Dr. not concerned with ANYTHING

So I had my first visit with the high risk specialist doctor today since finding out that I'm having twins. I had a huge list of questions mainly about special precautions that I should take because I'm now high risk. He pretty much shot each one down and made it seem as though I could go about my pregnancy as if I were carrying just one baby. Some examples are: He said I could keep exercising just the same as normal, but I was under the impression that I should be a little more careful with exercising. I asked about how much weight I should gain every week from now on and he said not to worry about that, that I only need to gain 30 lbs (although I read everywhere about how important it is to gain weight and that 35-45 lbs is usually recommended for twins). I said "So I'm due on week 37 now right?" and he said well no your due date is still on week 40 but you'll probably only carry to week 38. By all accounts I have read that twins are full term at week 37 but still even come before that 50% of the time.

I just expected the doctor to be telling me that I need to be a little more careful about everything and it sounds like he wants me to not worry about anything. I don't think I like this doctor and am hoping to switch. Hopefully I like the other choice that I have at this hospital. I'm thinking of switching hospitals anyways because this one does not have a NICU.

Also QUESTION - when did you all stop having sex during your pregnancy? Having an orgasm really freaks me out right now because my uterus gets super hard for like 3-5 minutes after and it just doesn't feel right. Did you experience this? Forgot to ask the doctor about this but I'm sure he just would have said to go on ahead.

Thanks!
Jewell

 

Hi there!

Really, unless you are having specific issues, like cervix is shortening or contractions....you don't have to treat your twin pregnancy any different than a singleton. You'll likely be more tired, might be a bit hungrier, might not have as much energy, probably gain more weight and you'll definitely have a bigger stomach than a normal singleton, but otherwise there's nothing to worry about.

I had more issues with my first singleton pregnancy, high bp at the end and on modified bedrest, than i did my twin pregnancy. My twin pregnancy was the easiest one I had. I gained 28 lbs, and my kids were 6.4 and 7.2 lbs. Between that and their placenta's, I lost all my baby weight in about 3 weeks

Try not to worry unless you are given a reason to worry. Many many women have an uneventful and lovely pregnancy. I'm not going to say something may not come up down the road, but for now, just enjoy the moment <3

 

This is a common misconception - twins don't necessarily mature any faster than singletons...there are numerous mom's on here that went to 39 and 40 weeks...depending on your pre-pregnancy weight you may only need to gain 30 lbs...I'm a fluffier kind of gal so 30 lbs was the maximum my doc wanted me to gain - and I gained 27 - and I didn't start gaining until 30 weeks...I don't necessarily think your doc expects you to run a marathon, but moderate exercise is ok unless you start having contractions or your cervix starts to thin...make sure you stay very well hydrated while exercising, and rest when you need to...honestly don't anticipate problems - you may truly have none - I didn't have any until 35+ weeks when I got pre-eclampsia, and nothing I did or didn't do caused it...I wound up delivering at 36 weeks (which up until 37 weeks you're considered late pre-term). Sex won't hurt the baby unless you have an underlying condition like placenta previa or a SCH - at which time the doctor would tell you that pelvic rest is expected...

 

I can't see if you have a ticker since I'm on my phone- how far along are you and do you know if you're carrying di/di, mono/di, or mono/mono yet? From the sound of you're appointment, I would assume they're di/di?

You really don't need to worry too much, really! I'd say to shoot for 35 lb of weight gain if that's a goal you're comfortable with. Your EDD really should remain the same (40 weeks) and you can mentally prepare for sooner.

Really, until anything develops to be concerned about, you should just be treated as a regular pregnancy. Take it easy, relax when you're tired (do don't push yourself!), and enjoy your time.

As for the sex- my first appointment with my girls I was warned to go on pelvic bed rest. Semen can cause a mucus plug to thin. Orgasms do cause tightening of the uterus. We had sex until the night my water broke (which was early) and I've often wondered if that was a contributing factor. But there are so many women who carried to term and had sex throughout their pregnancies that I just put it out of my mind. You can't fear everything, right?

If you want a second opinion, definitely get one. Confidence in your doctor is so important.

Good luck!

 

I agree with Danielle. My doc treated my pregnancy normally and everything was fine. It wasn't until I joined this site that I realized how much other twinmoms went through based solely on being pregnant with twins. Unless you have specific issues, there should be no reason why you should change much, save for the fact that carrying twins may make you less likely to WANT to exercise as much and you may not gain as much as you think considering how full you will feel toward the end. As for expecting to deliver at 37 wks, again, carrying twins in and of itself is no reason to expect to deliver earlier, it may happen, it is more likely to happen even, but we have plenty of 37+ weekers here too. My advice is relax first, express your concerns sure, but don't borrow trouble.

 

Thanks ladies! You really took some weight off my shoulders! Yes, they are di/di. I need to make a ticker, but I am at 23 weeks.

This really goes to show all the mis-information out there. Not that the information that I've been reading is incorrect, but it was all obviously geared towards women who have problems or are at higher risk than I am. As far as I know I am normal weight and in good health.

I was so torn about believing what is in the books or believing the doctor. Hearing what you all had to say really is a relief. I kept asking my husband "Maybe the doctor is just trying to get me to not stress out?" but we just weren't sure what to think.

I think I'll check out the other doctor just incase I like her better, but listening to what you gals had to say really put some trust back into that first doctor for me.

Thank you so much!

Jewell

 

Actually, numerous studies have shown that mortality rates and complications increase for twins after 37 weeks, so it's safer to NOT go full term. Some studies have been around at least since I was pregnant with twins 7 years ago, but here's a recent article I just found by googling it (there were many more, mostly about this particular study). I didn't keep looking to find the older studies which showed essentially the same thing. Of course, like many studies you can probably find conflicting information. But this is also what my Dr. (who had been the "twins-specialist" in my city for 20 years) told me, so I appreciated that she agreed with the research I read about at the time. I actually was induced at 37w5d instead of 37w because her husband had back surgery the week I hit 37 weeks. But Sabrina had stopped growing the entire last month and she possibly would have done better if she'd come out a little earlier. We didn't know that until the u/s the day before I was induced, though.

 

Dielle,

That is what I've been reading as well. The doctor did say that they would probably induce if I carried any later than 38 weeks.

Jewell

I can't get my ticker to work! Any suggestions? It is from lilypie.com...the link to it is below.

 

I think what's most important is that your doctor looks specifically at your case, and doesn't have hard and fast rules about anything. Chances are you will have a very smooth pregnancy and delivery, but you want someone who will be monitoring and respond if things go awry!

As for your ticker, if you just use this part:

 

Yes, I hope that is what he's doing. So far I fit the profile of a totally normal twin pregnancy, so he is probably just treating it as such.

Thanks for the ticker help!

 

I agree with everyone, your doctor sounds good to me! I can't think of anything more to add. I had a normal twin pregnancy and my doctor was pretty much the same way. She let me go to 39 weeks before insisting I be induced, which I was at 40 weeks.

I've read the studies that say 37 weeks is ideal, but I don't know how I feel about it. There's so much conflicting information out there.

 

I wish I had known that my di/di boys were lower risk than I thought. I was paranoid out of my mind with all of the possible complications with twins. Yes, I had cervical shortening and wasn't able to have sex in the beginning of my pregnancy (caused bleeding) or after I had cervical shortening. But. With modified bedrest (just laying around unless I needed to eat, pee, etc) my boys were just fine. I carried them until 37w5d when my water broke- 2 days before my scheduled c/section. In hindsight, it was a pretty uneventful pregnancy.

FWIW- my peris were really unconcerned with me, too, until I had the shortening and they got more 'interested'. I guess routine twins without complications are just old hat for them.

 

Having twins with separate sacs and placenta's is the safest twin possibility I think, and having boy/girl confirms that's what you have. There's less complications during pregnancy.

As for when you'll deliver, my ob said I'd go to 39 wks in the beginning too. He didn't change his mind until towards the end, and around 32 wks or so we finally scheduled my repeat c/s, and then he scheduled it for 37wks 5 days. My water broke at 36wks 2days anyways.

My ob wasn't going to do any extra u/s except the 20wk one, and no extra monitoring until I hit about 32 wks or so. It's not unusual for an uneventful twin pregnancy to have similar care to a singleton.

Unfortunately for me, I had 2 miscarriages before my twins, so I was a bit of a nervous wreck. At 14 wks I requested a referral to a specialist in maternal fetal medicine. At my first appt he reassured me everything was fine, kinda treated me like a basket case to be honest, but we did an u/s ever 5-6 wks from then until the end. It was probably "unnecessary" as, like i said, i had a very uneventful pregnancy, but it saved my sanity and gave me peace of mind that everything was okay with my babies

 

I was also told di/di is the safest twin pregnancy to have. I worked both my job at UPS and as a substitute teacher and did pretty much everything normal until about 28 weeks. Teaching ended a little before 28 weeks...then I stopped UPS right after Memorial Day. The only reason I stopped working then even is that I have a physical job and it was getting to be too hard to do with a huge torpedo belly! I never had a single problem- not even morning sickness and no aversions or huge overwhelming cravings (just a special fondness for orange juice and breakfast foods). Fluids were low for my Baby B at 36 weeks so doctor scheduled a c-section for the next day. When we arrived at the hospital to check in, the nurses were all amazed that we'd never been in even once for pre-term concerns. They said that was unusual.

I don't know what it's like to be pregnant with one baby, but I had an easy and uneventful pregnancy.

That being said, I know a woman who spent over 90 days of entirely HOSPITAL bed rest for her twins. I don't envy her that, but she almost made 36 weeks because of going through that!

 

My doctor hasn't really treated my twin pregnancy that much different and I'm having identicals.....I didn't even find out until 21 weeks! I have had more ultrasounds and NST's and they have watched my BP more, but I agree with the other ladies, you just have to rest when you get tired and you will be fine. Granted, my belly is a tad bit bigger than with my DD, so I am more tired, but my husband said I'm actually less hormonal this time around!

My doctor told me average twin birth is 36 weeks and he probably won't let me go past 38.

 

I only gained about 30-33 pounds. My doctor always goes with the minimum recommendations or just below (as she did with my singleton pregnancy as well). In her opinion, gaining any more than that (at least the way I gain weight while pregnant) just adds to how much you have to lose afterwards. Also, you may not gain weight at a regular pace throughout. I was very nauseated during the first 3-4 months of the pregnancy, pigged out for a month or two (to the point the dr was telling me to slow down!) and then could barely eat for the last couple of months because my stomach felt like it was the size of a peanut.

I had di/di girls at 39 weeks 1 day, weighing 6 lbs 8 oz and 6 lbs 3 oz - happy, healthy, and no NICU time. It was treated pretty much like a normal pregnancy up until 28 weeks. That's when she had me start working from home (so I could be off my feet more and avoid stairs). I think that was more for my comfort than anything else though! Around 30 weeks, sex was off the table (although we did cheat a time or two).

We talked about induction but it basically became a question of were they still growing well and were they doing well with the non-stress tests. Since the answer to both of those was yes, we jointly made the decision to continue with the pregnancy until one of those two items changed or I went into labor naturally.

All that being said, if you aren't comfortable with the doctor or the hospital and you have other options, investigate them. I am a strong believer in the idea that it should be a cooperative adventure and if you don't feel like your concerns are being addressed to your satisfaction, then you should speak up.

 

I agree with everything everyone else has wrote. I think your doctor sounds great. My first set of twins were fraternal girls and it was pretty normal. I only gained about 20-25lbs. I'm overweight to begin with so the doctor is never concerned. This time I'm having identical twins and it's slightly more high risk since they're sharing a placenta. I'm already going for more tests but the one doctor in the group doesn't even think it's necessary. They'll likely be canceled after next week.

 

I only gained 20lbs with the twins. As long as they are developing and gaining properly you are fine. As for when they should be born it depends on the doctor. The reason why some twins are born earlier is because of the doctor or medical reasons. I know there have been a few girls on here have gone to 40 weeks. I delivered at 37 weeks because my baby B was showing signs of failure to thrive. They were mono/di however. As long as you feel fine and they are doing fine you are good. Just listen to your body.

 

That was pretty much my doctor. I didn't even get to every 2 week appointments until I was 34 weeks. I worked at my office until I was 37 weeks then took vacation until my scheduled C (for me, not because I had to stop working). I also have to walk almost a half mile to and from my parking garage to my building and did that every day, plus walking around campus for classes (I probably walked 1-2 miles/day until the end). I rode my bike and towed my toddler in the trailer until about 15 weeks then didn't feel comfy doing that anymore.

The term thing is misleading. Term for twins is 36-88 weeks ONLY because most twins come at that time so it's highly likely they will be born then, not necessarily because they are ready but because your body is done.

I did carry on with my twin pregnancy as though it was a normal singleton pregnancy. The only thing I didn't do this time was any extra exercise other than my normal daily walking after about 20 weeks, but that was because I was so exhausted. When I tried even moderate exercise it just took me way too long to recover. Quite the opposite of my singleton pregnancy where I exercised regularly right until the end.

But otherwise, I was healthy, no pre-term labor at all, excellent BP, no sugar issues, I gained 52 lbs (and lost it all by 3 months postpartum), and my doctor never batted an eyelid at me because it was twins. My only complication was that they were both footling breech and I had scheduled a c-section at 38.5 weeks because of the risk of cord prolapse (and my first birth was a precipitous labor). If they had been head down or Baby A head down, I was geared up for going into labor on my own and sticking it out as long as possible because I wanted nice, big healthy babies and my doctors were happy for me to go to 40 weeks if they had been in optimal positions.

I think your doctor sounds normal if you're healthy otherwise with no complications right now. As for exercise, do what you feel comfortable with. Like I said, I just couldn't do it, but I was also taking classes, working full time and had a 2-year-old so my exhaustion was pretty extensive.

Edited to add: The most recent research I've seen on twin pregnancies says twins without any complicating factors do best when born between 38-39 weeks.

 

I was put pelvic rest from the first appointment - but my twins were IVF so that may have been the reason for that? We did not have sex until the girls were like 6 months old LOL!! I started seeing a MFM very early because I had a SCH at 9 weeks. In the beginning they treated me normally with the exception of doing an ultrasound at each visit to distinguish between the heartbeats but at 28 weeks it was found that baby A was no longer growing and that she had a low fluid level. At that point I was seen twice a week and told to keep my bag in the car because if Her fluid level got any lower that they would take them. At that point they also scheduled my c section for 38 weeks and I was put on bed rest. No one thought we would make it to 38 weeks but we did! Addison started to pick up and her fluid level remained low but not dangerously low. They told me that Ava would be in the 6 pound range and Addison in the 4 pound range - Ava was 6.8 Addison 6.9. They both came home with me 2 days later!

 

My twins are fertility too and I had major abdominal surgery for bleeding cysts just 60 days before I found out I was pregnant.

My specialist was pretty much the same as yours and has treated this as a very hands off pregnancy other than - early I was asked to limit exercising as I had inflamed cysts after fertility treatment and we didn't want to develop hemorrhagic issues again so I was walking/swimming only. My doctor is much more aggressive on weight gain....more along the lines of Barbara Luke's recommendations in her multiples book.

Differences is that at the end you will be larger and more uncomfortable!