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PPD After Delivering Twins

Multiples and Postpartum Depression

By Teri Brown

And then there's multiple birth itself. "It is believed that multiple birth may be a risk factor in itself," says Bowers. "Factors related to multiple birth which add risk include a higher incidence of preterm births, the volume and constancy of the babies' needs, insufficient support, sleep deprivation and social isolation. Many women with multiples have also had complicated pregnancies and births, including prolonged bed rest, making physical recovery harder."

"In addition, these women often have very high expectations of themselves as mothers," Bowers says. "When the parenting experience isn't what they expected, they may feel guilty or resentful. Some feel they can't complain about the difficulties of parenting multiples, thinking, 'After all, this is what I wanted.' And friends or family may expect them to be happy regardless."

A lack of consistent physical and emotional support, especially for those with triplets or more, is also a contributing factor to PPD. For mothers who receive initial support, it can be overwhelming when grandparents go back home or a spouse returns to work at the end of family leave.

Mothers of multiples often experience feelings of isolation. "Many mothers feel isolated, particularly when they cannot get out of the house, either alone or with their babies," says Bowers.

It is this sort of isolation that needs to be addressed and alleviated, says Mary Adcock, executive vice president of the National Organization of Mothers of Twins Clubs (www.nomotc.org). "There is a definite link between social support and wellness," she says. "Indeed, support is crucial when facing any major life change, whether it involves only joy or a combination of joy and challenge. For the mother of newborn multiples, support is even more critical."

Want to see more?

• Postpartum Depression: When Having a Baby Gives You More Than the Blues
• Learning to Let Go: Coping With the Stress of New Parenthood
• Postpartum Depression: Preventing Tragedy
• Talk about it!