Friday, 16 November 2012

World Prematurity Day - a multiple experience

Tomorrow, November 17th 2012 is World Prematurity Day.

Squeaks was 5 days late, that was ok, she was due on the 13th. Superstition meant I couldn't have a baby born on Friday 13th.

As soon as we received the news we were having twins we started reading up. Fortunately Tamba is a great resource for parents of multiples, and alongside a great peer support forum, we became aware of the difference our two pregnancies would take.

As an expectant parent of multiples you 'automatically' receive an increased level of antenatal care.
I wasn't particularly happy with my 'high risk' label, and I wasn't happy that I couldn't replicate the same midwife-led care I had received with my first pregnancy. But naivety and 'if it ain't broke' led to these feelings.

As it transpired consultancy led care meant my babies were born at the best time to secure their ongoing health.

Due to the high risk 'triggers' associated with multiple pregnancies you have consultant appointments interspersed with midwife appointment- working out at fortnightly appointments. More frequent ultrasound appointments mean than you become conversant in the language of 'liquid levels' and 'centiles' before you even start with this paranoia in the red book.

Fortunately, research from Tamba and peer support means you get a chance to understand 'norms'. A study by Tamba in 2009 identifies the most common conditions that cause premature labour as: high blood pressure (26%); vaginal bleeding (24%); pre-eclampsia (16%) ; twin to twin transfusion (6%); and pregnancy induced diabetes (4.6%). These, in addition to spontaneous onset delivery (which can on occasion be caused by infection), are thought to be the main reasons why twins and triplets are born early.

As it was, our reason for deciding to give birth at 36 weeks was not due to any of these.
At 30 weeks, due to the benefit of regular ultrasounds, it was identified that Twin 1's growth was not 'on centile'. By 34 weeks it was concluded that this was a concern and regular monitoring would ensue.
This transpired to be over the Christmas period and life was made up of regular fetal monitoring and growth scans.
At 35 weeks it was decided that the pregnancy was no longer beneficial to twin 1 and it would be best to induce.

Hearing this is such a difficult thing to comprehend. No matter how much research and peer support there is, being told your pregnancy, you as the 'host', is no longer best for your baby, it's a hard thing to comprehend.

The reality is that multiple pregnancies are generally less likely to carry to full term (40 weeks for singleton births, 37 weeks for twin births, and 34 weeks for triplet births). In the 2008 Tamba survey only 43% of twin births and 1.5% of triplet pregnancies lasted over 37 weeks.

Despite the plan to be induced that day, the boys took the cue and I was fortunate to have another 'easy' birth. Arriving at hospital at 6am, twin 1 was delivered at 06.35, and twin 2 at 06.53 with the aid of forceps.


Twin 1 was 4lb 7oz, twin 2 was 6lbs.

Whilst babies in a multiple pregnancy are much more likely to experience 'special' or 'neonatal' care we were able to keep the boys with us. We were to stay in hospital for at least 3 days to be monitored as they were premature, as it turned out this would be a week as Twin 2 was treated for jaundice.
I did not get as much skin to skin contact as I would have liked, the need to ensure the babies maintained their temperature with the aid of heated mattress, hats and lots of blankets. After two days they were maintaining their own temperature and finally I got to spend lots of time with them due to our 'confinement' within hospital.

We celebrated the boys 'official' birthday with a trip to Eureka!

For another reason, pyloric stenosis, Tiny would continue to struggle with weight gain. At 12 weeks he would come into his own.

At their 18 month check up it came as a shock to find that the boys were the same weight, and non-corrected on the 50th centile.

At 22 months, they are the most energetic, bossy, cheeky, loving boys to have around. They are never the same, they are my healthy, vivacious boys.

And, whilst I'd love to put it down to parenting, it simply isn't true.

The health system in the UK meant that our pregnancy was considered 'high risk'.
That 'complications' with the pregnancy were identified.
That the best care was offered to ensure the best possible start for the boys.

The statistics show that our story is common, and this is why World Prematurity Day means so much.

There are so many families in the UK who benefit from excellent care for premature births, and there is so much more that can be done.

And, then you stop, and breathe, and look at the world. And say silent thanks for how fortunate we are. That there is still so much to do to support and advocate change.
To ensure all babies are given the best possible start.
And that all families are given the much needed support and understanding.

2 comments:

  1. my daughter had pyloric stenosis as well, hadnt heard of it until she had.....and if I had £1 fir every Dr that asked me what the scar was and then queried it as "girls dont get that" I would be rich.

    ReplyDelete
    Replies
    1. I had a bit of a run-in with a GP who after the event was convinced it was pyloric stenosis because "he's not your first born"... the fact that the projectile vomiting stopped...?!

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