Multiple pregnancy is the formation of more than one fetus in the uterus. These fetuses can be identical twins, where a single egg is fertilized by sperm and splits into two during the division phase, or fraternal twins, which occur when two or more eggs are fertilized by sperm. Of these, identical twins are genetically identical, while fraternal twins are of the same or different sexes. The incidence of multiple pregnancies in this way is approximately one in 85 births. This probability is higher, especially if there is a family history of twins in the mother and father. At the same time, the chance of multiple pregnancies is higher in those who use ovum-enhancing drugs and in vitro fertilization treatment. Twin births are usually the case in multiple pregnancies. However, triplets and quadruplets can occur, although rarely.
There are certain risk factors that await the mother and the baby in multiple pregnancies. In such pregnancies, the burden carried by the mother increases and therefore the symptoms related to pregnancy are experienced more intensely. The risk of miscarriage is higher for women with increased nausea and vomiting complaints compared to single pregnancies. During this process, problems such as anemia, premature birth threat, and gestational hypertension develop more seriously. Babies born from these pregnancies may be born prematurely, with low birth weight, and have problems such as difficulty feeding after birth. In addition, in identical twins, there is a possibility of them remaining attached during the division phase. Risk of premature birth in multiple pregnancies
The biggest problem with multiple pregnancies is the risk of premature birth. In other words, the pregnancy can end early. Babies born before the 37th week of pregnancy are called premature. Births in multiples usually end around the 34th week. If the birth does not occur spontaneously, it is usually terminated by a doctor in the 37th week. Because pregnancies that continue after this period have a more difficult process. Women with multiple pregnancies have to go to the doctor more often. It is really difficult to carry more than one baby during pregnancy and to take care of them after birth.
Delivery method in multiple pregnancies
In the case of multiple pregnancies, the best choice is a cesarean section. Normal birth is considered risky for the babies and the mother. Usually, in the last months of pregnancy, the method of birth is decided according to the position of the babies in the womb. The important thing is to choose a method that will not pose a risk to the babies and the mother. Even if a decision has been made for vaginal birth, a switch to cesarean section can be made in case of problems that may develop during birth. However, in multiple pregnancies, women are more likely to have a cesarean section.
Problems that are likely to occur in multiple pregnancies
Compared to single pregnancies, it is a more difficult process for the mother and the baby.
These expectant mothers experience problems such as nausea and vomiting, back pain, fatigue, lower back pain and cramps more effectively.
The shortness of breath problem experienced by expectant mothers in the last trimester of pregnancy disturbs the expectant mother more in multiple pregnancies.
Iron pills are used to prevent mothers from suffering from anemia during pregnancy. This poses a greater risk in multiple pregnancies. Therefore, it is appropriate for the mother to start taking iron pills at an earlier stage. Otherwise, both the mother and the babies may develop anemia due to iron deficiency.
High blood pressure problems are more common in mothers who have multiple pregnancies.
These expectant mothers are at greater risk of premature birth.
The risk of miscarriage in multiple pregnancies is higher than in singleton pregnancies.
In these pregnancies, the probability of birth ending in a cesarean section is quite high.
In multiple pregnancies, more doctor follow-up is needed both during pregnancy and after birth.
What should expectant mothers with multiple pregnancies pay attention to?
In case of multiple pregnancies, expectant mothers should not neglect to go to the doctor for a check-up and should be more careful than women with single pregnancies.
According to her doctor's recommendations, she should follow the rules regarding nutrition, rest and sexual life and ensure that her pregnancy is healthier.
If women with multiple pregnancies are employed, they can take leave from the workplace starting from the 30th week of their pregnancy.
These expectant mothers should avoid exercises that will strain them and pay attention to themselves. This is important for both their own health and the health of their babies.
As with all pregnant women, harmful habits such as smoking and alcohol should be avoided.
Expectant mothers should definitely consult their doctor before taking long journeys.
Since the risk of premature birth is higher in these pregnancies, the expectant mother should always be prepared for birth. She should not perceive this as fear, but should prepare herself for birth with help from those around her.
The baby should receive the necessary help from her elders after birth, just as she did before birth. This should help her feel more comfortable psychologically.
Since the anemia problem will be more common during pregnancy, she should not neglect to use the iron medications recommended by her doctor and should be more careful.
Risk of depression in multiple pregnancies
The risk of depression is higher in mothers who have multiple pregnancies. Even if the mother has not had depression before, the changes that occur during pregnancy increase the tendency for depression. This is more common in multiple pregnancies. In particular, mothers who have lost their babies due to premature birth or other complications are more affected by this.
Nutrition in multiple pregnancies
In order for the 9 months of multiple pregnancies to pass healthily, importance should be given to nutrition. Although the nutrition in these pregnancies is similar to singleton pregnancies, there are changes in the amount of nutrients taken. Expectant mothers have a greater need for nutrients. They especially need more iron, calcium, omega 3 fatty acids and protein. What to do for this;
Iron must be taken from outside through supplements and foods. Therefore, iron-containing red meat, eggs, green leafy vegetables and legumes should be consumed. While the need for iron is around 30 mg in a singleton pregnancy, it is around 60 mg in a twin pregnancy.
Care should be taken to take vitamin C, which supports iron absorption, and avoid consuming tea and coffee, which will inhibit absorption.
A decrease in the amount of calcium in the expectant mother can cause problems in the long term if it is not replaced. Especially with the 28th week, when there is a calcium deficiency, the calcium in the blood begins to decrease. This increases the damage to the bones in the long term. Therefore, milk and dairy products containing calcium should be consumed in sufficient amounts.
Omega 3 fatty acids, which are an important nutritional support in the last trimester of pregnancy, are very important for brain, eye health, heart and development. The best source for this would be fish consumption.
The protein requirement in multiple pregnancies is also higher. This requirement is especially higher from the sixth month onwards. Therefore, protein-rich foods should be consumed.
Postpartum problems in multiple pregnancies
With the birth of babies, the mother-to-be becomes more tired. After this stage, dealing with more than one baby, their care, and being able to show the same attention to each baby is the most difficult issue for the mother. If this becomes a problem, they may experience depression even after birth.
Multiple pregnancies are not only a situation where the mother is affected. At the same time, each family member, the father and any other children are affected. Compared to singleton pregnancies, families are more likely to be stressed and tense. Especially families that have encountered multiple pregnancies for the first time are affected more. Pregnancies are riskier, and since even sexual life is restricted at an earlier stage, problems may occur between spouses.
Caring for more than one baby after birth, changes in the order of the home, and increased financial expenses due to the birth of babies can cause conflicts within the family. Factors such as increased risk of premature birth during pregnancy, increased probability of miscarriage, and more intensive care due to babies being born with low birth weights, all impose additional financial and emotional burdens on the family. Especially, the fact that all the spiritual attention and care is directed to the babies causes some problems between the spouses.
If there are other children in the family, they may feel neglected after the birth of the baby. In this case, it is very important to maintain the balance between the spouses and to strengthen the foundations of the relationship between them. In particular, the support of the elders in this regard will be the greatest help for the spouses to take responsibility for the babies.
Problematic birth of babies in multiple pregnancies
Babies born as a result of multiple pregnancies are more likely to have developmental problems and genetic defects. If such problems occur, the order in the family will completely change. In our country, the father usually prefers to stay out of such problems and leaves the entire burden on the mother. A family relationship that deteriorates in this way can cause families to break up because the mother and father become depressed about this issue. Therefore, families should be more careful in multiple pregnancies and be prepared for everything.
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