Twin babies

Australia has seen a rise in the multiple births during the last three decades. If you are considering having a baby, understanding the notion of multiple birth, as well as the triggers in what causes these pregnancies are necessary for your preparation and peace of mind.

The rise of multiple births

A multiple birth is when a mother delivers two or more offsprings, one for each fetus. In Australia, these account for almost 3% of births. The most popular type of multiple birth is dizygotic (2 eggs) which results in fraternal twins. These can vary among populations.

The second most popular multiple birth is monozygotic (1 egg that splits into 2) which results in identical twins. The rate of the latter is relatively constant worldwide, at 3-5 per 1000 births.

Understanding the causes of multiple births

There are several causes that contribute to the developing of dizygotic twins, but the most important to consider are infertility treatments and delayed childbearing. Across the years, these two factors have had the highest impact on the rise of multiple births.

Expert gynaecologist Dr Sean Burnet from Specialist Clinics of Australia believes fertility treatments as a direct cause of multiple childbirths. “These treatments work in different ways to stimulate ovulation inducing agents, therefore leading to a large number of multiple childbirths,” Dr Burnet explains. “Options such as fertility drugs or in vitro fertilisation have been regarded as miracle treatments, offering women who struggled to conceive an easier opportunity to bear children.”

On the downside, public mentality saw these therapies as a way to conceive faster, regardless of whether they needed the treatments or not. As Dr Burnet stresses, “resorting to infertility treatments not only increases a woman’s chance of conceiving, but also increases the chances of multiple pregnancies.”

Another relevant factor is delayed childbearing. The chances of conceiving dizygotic twins can increase by four times between ages of 15 and 35. A reason for this could be the rising follicle that stimulates hormone concentration, which accelerates as our bodies age.

Although late maternal age has not significantly impacted birth outcome, it is still important to note that delayed pregnancies account for one out of three multiple childbirths in Australia.

Family history is another factor on whether women can conceive multiple offsprings. A common misconception is that the probability of multiple childbirths is dictated by the mother, whereas research shows this can come from either parent. Gene mapping studies in animals found that specific genetic mutations expressed by ovarian cells were at least partly responsible for twinning.

In terms of race, it has been discovered that women from African descents are most likely to have multiple childbirths, with a staggering rate of 50 out of 1000 births to be dizygotic twins in Nigeria.

Having gone through the main factors of multiple childbirths, Dr Burnet feels there is still one we need to consider: “If you have more than one child and are trying to conceive, it might be worth to know that the number of previous pregnancies also increases your chances of bearing multiple offsprings.”

Classifying multiple birth babies

As mentioned, the most popular multiple births result in monozygotic or identical twins, and dizygotic or fraternal twins.

Identical twins are a least common form of multiple births. These twins are born from a single fertilised egg that is split into two and ultimately develops into two different but identical babies. Their genetic code is completely identical, as they have the same chromosomes and physical traits, as well as identical sex.

Fraternal twins are born from two separate eggs that were fertilised by two different sperm cells. They can have different or same sexes, as well as physical traits and belong to the same parents. This is the most common form of twins. It is important to note that this is the only type of multiple pregnancy reliant on family history, maternal age, race and the number or previous pregnancies.

The least common type of multiple birth are the super-twins. These can be triplets or any higher number and can be classified as either identical, fraternal or a combination of both.

The dangers of multiple childbearing

Whether the idea of having multiple babies might seem fun or interesting at first, it is important to know the risks associated with this condition in order to prepare and find the right support.

When we asked Dr Burnet about the most common danger associated with multiple childbirths, he outlined premature delivery. “If a simple pregnancy lasts for about 40 weeks, a premature pregnancy as for nearly half the twins born can last for only 35 or 37 weeks”, he states. “When it comes to multiple births, the number of babies can actually speed up the delivery process.”

Premature babies can be born with a number of health deficiencies, one of the most common being developmental delays and cerebral palsy. But Dr Burnet feels the mother needs to consider the risks for herself as well: “The mother can also be subject to health problems when delivering more than one baby, such as preeclampsia which leads to high blood pressure and diabetes.”

At Specialist Clinics of Australia, we stress the importance of knowing these risks and taking extra precaution when going through a multiple pregnancy. Soon-to-be mothers of twins should take up extra monitoring, and increase their ultrasound visits.

Other relevant considerations include prioritising health, as Dr Burnet suggests “I advise all my patients who are having twins to mind their nutrition and take extra vitamins, like 1mg of Folate through the pregnancy along with 30 mg’s of Iron and 250mg of Calcium.”

Optimise your health

Resting properly, having a balanced diet and not skipping any doctor’s appointments are essential for any soon-to-be mother to keep her health optimal. However, these things change when the mother expects twins or more babies.

Dr Burnet advises multiple births women to “increase the number of visits to their gynaecologist, as multiple births are immediately labeled high-risk and require closer monitoring.”

Speaking about Specialist Clinics of Australia, Dr Burnet points out: “As an expectant mother, you want the best care for yourself and your child. For a multiple birth, you need to find the right clinic to cater for your specialised needs. At Specialist Clinics of Australia, our medical professionals have had experience in dealing with a wide range of pregnancies, multiples included. Finding specialised medical care is vital to ensure both yourself and your child receive the best care possible.”

Ensure you have a balanced diet

If you are having a multiple pregnancy, taking extra care of your diet is essential. So consider everything you’ve read about what to eat and the vitamins that are most important to pregnant women, and make sure these are part of your everyday diet.

Dr Burnet highlights the importance of increasing the calcium and folic acid intake, which is why he recommends “women integrate extra milk, fortified orange juice, broccoli, sardines and other calcium-rich foods in their diet.”

In terms of folic acid, “I usually recommend my patients take folic acid throughout their pregnancy to reduce the risk of neural tube defects”, Dr Burnet recalls. Iron supplements are also very important, since multiple pregnancy women at a higher risk of anaemia and can suffer from shortness of breath and extreme fatigue.

Watch your weight

There is a saying, that once you are pregnant you need to eat for two. Well, that would be three or more, in case of a multiple birth. The assumption is largely exaggerated, but it does hold some truth, as women need to watch their caloric intake per fetus.

As Dr Burnet points out, “Pregnant women with multiples should consume around 300 additional calories each day per fetus. But we understand how difficult it must be to ingest such a high quality diet when expecting more babies; nevertheless, try adapting this advice to your own lifestyle and perhaps split your meals into smaller portions.”

Expecting your child is an overwhelming feeling, and it only gets more intense when you expect more than one baby. Understanding the factors involved in multiple fetus development, knowing the risks and how you can combat these by optimising your health are steps you need to take in order to be prepared.

Afterwards, medical specialists can best advise you on delivery methods, so you can quickly recuperate and enjoy your babies once you get to take them home.

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