STOP – If You’re Having TWINS! Your ULTIMATE GUIDE (Twin Secrets No One Tells You) | 205

My name is Trish Ware and I am obsessed with all things pregnancy and birth, and helping you to navigate with the practical and the magical seasons of this journey called motherhood.

I'm an all day coffee sip and Mama of seven.

I've had the amazing privilege of delivering mini babies.

In my 15 plus year career as a labor and delivery nurse, and as a mama of seven, I'm here to help you take the guesswork out of childbirth so you can make the choices that are right for you and your baby.

Quick note, this podcast is for educational purposes only and does not replace your medical advice.

Check out our full disclaimer at the bottom of the show notes.

If you just found out you're having twins, stop everything you're doing right now and listen to me.

First off, congratulations, but I'm about to tell you three things about twin pregnancies that most of the times your doctors will never mention, and the third one could literally change your entire twin birth experience.

I'm Trish Ware.

I've been a labor nurse for 16 years, and I've delivered hundreds of twins, and I've seen what happens when mamas do not know what I'm about to share with you.

So by the end of this video, you'll know the exact questions to ask your doctor.

The hidden risks they don't discuss all the time, not all of them.

And the one decision that 90% of Twin Mamas make that they later regret.

And listen, even if you think you already know everything about twin pregnancies, even if you've read every book and talk to every expert, what I'm sharing today will shock you.

Don't worry, this isn't about scaring you.

Y'all know I'm not about scaring you.

I am all about empowering you to have the birth you deserve.

Let me tell you something.

In my 16 years as a labor nurse, I've.

Seen the most beautiful twin births and I have seen absolute chaos.

And the difference is that the mamas who knew the things I'm about to teach you, that they were educated and prepared and understood their rights versus the ones who didn't.

Here's what's Wild Twins account for about 3% of all births.

So you have to be educated because if not, you're gonna walk outta that birth with a lot of trauma and we don't want that.

So before we dive in, I need you to know, number one, I say this all the time, you can refuse anything, but should you remember that hospital policies are not laws and you are the CEO of your twin birth.

Whether it's one baby or not, doesn't matter.

You're still the boss of your birth.

So the first thing doctors don't tell you is that not all twin pregnancies are created equally.

They'll say, congratulations, you're having twins.

But they don't explain that there are actually four different types of twin pregnancies, and the type you have determines everything.

Most mamas think it's just identical versus fraternal, but they're wrong.

There's something called core ethnicity and amity, and I'm getting tongue tied right now, but core ethnicity and then amni ethnicity are two different types of twin pregnancies, and I promise I'll make this simple for you.

Think of it like this.

Some twins are like roommates with.

Separate apartments.

Some are roommates who are sharing an apartment, but with separate bedrooms and some roommates share everything including the same bed and the bed sharing twins.

That changes your entire pregnancy management.

But here's what's crazy.

A lot of doctors don't tell you this right away.

They don't explain this until you're like 20 plus weeks pregnant, and by then some of your options have already been decided for you, and I don't want that for you.

I had a mama last month who didn't find out she had mono mono twins until 28 weeks.

Now those are the twins.

She in the bed.

She spent the last eight weeks of her pregnancy in the hospital because nobody explained this.

Early enough to her and she wasn't prepared for that time in the hospital, which if you're having mono mono twins, you very likely could have to stay in the antepartum unit.

The second thing they don't tell you, and this one makes me a little aggravated, is about your delivery options.

They automatically start talking about C-sections like that is what you have to do.

But here's the truth.

60% of twins, number one, are delivered by C-section, but not.

Because they have to be.

A major study called the twin birth study proved that for most twins, vaginal delivery is just as safe.

But the kicker is that.

Most doctors have lost the skills to deliver twins vaginally.

'cause they hop right to C-section and that is an unnecessary C-section.

So they're not offering you the option because they are not comfortable, not because it's.

Not safe for you.

So you have to ask a lot of questions.

You have to interview doctors.

You have to find a doctor who has been doing twin vaginal deliveries before you get the advice on which is best for you.

And I have seen some mamas be told that they have to have a C-section when baby eight is head down, and both babies are great sizes.

And there was absolutely no medical reason for surgery.

I had a student that happened to her.

She ended up switching providers at 35 weeks, and she had an absolutely gorgeous, beautiful vaginal birth.

So there's also something else about twin deliveries that they don't prepare you for.

Something that happens in the operating room that nobody talks about you and, and I'll talk about that in just a minute.

The third thing, and this is a big one, is about timing.

They'll tell you that twins come early, but they won't tell you that when your twins are born.

Can be completely within your control.

For many twin pregnancies, not all obviously, standard protocol says, let's deliver Die.

Die twins at 38 weeks.

Mono die twins at 36 weeks.

But here's what they don't tell you.

These are the guidelines, not the laws.

And for many mamas waiting even one more week can mean the difference between a NICU stay for the babies.

Or going home at the same time, which that is really important.

I had a mama who was scheduled for induction at exactly 38 weeks with Die Die twins.

Inside my community with my students and why I hang out with them a few times a month on Zoom as we talk through these things, and we call it baby step compromises.

She asked for a baby step compromise and asked to wait until 39 weeks.

She agreed to more.

Monitoring, because she said, if babies both look good, can we wait until 39 weeks?

Her doctor said no.

She actually switched providers, waited an extra week.

Did the compromise more NSTs and Bpps, and both babies were born at 39 weeks.

Great weights did not go to the nicu.

But here's the thing.

They make these decisions based on population statistics, not you.

And y'all know I'm all about let's treat each and every pregnancy individually and what is going on with this mom.

There is a way to advocate for individualized care that most mamas never learn.

And that is something I teach inside my classes.

I'm so passionate about individualized care, whether you're an older mom, an IVF pregnancy, whether you have a higher weight, A BMI, whatever you need to be individualized.

Speaking of timing, there's something that happens during twin labor that they don't necessarily prepare you for something about the time between baby A, baby B, that can be absolutely.

Terrifying for you if you don't know that it's normal.

So let me tell you what really happens during a twin delivery so that you're prepared for that because that is what I'm passionate about, you being prepared.

So you are going to labor like normal?

Yes.

All my labor techniques work for twins as well.

But then comes this moment, right?

Baby A comes out and everyone's celebrating so excited, but you're not done.

Obviously, now you have to deliver Baby B, but here's what a lot of moms don't know.

Sometimes baby B decides to flip around.

Sometimes they, you know, will get a little wonky and sometimes there can be like a 30 minute or more.

Wait between the babies and I've seen some moms who don't know that they're not aware of that and they panic because no one told them this was normal.

And shocker again, doctors aren't always educating moms.

And I've also seen some partners get like kind of freak out.

They think something's wrong.

Like they almost think Baby A comes out, baby comes.

I've, and I've seen some medical teams rush in unnecessary interventions because they're impatient.

So remember, we do things on your time, but here's the secret.

If you know this is coming, if you understand what's happening, you can stay calm and advocate for a patient wait for baby B. Baby B just often needs time to settle into the right position after baby a.

You know, vacates the apartment and there's something else they're going to want to put you in the operating room just in case.

Now this isn't necessarily bad, but they don't tell you that you can still have your birth preferences honored, even in the OR and make it almost like a birth room type of vibe.

Whether it's music, you, there's things you can't have, like you can't have incense or oils or anything like that.

All right.

Let's go back and break down the twin types I mentioned earlier, and hopefully this isn't hopping all over the place, but this is crucial information that will determine your entire pregnancy management.

So die.

Die twins.

These are the separate apartment twins.

Each baby has their own placenta and their own sack.

This is about 75% of all twins, and it's the lowest risk mono die twins, mono chorionic diamniotic, oh my Lord.

Mouthfuls.

These are the shared apartment, separate bedroom twins.

They share one placenta but have separate sacks.

This is about 23% of twins, and it comes with some specific risks that we need to watch for.

Mono, mono twins, mono chorionic.

Mono amniotic.

So you, you get that right?

They are sharing everything, including the bed twins, right?

They, they're all in one bed.

One persona, one sack, both babies floating together, and this is only about 1% of twins, but it is the highest risk.

Now, fun story.

I had an antepartum patient when I was working a travel assignment in la and she was a mono mono twin mom.

She was there my entire travel assignment that I was there, and she is the one who recommended.

The sesame seed oil that I recommend to you guys, and we'll link to it in the show notes for not getting stretch marks, and she did not.

So that was a side note.

Okay.

And then there's the rarest type of twins, conjoined twins, where the babies are physically connected.

This is extremely rare, like less.

Than one in 50 K births.

Now, here's why this matters so much.

If you have die, die twins, your pregnancy management is going to be completely different than if you have mono, mono twins die.

Die twins might be able to go to 39 weeks if everything looks good.

Mono mono twins will likely need to be delivered around 32 to 34 weeks and will require hospitalization for monitoring.

Like my mama on my assignment, she was there for like nine weeks.

I wanna say maybe longer, but here's what makes me a little upset.

I've seen doctors not explain this difference to mamas.

Until later in the pregnancy, and then you have to be in the hospital for all these months, and you may have a toddler at home or what have you.

The thing is, you have the right to know from day one, as soon as you can, what type of twins you're carrying and what that means for your care.

Now let's talk about that delivery deception.

I mentioned the twin birth study.

This was a massive international study that followed over 2,800 twin pregnancies, and the results were clear for twins where baby A is head down.

Planned vaginal delivery is just as safe as a planned C-section.

But here's what happened after this study was published.

Crickets, not much.

Many doctors continued recommending C-sections because that's what they were comfortable with, not because it was medically necessary.

Listen, mama, you have the right to ask your doctor based on my specific situation, am I a candidate for vaginal delivery?

If not, why not?

What would need to change for me to be a candidate?

Remember, I believe in individualized care.

So if your doctor says you have to have a C-section just because you're having twins, that is a red light, that is a warning, and baby A is head down like girl, and there are no other complications.

That's when you ask for a second opinion.

Now about that timing issue, the standard recommendations are based on population studies, but your pregnancy is yours.

It's individual.

If you have die, die twins, and both babies are growing well and the placenta look healthy and you have no complications.

There might be room to negotiate on timing.

Take those baby step compromises, right?

The key questions to ask are what specific indicators are we watching for that would tell us it's time to deliver?

Are we delivering based on the calendar or based on how my babies are actually doing?

What would need to happen for us to wait another week, and I want you to have these conversation, but here's something crucial.

I'm not telling you to ignore medical advice at all 'cause I don't know your entire situation.

I'm telling you to make sure that that advice is based on you and your situation, not just protocol.

Y'all know I'm not about that.

Now, let me tell you about the risks.

They don't always explain clearly.

With mono die twins, there's something called twin to twin transfusion syndrome or TTTS.

This is where the shared placenta has blood vessels, connections that aren't balanced.

So one baby might get too much blood and the other is not getting enough.

This sounds terrifying, but here's what they don't tell you.

It only happens in about 10 to 15% of monody pregnancies, and when it's caught early, it can often be treated successfully with mono, mono twins, the biggest risk is a cord interment, because remember, they're in the same bed rolling around.

Both babies are floating in the same sack with their umbilical cords, and those cords can get tangled.

So that's why you need to be in the hospital and be.

Watch, this is why you're getting close monitoring and early delivery.

'cause we obviously, we don't want that to happen.

But again, knowledge is power.

So if you know you have mono, mono twins, you can prepare mentally and practically for what being in the hospital means because that hospitalization for the monitoring is definitely important.

And probably a longer NICU stay.

So you've got the antepartum stay and now a NICU stay.

So you need to have it practically planned for your other children if you have other children or what that's gonna look like for you and your partner and getting prepared of what you wanna have visitors, all of that mentally will help you so much.

Here's what I want you to know right now.

If you are pregnant with twins, I want you to call your doctor's office tomorrow and ask your specific questions if you don't know them already.

What type of twins am I carrying?

Die.

Die, mono die.

Or mono?

Mono.

And what does this mean for my pregnancy management?

What are the specific risks I should be aware of and what are my delivery options based on my individual situation?

And what can I do to optimize my pregnancy and my baby's outcomes?

Because here's the thing.

There's so much you can control, even with a twin pregnancy, and you probably feel like it's out of control, but you can control your nutrition and your nutrition matters even more.

With twins, you can control your stress, your stress management matters.

Your birth preferences still matter, and you can still have a beautiful, empowering birth experience with twins.

You can still do skin to skin, you can still breastfeed.

You can still have the support team you want, but.

I promise you, you need to be informed and you need to advocate for yourself.

Let me tell you about Sarah.

Sarah came to me at 32 weeks pregnant.

She was having die die twins.

Her doctor had scheduled her for a C-section at 38 weeks.

No discussion.

Both babies were head down, growing perfectly, no complications.

Now we're calling her Sarah 'cause I don't want to violate any of my students.

But Sarah in quotes asked why she couldn't try for a vaginal delivery, and her doctor said, we don't do that with twins.

Did not say that.

That's not a good plan for you.

It was a policy, and Sarah got a second opinion.

Her new provider was experienced with twin vaginal delivery.

She went into labor naturally at 38 weeks, funny enough, and had a beautiful vaginal delivery.

Both babies went home with her and no NICU stay.

The difference is that Sarah knew her rights and she wasn't afraid to advocate for.

But I wanna address something important.

So you might be thinking, but Trish, isn't it safer to just do what my doctor says?

Isn't it better to be safe than sorry?

Obviously I am crunchy with a side of medical, but I am not anti medical intervention.

I'm anti unnecessary interventions, and that is the big difference.

So if you have mono, mono twins, yes, you need the close monitoring, you need the early delivery.

If you develop TTTS, yes, you need intervention.

If baby A is breach, a C-section might be your safest option.

But if you have uncomplicated, die, die twins with baby a head down and your doctor's recommending a C-section, just because that's what we do, then that's when you ask questions because your body was made for these two babies.

Twin pregnancies are higher risk, but higher risk doesn't mean.

High risk.

It just means higher risk.

It means we watch more closely and we're prepared for complications, but it doesn't mean complications are inevitable.

This is where being educated and asking questions.

Come in.

So here's what I want you to remember.

You are not a statistic.

You are an individual with your own unique pregnancy, your own unique babies, and your own unique circumstances.

The guidelines are starting points for discussion, not ending points for decision making.

And Mama, whatever happens with your twin pregnancy and delivery, you've got this.

Your body's amazing.

You are growing two humans.

That is incredible.

Like two actual.

Fricking humans, but you deserve to be informed.

You deserve to have your questions answered.

You deserve to be treated as the queen of your birth, not as a passive patient who just goes along with whatever is decided for you.

So here's your homework.

Write down those questions that I mentioned.

Call your doctor.

Get the information you need, and if you don't like the answers you're getting, remember.

You can always get a second opinion.

You can refuse anything, but you should make those decisions from a place of knowledge, not from fear.

And remember, I say this all the time, nothing out of convenience or curiosity except yours.

Your convenience matters.

Your preferences matter.

Your birth experience matters.

So if this helped you, please share it with any mama you know who's expecting twins, because knowledge is power.

And every mama deserves to have this information.

And if you want more support for your twin pregnancy, I've got resources for you.

Check out my birth classes.

And yes, they work for twins too.

Follow me on Instagram for more real talk about birth.

You've got this mama.

Both of those babies are lucky to have you as your mom now, go advocate for the birth you deserve.

Okay.

I am so happy that you are here today.

I hope that you are feeling better about your twin pregnancy, or if you're not pregnant with twins, go, go.

Comfort a mama who is and congratulate her and let her know that she has a right to ask questions and plan for her birth.

As always, hit subscribe.

Leave a review and I'll see you again next week.

Bye for now.