I have listed many great resources for BC’s Interior Women on this site. I also offer the opportunity for questions and comments. You can find me at Within A Woman Doula Care.
Lets start a network of mothers supporting mothers and show your support for doula service in our rural communities.

Kindly,
Casie

Helpful Tips Using a Doppler
Using a fetal doppler for the first time can sometimes take a bit of getting used to, especially in the early months. Please follow the tips below to ensure your success!

In the early months a full bladder may help to lift the uterus out of the pelvic area. The further along you are (after 12 weeks) the less important it is.

Lying down on your back seems to be the easiest and most comfortable way to find the baby’s heartbeat.

Generally its common practice to start from the belly button and move down towards the pubic bone, then move side to side. The earlier along in pregnancy the lower in the abdomen you will hear the heartbeat. Early in the pregnancy (8-12 weeks) you will likely hear the heartbeat just above your pubic bone and may benefit from angling the doppler down towards your tail bone.

Move the doppler wand SLOWLY, very SLOWLY. Often people miss the heartbeat because they are moving around the abdomen too fast.

You will probably hear your own heartbeat a number of times before you pick up your baby’s. We have found that the baby’s heartbeat is often just behind your own heartbeat. Locate your own heartbeat and then just move the doppler ever so slowly, it’s likely you will hear a more faint and faster heartbeat near to where you found your own, that’s the baby’s heartbeat!!!

Are Sonotrax fetal dopplers safe to use?

Doppler ultrasound is regulated by Health Canada the FDA. Years of studies have shown no harmful effects on the fetus. The Mayo Clinic states “In 30 years of regular use, no adverse effects have ever been demonstrated from ultrasound testing. Research has been done investigating both the noise produced in utero and the heat produced by ultrasound, and no problems have ever been detected from its use in exposed babies. There is no reason to feel uncomfortable about the use of ultrasound during pregnancy and there are great benefits to using it.”

I am having trouble hearing my baby’s heartbeat, does that mean something is wrong?

Not detecting a fetal heartbeat (especially in the first trimester) is NOT an indication that something is wrong with your baby. Sometimes it takes a few tries to get used to using a fetal doppler, especially in the first trimester. Make sure that you are using a good amount of gel and place the probe directly on top of the gel (the gel acts as the transducing agent).

The Sonotrax fetal doppler should not be used in any way for diagnostic or medical purposes by anyone other than a medical professional.

• The Sonotrax fetal doppler should not be used as a substitute for regular prenatal care by a medical practitioner. Any concerns about your pregnancy should be addressed to your care provider.
• Fetal heartbeat is not the only indicator of fetal well being, if you have any concerns please consult with your care provider.

I have run out of gel what should I use?

You may either purchase more from us here or your local medical supplies store should be able to help you. Aloe vera gel works well, is gentle enough for your skin and wont damage the probe. Hand cream or vaseline will also work although there is some speculation that it may cause damage to the probe.

What is the difference between a 3 Mhz and a 2 Mhz probe?

A 3 Mhz probe has a wider beam so it is more sensitive than a 2 Mhz probe and can pick up baby’s heartbeat as early as 8-10 weeks gestation. A 2Mhz probe tends to work best after 10-12 weeks and on overweight or very tall women. Typically though, a 3 Mhz probe work better early on and throughout the rest of pregnancy.

What do your dopplers come with?

All of our dopplers come with digital display with which you are able to see your baby’s heartrate (the number of beats per minute). Our dopplers come complete with a convenient carrying case and one tube of doppler gel and easy to follow instructions.

What is your return policy?

We offer a 7 day money back guarantee and 1 year warranty on all of our dopplers. If for any reason you are unsatisfied with your doppler, simply call or email us within 7 days and we will offer you a full refund, less the shipping charges.

I am hearing two heartbeats, does this mean I am having twins?

No, not necessarily. It is very possible to hear the heartbeat in more than one place especially later on in pregnancy. If you are picking up a heartbeat in two locations at roughly the same rate (within 10 bpm or so) then assume its just a single baby’s heartbeat in two places. However, if you are picking up a heartbeat in two locations at drastically differnent beats per minute (ei: one is 130 and one is 160) then that may be more of an indication of twins. The only way to be sure if you are having twins though, is through an ultrasound.

What is considered to be normal for a fetal heart rate?

A normal fetal heart rate is usually between 120 and 180 beats per minute and vary according to fetal age and activity level at the time.

How much gel should I use?

You need to use about a quarter sized blob at first, do not rub it into your skin but rather place the probe directly on top of the gel. The gel acts as a conducting agent and will help to give you an accurate heart rate display and good clear sound.

1) Using a double ended male mini jack audio cable, insert one plug into the audio input (usually microphone input)socket of the PC, the other plug into the earphone socket of the Doppler.

2) Turn on the PC, startup the sound recorder (Click “Start”→ “Programs” → “Accessories” →
“Entertainment” → “Sound Recorder”).

3) Click Start to start recording. You can record 60 seconds every time, when time is up,
click Start again to keep on recording.

4) Click Stop to stop recording.

5) Click “File” → “Save”, input the file name and click Save. The recorded sounds are saved as a waveform (.wav) file in your computer.

6) To start a new recording, click “File” → “New”. To play the recording, click Play in
Sound Recorder, or play it in any other program that supports waveform (.wav) files.

7) The waveform files saved in your PC are normal audio data files. You can save them to CDs, or e-mail to whomever you want.

Once you develop a birth plan, review and agree upon the information in advance with your spouse, healthcare provider and labor support person(s). Ask your OB care provider to attach a copy to your in-office records and send another copy to the hospital obstetrical unit. Also, provide your spouse/partner and any labor support person or doula with a copy. Plan to take extra copies with you for your labor and delivery chart.

Letter:
Birth Plan for (insert your name and your husband’s/partner’s name)
Due Date (insert full-term due date)
Client/Patient of (insert the name[s] of your obstetric care provider[s])
To give birth at (insert name of hospital/birth site, and list a second hospital name if you plan to give birth a higher-level obstetrical care site if preterm labor or birth occurs)
(Insert today’s date)
Dear Dr. (insert name[s]) and the staff of (insert birth site):
My husband (partner) and I are looking forward to sharing the birth of our twins (triplets or more) with you. The following birth plan describes our preferences for care during various aspects of the labor, birth and postpartum experience. It includes our preferences whether the babies’ birth is “by the book” or involves complications. We have been preparing for our babies’ birth by reading books, attending (multiples-related) childbirth classes, and arranging for someone (doula or other) to support us during labor and birth.
I have been doing everything I can to have the healthiest possible pregnancy and minimize the risks associated with multiple pregnancy. However, my husband (partner) and I recognize that multiple pregnancy, labor and birth entail more risk than single-infant pregnancy and birth. We understand the need for flexibility during labor, birth and postpartum, and we know that a healthy outcome for the babies and myself is the main goal.
Birth Team
No matter what situation arises during labor, birth or postpartum, my husband (partner) and I expect to be an important part of the decision-making team. We expect to take part in any discussion of, and to give permission for, any type of medical intervention being considered. If any of our birth plan preferences are not possible, or become impossible later, we expect to be provided with a research-based rationale, including the benefits, risks, possible consequences or other options for any recommended intervention.
Personal Wishes
 For issues of personal privacy, we request that the minimum number of staff necessary for an optimal outcome be included on the birth team.
 We would like to photograph or record the babies’ birth on videotape.
Labor and Birth
Baby A (Check any/all that you prefer): We prefer as little intervention as possible if labor is progressing normally:
 I want my husband (partner) and/or labor support person (doula) to stay with me at all times, including during admission, examinations or any medical procedures.
 I prefer intermittent fetal monitor during labor to allow for mobility.
 I would like to walk during early labor.
 I would like to labor in water during active labor.
 I would like to determine optional positions for active labor.
 I prefer a heparin lock (hep lock) insertion to a standard intravenous (IV) line.
 I would like to sip water or other clear liquids during labor.
 I prefer that vaginal exams be kept to a minimum.
 I prefer that labor progress without augmentation. If it becomes necessary, I prefer time to adjust to changes in contractions with any increase in dose.
 I would prefer that the baby’s membranes be allowed to rupture spontaneously.
 I prefer the use of nonpharmaceutical pain control techniques.
 I am an adult and able to request medication if desired. I do NOT want medication offered prior to my request.
 I prefer (insert type) anesthetic for each birth. (I understand that a general anesthetic may be necessary if a complication arises during the birth of Baby B [or C] if I choose to deliver Baby A spontaneously or with only a local anesthetic. (Some healthcare providers are willing to insert epidural tubing, but use it for analgesia/anesthesia only if a complication arises.)
 I prefer to push and deliver Baby A in whatever position feels best at the time.
 I would like to hold Baby A until labor begins for Baby B.
 I do not wish to hold Baby A until after giving birth to Baby B (and/or C).
Each birth
Assuming there are no complications:
 I prefer not to have an episiotomy, unless absolutely necessary.
 I would like each baby to be placed on my abdomen immediately after birth.
 My husband (partner) would like to cut each baby’s cord.
 We prefer that treatment of the babies’ eyes with drops or ointment be postponed until an hour or two after birth, so they can see clearly during early interaction. (Option if certain of parent health history: We do not want our babies treated with eye drops or ointment.)
Labor and Birth (Baby B or C)
 Once Baby B (or C) is engaged in a normal position in my pelvis and the fetal monitor is in place, I prefer to push and deliver that baby in whatever position feels best at the time.
 If an emergency vaginal or surgical birth is necessary and I have had no anesthetic or only local anesthetic, I would prefer a regional anesthetic if there is time.
 If general anesthesia is necessary for the birth, I would prefer the type and dosage be given in a way that allows me to regain consciousness as quickly as possible.
Surgical (Cesarean) Birth
 I would prefer a regional anesthetic (epidural, spinal block, etc.) if there is time.
 If general anesthesia is necessary, I would prefer the type and dosage be given in a way that allows me to regain consciousness as quickly as possible.
 I would prefer to be catheterized after receiving an anesthetic.
 I would like my husband/partner present at all times for emotional support.
 I would like to see and touch each baby after an initial examination determines each is in stable condition.
 I prefer post-operative analgesic (pain) medication that allows me to remain alert and able to interact with my babies, such as epidural morphine (Duramorph) if I have had an epidural or intramuscular (IM) or IV ketolac (Tordal).
Post-birth Recovery (4th Stage)
 I prefer that each baby remain with me in the birth and recovery room(s), unless a particular baby requires special care due to its medical status.
 I prefer a private room, such as a labor or LDR (labor-delivery-recovery) room for the recovery period.
 Breastfeeding:
 I expect to breastfeed any stable, healthy twin (triplet) as soon as the infant(s) exhibits feeding cues, which is usually within an hour of birth.
 If any or all babies require NICU care, I would like to initiate breast-milk expression (pumping) within 3 hours of birth.
 I would like the staff’s help to breastfeed or pump within several hours of birth if I experience a complication that interferes with immediate breastfeeding or milk expression. (If necessary, I would like the staff to actually pump my breasts or teach my support person to do it until I am able.)
Postpartum
 Rooming-in/non-separation: To care for multiple infants, I would prefer a private room. I expect to keep any stable, healthy twin (triplet) stay in my room with me as soon as possible. (I understand that the degree of rooming-in depends on both the babies’ and my conditions after birth.)
 We prefer that any physical examinations, tests, etc. of the babies take place in my room.
 We prefer no artificial infant formula, bottles of any kind or pacifiers be given to any baby, unless found medically necessary and after consultation with us.
 Support person(s): I would like to have my husband (partner) or another support person remain in my room around-the-clock.
 Medication: I prefer medication options that allow me to remain clear-headed and able to interact with my babies and support persons.
 Circumcision: We prefer a local anesthetic be used for circumcision.
 We do not want our son[s] circumcised.
NICU
 No matter what situation arises during any baby’s NICU stay, we expect to be part of any discussion of, and to give permission for, any medical intervention being considered for our child(ren).
 Breastfeeding/lactation: We want our babies to receive as much of my colostrum and milk as possible. Further, I would like help to initiate breastfeeding as soon as any baby shows signs of interest or begins to coordinate sucking and swallowing.
 Kangaroo Care: We would like to initiate skin-to-skin care as soon as possible, as supported by research evidence and implemented at high-level NICU centers.
 Co-bedding: If two or more of our babies require NICU care, we would like them to be co-bedded in a single crib as soon as two are medically stable.
 If co-bedding is not yet possible, we would like their cribs/isolettes to be placed side-by-side. If not implemented, we expect to receive an evidence-based explanation immediately.
Thank you for respecting our wishes to the extent that is safely possible for the best outcome for all involved and for providing the evidence-based rationale when any of our preferences cannot be met.

Sincerely,
(Your signature)

By Kristy Zurbrick

Months have gone by. You’ve gotten used to having two babies inside you. Now, as your due date draws near, you must think about how you and they will make the transition to meeting face-to-face-to-face. Labor and delivery with twins can present some unique decisions and challenges. The best thing to do, as they say in the Boy Scouts, is to “be prepared”.

1. Learn the signs of labor.
Typically, you’re not far from labor when the baby’s head drops into the pelvis, the mucous plug dislodges, your water breaks, and you experience stronger, regular and more frequent contractions. For women who are expecting one baby, these signs crop up around the 39th week of pregnancy. For those with twins, however, labor usually occurs much earlier; the average twins are born at 36 weeks.

Recognizing the symptoms of labor isn’t always a clear-cut process, especially when the signs show up earlier than expected. “Compounding this problem is that some women do not trust their own intuitive feeling that something is wrong and therefore fail to act on it,” says Dr. Barbara Luke, author of When You’re Expecting Twins, Triplets or Quads (1999). “So remember, at whatever point in your pregnancy you experience any symptom of labor, call your physician. He will most likely instruct you to get to the hospital for further evaluation.”

2. Know your pain relief options.
Once labor begins, there are various methods available for relieving the pain that comes with it. Beyond relaxation techniques and breathing exercises, you may consider receiving medication for the pain. The medication comes in two forms: analgesia, which decreases the pain but does not eliminate it, and anesthesia, which numbs you and may involve unconsciousness. Discuss these options with your doctor ahead of time.

Dr. David A. Ruedrich, an obstetrician who specializes in multiple births, often recommends epidurals to his patients. As the most common method of labor pain management, epidurals allow medication to be inserted through a catheter into the lumbar space beneath the spinal cord. In addition to allowing the mother to stay awake and alert during the birthing process, this medication also helps in the case of emergencies.

“You have to be prepared for complications if one or more of the babies isn’t doing well,” Ruedrich says. “The epidural allows us to transition from a vaginal birth to a c-section if an emergency arises. This transition can be made more easily and safely if pain medication has already been administered.”

Expectant mothers of multiples may be happy to know that their labor pains are usually comparable to those of mothers delivering single babies.

“Patients are always relieved to hear that labor is generally no more painful with twins than with a singleton baby,” says Luke. “You need to go through the first stage of labor, including transition, only once, even though you are giving birth to two babies. While you do go through the second stage twice, this usually proceeds more rapidly with baby number two.”

In some cases, the second baby arrives within a couple minutes of the first. Most of the time, however, the second baby comes 20 to 30 minutes or more after the first one.

3. Vaginal vs. c-section delivery
“The biggest thing we talk about with multiples is route - whether they will be delivered vaginally or by Cesarean section,” says Ruedrich. The chance of either is roughly 50 percent. Approximately 40 percent of the time, both twins will be born head-down. In these cases, Ruedrich says, obstetricians will try to deliver the babies vaginally. It’s when the babies present themselves in different positions that the route may change.

“Other presentation combinations, such as one baby being head-down and the other breech (feet or buttocks first), can lead to c-sections, somewhat depending on the desires of the parents, the obstetrician and the gestational age of the babies at delivery,” he says.

The main deciding factor in delivery method is the position of the baby closest to the cervix. If the first twin is breech or sideways in the womb, a c-section will likely be scheduled.
If the first twin is born vaginally and the second one is breech or sideways, the obstetrician may move the second twin into a better position by pushing on the mother’s abdomen externally or perform a breech extraction. If these methods don’t work, a c-section may be necessary.

“In all of these combinations, you have to weigh the risks to the babies and to the mother,” Ruedrich says. “Beforehand, mothers should be emotionally prepared to handle a c-section, since about half of twin births are delivered this way.”

The more you know about the possibilities, the better you will navigate the ups and downs of labor and delivery with twins. No matter what challenges present themselves the end result is a miracle times two.

Conception
There are a number of different reasons why a multiple birth may occur:

Multiple eggs are released or there is more than one ovulation during your menstrual cycle. Two (or more) eggs are fertilized resulting in fraternal twins. This can occur naturally or through the use of fertility drugs.
In the case of identical twins, one egg is released and fertilized but divides in two. This can happen with or without the aid of fertility drugs.
In cases of IVF or other reproductive technologies, there are usually 3 or more fertilized eggs put back into the uterus. The rationale is that not all of these will implant, though sometimes they do. How do I Know if I’m Having Twins?
Many people learn about their multiples at an early ultrasound. Others find a rapid rate of growth in their uterus causing them to suspect twins. If this is your second child, however, you may not want to be so quick to assume you’re having twins. It is common for your stomach to grow faster during a second pregnancy compared to your first pregnancy.

Sometimes multiple heart beats can be heard, leading your practitioner to believe that there is more than one bundle of joy in your uterus. Other times, during your prenatal tests, the doctor may find abnormally high levels of hCG since multiple babies will increase the levels of these hormones. The more babies you are having, the faster the rate of rise in hCG. In single births, hCG should almost double every 48 hours. Only a very small number of twin pregnancies remain undetected until birth.

Preparing for Multiple Pregnancies
When you are having a multiple pregnancy, it is necessary to increase your nutritional intake even more than you would with a single pregnancy. In general, you need to increase the amount of protein that you eat. Protein is the building block of every cell in your body and your babies’ bodies. It will help you build a good placenta and a strong amniotic sac. A healthy diet will also help fight against infection.

As for your health care provider, you will want to find a midwife or doctor who has experience with multiple births. Youd don’t want someone who will panic at every corner. While the amount of care you receive will generally be the same as a single pregnancy, you will probably see your practitioner more frequently towards the end of your pregnancy. You may also have more testing than most women during pregnancy, but not always.

Healthy Pregnancy
Here are some tips to help you have a healthy pregnancy:

Proper Nutrition: Low birth weight is one of the most common problems with a multiple birth. However, following a healthy diet can help lower your babies’ risk of this complication. Thus, when eating for three or more, be sure to consume about 300 additional calories along with one additional protein serving, one additional calcium serving and one additional whole grains serving.
Extra Care: Expert medical monitoring can help reduce many of the risks associated with multiple pregnancies. By adhering to your appointment schedule — which will be more frequent — you can ensure that you are getting the best care possible.
Increased Weight Gain: Due to the extra baby and the extra baby by-products, your practitioner will most likely advise a carefully monitored weight gain of at least 35 to 45 pounds.
Proper Rest: Since your body will be working twice as hard, it will need twice as much rest. Ensure that you take regular breaks from your daily actvities. Getting at least eight hours of sleep will also ensure that your body is properly rested. Yor doctor may prescribe taking an early leave from work, getting help with the housework and even bed rest at home.
Complications of Twins and Multiple Pregnancies
There can be a higher risk of complications with twins than with single births. Along with the regular monitoring of fetal growth and normal complications of pregnancy, like high blood pressure, you will also be monitored for complications specific to multiple births, such as intrauterine growth retardation and twin-to-twin transfusions.

Giving Birth to Your Twins
In years past, cesarean was the common way for delivering multiple births. However, vaginal birth is usually very safe for multiples, who frequently need the stimulation and rise in hormones levels associated with labor. Whether or not you will have a vaginal birth will depend on many factors, including the position of the babies and how the babies tolerate labor.

If your babies are in a position where neither can move, they are said to be locked. These babies will have to be born via cesarean. Breech babies really depend on the size of the baby and the skill of the practitioner. Usually if one of the babies is head down, a vaginal birth will be attempted. If the second baby is breeched or transverse, an internal or external versiom may be attempted to help out with the birthing process.

Increased need for pitocin
Increased need for forceps or vacuum extraction
Increased Use of episiotomy
Increased length of time for pushing

Epidurals can also increase the length of the second stage by numbing the muscles in the vagina. Since the muscles are a bit more lax, they cannot provide the baby with the same type of taut muscle to help rotate into preferred positions. Epidurals can also interfere with the oxytocin feedback mechanism, meaning that additional oxytocin (pitocin) is needed to enhance labor.

Urges to Push with an Epidural:
In some women, the urge to push can be dampened or completely missing in the second stage. Laboring down is a term used to describe waiting to push until the baby is fairly far down into the pelvis. This allows the mother to rest, can prevent fetal distress, prevent prolonged pushing, perhaps prevent some fetal malpositions or allow the baby time to rotate into a better position.

Positions for Pushing with the Epidural:
Since the mother is anesthetized she cannot assume many positions. This limit on the positions can hinder progress in labor. With good support from the partner, doula, labor nurses and others there are some positions that the mother can assume. Birth Support and Partners can help guide the mother to feel her contractions and push at the peak of each contraction.

Semi-sitting with people or leg supports
Side lying
Supported squat
Semi-prone
Kneeling on the foot of the bed, leaning over
Supine with stirrups or leg supports
Time Limits on Pushing with Epidural:
The research shows us that time limits, when both mom and baby are doing well, is not necessary. Since an epidural may increase the time needed to push the baby out, if mom and baby are doing well, ask your doctor or midwife if there is any reason why you shouldn’t be allowed to keep pushing before a cesarean section is performed.

Milk from mothers of premature babies is quite different from that of mothers of term babies. If your babies are early, they will especially need your milk.

If both babies are born healthy, talk to the pediatrician about breastfeeding them on demand. The ideal setup is rooming in with your babies.

If it should become necessary that the babies receive a supplement, you may want to look into other methods of feeding such as cup feeding, finger feeding, or using a spoon, medicine dropper or syringe. Bottle feeding sometimes can interfere with lactation due to the fact that some babies develop a preference for the artificial nipple, making it harder to reestablish breastfeeding.

Once you and your babies are home, you will need to take care of yourself as well as the babies. Eat healthy food, and enjoy frequent snacks (such as low-fat cheese and crackers, vegetables, yogurt and fruit). This is your chance to be able to eat a lot without gaining weight. Be sure to drink water, juices, or milk to thirst. Try to sleep when the babies are asleep.

Develop a plan for getting the housework and other home management tasks done. Enlist any and all available help, and carefully consider what tasks are most important to you and your family. Assign priorities along with your mate. People’s needs come first, especially babies’ needs, then comes food and clothing.

Limit your visitors during the first weeks. Family members and friends who come to see the babies can help you in many ways– they can bring you meals, change diapers, give you a massage, watch the babies while you take a 15 minute walk or a shower, listen to you, etc. Don’t be shy about asking for the help you need.

Be aware that many mothers of twins receive criticism from those around them who do not share their enthusiasm for breastfeeding. They may pressure you to use formula or other foods before they are needed or to wean before you feel ready. Sometimes, questions such as “Are you sure you have enough milk?” or “Isn’t this too hard for you?” are enough to lower a mother’s confidence. Your belief in your ability to produce enough milk for your babies is one of the most important factors in maintaining a great milk supply. Remember always that milk is produced on the principle of supply and demand. The more your babies breastfeed, the more milk your body will produce for them.

Tips for life with breastfeeding twins:
Breastfeed them together to save precious time. This works well during the first weeks. After this you may have to breastfeed them one at a time depending on their particular hunger patterns.

There are several different ways that you can position the babies in order to nurse them at the same time. One way is to place the babies in front of you with their legs overlapping, making an X across your lap. The other position is to place both babies in the clutch hold. You will need pillows at your side (and maybe one on your lap) and you will place the babies on the pillows with their legs going toward the back of the chair. Remember that if you are placing the babies in front of you, you must try to keep their whole bodies turned toward you, their chests against your chest. Their bodies must not be facing up. This is very important to avoid soreness and also to make sure that the babies are receiving enough milk.

Use lots of pillows. There are special pillows available that help in positioning twins, or you can make a nursing pillow yourself.

Alternate feeding each baby from both breasts. This evens out their particular needs and also gives them extra visual exercise.

Learn different positions to breastfeed. Learning to nurse while lying down may be a little tricky to learn the first few weeks, but is worth it for the added rest you will get.

Note: It is acknowledged that not all relationships are composed of a mother and father. The following has been prepared in order to assist the partner in being supportive of the pregnant woman. For ease of writing, the “partner” throughout this article has been referred to as “Dad”.

During pregnancy and childbirth, it is not unusual for Dad to feel somewhat left out and unimportant. In reality, nothing could be farther from the truth! Dad’s role as supporter, labour coach, listener, evaluator of when Mom may be in (preterm?) labour, baby handler/changer, cook, cleaner and, did we mention listener? - is not to be underestimated. Children thrive under the guidance and nurturing of both of their parents. However, when children are born two or more at a time, it is imperative that Dad become proactive in the care of the babies. Multiple birth babies can cause a lot of stress in the family and being aware of this ahead of time can be important. Taking the initiative in child care, communication and sharing of thoughts and tasks is essential for the well-being of all concerned.

Night Feedings

It may take several days before you find a routine which works well for the whole family. One family of twins worked out a system whereby when a baby awoke, Dad would get the baby, change him and bring him to Mom to feed in their bed. He would ’sleep’ until they were finished, take the baby back to his crib, wake the second baby, feed her and bring her to Mom to feed and then return her to her crib when feeding was finished. A variation of this style of feeding would be to wake both babies and feed them simultaneously, thus shortening the awake time.

Some families agree that since Dad probably works in the daytime, he needs to sleep the night through. Two possible scenarios could help you if this is your decision:
If bottlefeeding, Dad could do the last night feeding, say at 11:00p.m. and the first morning feeding, say 6:00a.m. Both parents can there get some extended sleep time.

If breastfeeding, Mom could get up to do the night feedings and try to catch up on some of her sleep during the next day when the babies are also sleeping.

Some families have hired a night time nanny instead of a daytime nanny. This could be especially helpful for parents of higher order multiples.

Another breastfeeding twin family used this idea, which worked for them. Mom would continue pumping her breasts after each feed during the week, collect and freeze the milk. Friday and Saturday nights, each parent would take a child to a different part of the house and Mom would breastfeed while Dad bottlefed the baby the expressed breastmilk. This guaranteed each parent longer periods of sleep time at least two nights a week.

You will need to communicate often with each other and establish a routine which works not only for you but for your babies too. It may take some time to work out, but don’t give up. Ask other parents of multiples how they worked out the night feedings and be creative with what will work for all of you.

Some Things Dads Need to be Aware of

It is important that each parent remember that in times of stress and sleep deprivation, things may be said to one another that are unintentionally hurtful. If Dad is the main source of family income, he has the opportunity to leave the home, engage in adult conversation, have uninterrupted bathroom and coffee breaks and he receives positive feedback for achievements. Mom, at home, doesn’t have these small, but important, luxuries. Further, Dad leaves his work and comes home to a new routine. As the stay-at-home Mom, she is on duty 24 hours a day, 7 days a week. It is not unusual for Mom to be waiting at the door for Dad and to thrust a baby into his arms. Getting away to shop for groceries or run errands can provide a much needed change of scenery for Mom.

Sick, cranky or colicky children can cause tears, anger or venting by Mom when Dad returns home at the end of his workday. If you find yourself in such a situation, please remember not to take it personally. An acknowledgement of the situation: “It sounds as if you have had a long and tiring day” or “My how did you manage to do all of that?” is an important validation of what Mom has been dealing with all day. Nothing is going to change, the children aren’t going to “be returned”, but sometimes a validation of our exasperated feelings and a realization that we are together and not facing the situation alone, can make a huge, positive world of difference to all. Listening and acknowledging another’s business in any situation can never be the wrong thing to do.

Remember that each of you are learning how to take care of children from Day One. Women are not born knowing how to look after children and babies don’t arrive knowing how to suckle. Child rearing is an on-going learning situation and Dads are learning too. He needs to learn to diaper, bathe and dress babies. While of course you are assisting your partner in taking care of your children, you are also developing a close rapport with your babies. This is an extremely important and beneficial side effect for all of you.

Little Things Mean a Lot
If your partner has had a cesarean section, you may need to do all of the shopping and carrying for the first few weeks;

This may be the time to hire someone to cut the grass or shovel the snow. Make your life as simple as possible over those first few weeks;

If there is another child(ren), take her grocery shopping with you. This changes the dynamics at home and provides quality time with your other child(ren);

You might take one baby grocery shopping. Strap him on into a baby Snuggli and away you go. This is helpful for everyone and allows for important one-on-one time with each child plus encourages each child to become independent and separate from the others;

Bring home supper once in a while;

Hold/pick up a baby whenever necessary. Don’t wait to be asked to do so;

Give Mom a chance to bathe or take a shower, uninterrupted and at her leisure;

Learn how to work the washer and dryer and throw in a load of laundry;

After the babies are in bed, take some time to be together. You can talk, cuddle, share a glass of wine, offer a back rub to each other or simply sit together. It is important to remember how you got to this place and to take time and space for each other as well;

Listen to each other! This cannot be emphasized enough;

Provide time for your partner to go out somewhere with friends, alone or to a multiple birth support Chapter meeting;

Bring home flowers once in a while;

Keep a sense of humour;

Join a fathers of multiples support group;

Enjoy your children. They will make you feel very special and proud.

Additional Resources

The Art of Parenting Twins by Patricia Maxwell Malstrom and Janet Poland

Twins, Triplets and More: Their Nature, Development and Care, by Elizabeth Bryan, published by the Multiple Birth Foundation, London, England

Twin Care: Prenatal to Six Months, Multiple Births Canada

Finding our Way: Life with Triplets, Quadruplets and Quintuplets, published by Triplets, Quads, Quints Association: www.tqq.com

The Joy of Twins and Other Multiple Births by Pamela Patrick Novotny

Written and Developed by Lynda P. Haddon and Sandra Tompkins, 1998