancy," she says. "You never know what to expect when you're pregnant with multiples, and I think losing one of the babies or going into labor too soon were probably my biggest worries."
This is why prenatal care is so crucial, says Clayton. Prenatal care allows for close monitoring of you and your babies. "The rate of birth defects, miscarriage, preterm delivery, placental abruption, gestational diabetes, pre-eclampsia, fetal growth restriction and amniotic fluid abnormalities is increased in multiple gestation," says Dr. Plevyak. While some of these conditions may not be entirely preventable, proper nutrition, hydration, rest and consistent prenatal care are vital for a healthier pregnancy.
Basic guidelines for women carrying multiples include monitoring weight gain. You should add at least 300 calories per day to your diet. If you are carrying triplets, gaining 10 pounds more per baby is a good rule of thumb. Prenatal vitamins are a must, and most doctors will increase iron and folic acid intake as well.
It's also important to drink at least 2 quarts of water a day. Dehydration can cause contractions, which can lead to premature birth. Rest is another important factor: About half of all women carrying multiples will spend part of their pregnancy on bed rest. Depending on your job, your physician also may prescribe some time off from work. "I feel the risk of delivery may lessen with decreased activity," says Dr. Plevyak. "I often take a mom out of work if they are a waitress, but not if they have a desk job." Making a conscious effort to rest frequently may decrease the likelihood of bed rest.
