5 Way Pregnancy After Miscarriage is Different!!

1. Fear of the unknown. When I became pregnant with my daughter, I dreaded my first prenatal visit. Relief at seeing a heartbeat quickly turned to panic at learning my progesterone levels were low. As I filled the supplement prescription, I felt myself being submerged into an all-too-familiar nightmare. After each appointment, I waited to learn my "levels" like a prisoner waiting to hear her sentence. I felt trapped in a body that didn't work, that couldn't hold on to what mattered most. Even when I made it past the first trimester, my hesitations continued, shrouding every moment in a layer of anxiety and fear.
2. Loneliness. With my first pregnancy, we told our families right away. It was Christmas, and we were celebrating. I never dreamed I would be un-telling everyone a month later. With my next pregnancy, I was determined not to make the same mistake. We waited a long time before telling anyone, which made me feel protected, but also alone. My pregnancy became a secret to keep, instead of happy news to share. I held everything inside -- exactly when I needed my friends and family the most.
3. Guilt and self-doubt. During this time I often questioned my decisions, worried that any lapse in judgment might end my pregnancy. I was nervous to lift chairs at a work event, scared to help a family member carry luggage up the stairs. (Positions I found myself in because I was too afraid to tell anyone I was pregnant.) When you've had a miscarriage, it's easy to grab hold of the idea that by doing everything "right" you have some semblance of control -- and, by doing something "wrong," you're to blame for the loss. It's a heavy burden to bear.
4. Morning sickness envy. Most women dread morning sickness. I found myself longing for it. I craved the physical reassurance that things were "normal" inside me. I desperately wanted to know that my baby was there, growing and developing as expected. My lack of morning sickness felt like a punishment. Every moment I didn't feel nauseous was a reminder of how little I understood what was happening inside of me -- and how little I could control it.
5. Fear of joy. For a long time, I found myself prefacing every statement about my baby with "If we make it through the pregnancy" or "If the baby is born." I was afraid to be excited, terrified of letting in too much joy. I was uncomfortable buying furniture for the nursery, shopping for onesies, or even thinking of names. Looking back, I wish I had let myself enjoy it more. But my wounds were still fresh. I didn't want to indulge hopes that might lead to another heartbreak.
Sometime in my ninth month I began to relax, to feel hopeful that soon I'd hold my baby in my arms. I stopped saying "if" and started saying "when." When my daughter was born, I knew she was the baby I was meant to have. But as blessed as I am with my children, when I hear of a friend's miscarriage, I feel a pang in my heart. I'm glad that there's a day to shine a light on this issue -- for people to acknowledge and share their sadness about such a difficult subject. It was this openness -- talking with others who'd been through it -- that helped me get through those nine long months. Hopefully this openness will help others to know that there's light -- and even hope -- beyond the darkness.

Readings

Twin Pregnancy

One of the first questions a newly pregnant mother often asks is “Am I having twins?” And until it is confirmed that only one embryo is present, there is always the potential for this to be true.

For women who have a family history of twins, who have previously conceived with twins or have had fertility assistance, then the likelihood of having twins is higher. Because some types of fertility assisted conception do increase the likelihood of having a multiple birth, this is usually raised very early on in the pre-conception assessment and consent phases of treatment.

I’m having what?

Some women view the thought of having twins as being an absolute highlight, but others dread the possibility. Your own perception will be influenced by your personal experiences, history and supports.

For women who have been informed of the risk, or who have a history of twins in their biological family, having their own twin pregnancy confirmed is not such a shock. But for women who did not expect to conceive with more than one baby, or who may not having been planning to conceive at all, then finding out they are pregnant with twins can come as a real surprise.

Denial, shock, feeling numb and even angry are common emotions in the early days of having a twin pregnancy diagnosis. But with time reality soon descends and most women just learn to accept the fact that they are having two babies.

What’s so different about being pregnant with twins?

Twin pregnancy symptoms are not so much different to normal pregnancy symptoms, but they are felt much earlier. For the stage of gestation, twin pregnancy symptoms tend to be felt more clearly and with more emphasis before the normal gestational age and stage.

It is important to remember that just as every woman is unique and her pregnancy highly individual, there are some “classic” or standard symptoms which are attributed to twin pregnancy. Many of these are due to the elevated and more concentrated levels of hCG (Human Chorionic Gonadotrophin Hormone) which is the pregnancy hormone. It is primarily responsible for sustaining the embryo and maximising its chances of survival.

When twin pregnancy is more likely

For women over 30 years of age. In women who are peri-menopausal twins are more common.

In women who are taller than average, the odds are higher for having a twin pregnancy than for those of average or shorter height.

Women who are overweight with a BMI (Body Mass Index) of >25.

If you have a history of already having twins or if there are twins in your biological family e.g. your mother, aunts or sisters have had non-identical (fraternal) twins.

If you have had fertility assistance to conceive.

If you are of African American descent.

For women who have been pregnant previously.

Symptoms of twin pregnancy

Some women will “just know” they are pregnant with twins. This may be before they have even had confirmation that they are pregnant. They may dream, sense or have a vision or inherent belief that they are pregnant with twins.Some women will be told they are pregnant with twins by their partner, relatives, family or very close friend. Although there is often no evidence to support this claim, when their twin pregnancy is confirmed it really comes as no surprise.

Feeling very nauseous from early in the pregnancy. This is sometimes so extreme that the mother finds it difficult to tolerate anything but the blandest, easiest to digest foods.

Extreme intolerance to foods, smells, textures and appearance of some foods. Commonly meat, seafood, coffee and tea are the first substances to be found repugnant.

The uterus is “large for dates” which reflects the fact that two embryos, rather than one is present.

Extreme breast tenderness – to the point where it may be too uncomfortable to wear a bra. Some women find they need to wear crop tops or bandeau style tops as an alternative until their breasts become more comfortable.

Wanting and needing to pass urine much more frequently. Although urinary urgency is a common early pregnancy symptom, when pregnant with twins, this is much more magnified.

Utter exhaustion and a feeling of being unable to get through each day. This again, is a common pregnancy symptom but is exacerbated during a twin pregnancy.

Higher levels of hCG. This may be reflected in a very early pregnancy urine test. Even before a missed period, the level can be so high that there is an immediate, strong and clear positive confirmation on the pregnancy testing stick. For women who have undergone fertility assistance, blood tests may reflect a very high concentration of hCG early after conception.

Some women will experience more uterine cramping which is not associated with any blood loss. This can be a symptom of round ligament pain and is due to the uterus expanding relatively quickly.

A sense that your heart has to work harder than it usually does. Many women are aware that their resting heart/pulse rate is higher than normal. This is a sign of their heart having to pump out a greater blood volume with each heart muscle contraction in order to supply the uterus with oxygen saturated blood.

Moodiness, being prone to tears and feeling mentally unstable. Again, labile moods are a common pregnancy symptom, but when pregnant with twins, they tend to be more extreme.

You may find you can feel your baby/babies moving much earlier in your pregnancy. Women who are pregnant with twins say that they are conscious of feeling movements, known as quickening, earlier than the standard 15-16 weeks.

How is a twin pregnancy confirmed?

Although you, your partner or your health care practitioner may suspect you are pregnant with twins, it is not until twins are confirmed that you can be 100% sure.

Ultrasound, where two embryos are clearly defined on the screen.Hearing two, separate heartbeats on a Doppler.In the absence of sound ante-natal care, it is still possible that a twin pregnancy may not be evident until two babies are born.

Complications of a twin pregnancy

Unfortunately, the overall risks of pregnancy are increased during a twin pregnancy. But many women have an uneventful gestation and just because you are pregnant with twins, is not a guarantee you will have complications. But it does help to be informed and keep an open mind.

Premature birth – e.g. before 38 weeks of gestation.

Smaller babies with lower birth weight – simply because there have been two growing in the same space. One baby which is smaller than the other. It is common during twin pregnancy for one twin to receive more nutrition and space allocation than the other.

Preeclampsia.
This is why it is so important for you to have your BP monitored during your pregnancy. Fluid retention and passing protein in urine are other signs of preeclampsia.

Gestational diabetes.

What’s important to remember if pregnant with twins

Regular ante natal care with a qualified health care practitioner is essential.It may be worthwhile seeing an accredited practicing dietician to receive evidence based information on diet and meeting your body’s nutritional demands.

Allow yourself plenty of opportunity to rest. Growing twins and supporting them towards maturity takes a lot of energy. You may need to consider your work/leave entitlements and arranging regular home support and child care for older children.

You may need to have more regular ultrasounds than if you were carrying one baby.Your healthcare rebate and entitlements may be affected; find out early in your pregnancy what you are covered for, or consider accessing the public health system. Premature baby care can be extremely expensive. Find out your status and coverage early in your pregnancy to avoid unwanted and avoidable expenditures.

Plan for an earlier than expected delivery. Twins have a habit of coming early and it pays to be well organised.