We did plan for a third child. But we didn’t plan for the fourth. We did not expect twins.
As a third-time mum, I confidently suspected my pregnancy by week 4 and was confirmed by my gynae by the subsequent week. The twin pregnancy was only established in week 9 upon our third visit. My gynae said in the midst of the scan “Hm…., Melissa… I have good news for you. You are having twins!” I must have said “oh my god!” to my gynae for at least 3 times, followed by a series of laughter, the bitter kind as I have already put in my resignation letter… I left the room and texted my hubby “We need to eat porridge for the next few years liao”. The thought of raising 4 kids in the ever expensive Singapore is just too daunting.
We have to date endured lots of ups and downs. Not only were we not mentally prepared for the 4th child, the pregnancy became complicated… There is always something new to learn even though this is technically my 4th pregnancy. This is what I have learned so far:-
1. Being fit does not guarantee a smooth pregnancy journey.
I was admitted to the hospital by week 11 for severe bleeding, likely because I walked quite a bit over the past few days. Running errands, fetching kids from school. Doc thought my water bag might have broken. The idea of me been weak was actually inconceivable to myself as I am known to be a health freak and fit yoga fan. Alas, with this experience, I have to admit my age is catching up and I should not have pushed myself so hard physically.
Was the bleeding a terrifying experience to me? Not quite as the fetuses were not well-formed yet, and I had experience miscarriage before.
I stayed in the hospital for almost 3 weeks with a huge damage to our wallets. Yes, I have hospitalization insurance but it does not cover pregnancy complications unless the complications affect my survival. It has been also 3 months since we put in the claim, and we are not hopeful of any reimbursement from the insurer.
From week 14 to week 20, I stayed in bed, strictly lying down to avoid further mishap and hefty hospital bills. Week 20 onwards, I am being careful and avoid unnecessary walks.
2. My twins share a single placenta. So what’s the big deal?
As my twin share one placenta, they are identical or monochromic. According to American researchers, about 20% of the twin pregnancy are monochromic, which may occur when a single fertilized egg splits and develops into two fetuses. They will be the same-sex and mine pair are girls.
With identical twins, there is a risk of twin-twin transfusion syndrome (TTTS). This means one baby may receive too much blood (receiver) and the other too little (donor). In the worst case scenario, the donor twin may not strive. Aggressive intervention may be required during pregnancy. My gynae warned me in advance that he will refer me to the TTTS specialist in KKH should the inconsistent growth persists.
Thank goodness the twins have separate amniotic sacs. In about 1% of monochromic twin pregnancies, the babies will also share one amniotic sac. That would mean there is an added risk of entangling the two cords.
While there is nothing much I can do about having a single placenta, Doc advised that I lie down sideways as much as I can (either left or right side is fine). This is to help to release weight pressure on the placenta and promote blood flow into the placenta. This is because the blood vessels connecting to the placenta are typically behind the uterus.
As a result, I was required to see my gynae on a weekly basis for detailed monitoring and injections. Only by week 20, my visits were reduced to bi-weekly.
As of week 25
I am now in week 25. Baby growth is even and on track. Thus reduced the risk of TTTS. I am still resting as much as possible, yet my gynae just mentally prepared me for another period of bed rest nearer my EDD in February. This is typical for multiple pregnancies but no one knows when it will start. I guess it really depends on how long my uterus can hold the weight of the twins.