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Everybody loves twins.

Seeing them in those beautiful matching outfits definitely triggers the ‘feel good’ hormones in all of us.

Want to know more about twins and multiple pregnancies?

Then read on, this article contains everything you need to know.

What Is A Multiple Pregnancy?

A multiple pregnancy is one with two or more babies growing in the mother’s womb. It is the less common alternative to a singleton pregnancy, where there is only one baby.

How Does A Multiple Pregnancy Happen ?

There are two main types of multiples; Non-identical (fraternal) and identical multiples.

During ovulation, usually, only one egg is released.

However, if more than one egg is released and they are all fertilized by sperm separately it results in a fraternal or non-identical multiple pregnancy.

In some other cases, after one egg is released and fertilized by a sperm, it divides into two or more embryos before implantation, resulting in an identical multiple pregnancy.

Thus, identical twins arise when a fertilized egg divides into two in the early stages of pregnancy before implantation. Conversely, non-identical twins are formed when two eggs are released during ovulation. Separate sperm then fertilize each egg.

Identical twins have the exact same copies of genes, and they have the same sex. However, fraternal twins are not genetically identical.

What Causes This?

1. Fertility Drugs: The use of fertility drugs to induce ovulation. This can result in more than one egg released from the ovaries leading to their fertilisation.
2. Assisted Reproduction/In-vitro fertilisation (IVF).: This results in multiple pregnancy when more than one embryo is transferred to the womb.
3. Maternal Age: Women above 35 are more likely to give birth to twins. This happens because women of this age often release more than one egg in a single menstrual cycle.
4. Maternal Height and Weight: Taller and heavier women tend to give birth to twins more often.
5. Genes: This relates more the woman’s genes; a woman is likely to have twins if she is a twin or has siblings/cousins who are twins.

How Can You Stay Healthy During A Multiple Pregnancy?

1. Eat Nutritious Food: As an expecting mum of two or more, you need to eat more protein and stay hydrated. Also, you will need to eat some extra calories so that your babies will feed well .
2. Exercise: Consult your doctor to know which exercise is good for you at each stage of your pregnancy. Nonetheless, you need to avoid strenuous activities.
3. Rest : Do so much as you can. This will require support from family and friends
4. Attend Clinics Attend these regularly as directed by your doctor so that your well being and that of the babies can be closely monitored.

What Are The Risks?

1. Early Labour and Preterm Delivery: Sadly, this is quite common in multiple pregnancy – delivery is more likely to occur before a gestational age of 37 weeks. Also, the babies are more likely to have a low birth weight.
2. Hyperemesis Gravidarum (HG): This is excessive vomitting in pregnancy . It can cause a significant disruption of the fluid and electrolyte balance of the mother, requiring hospital admission for treatment.
3. Diabetes: Gestational diabetes is more likely to develop in women with multiple pregnancies. Unfortunately, this may cause respiratory distress in growing babies.
4. Preeclampsia: This refers to high blood pressure (hypertension) that occurs in pregnancy. Preeclampsia is more common in multiple pregnancies than single pregnancies.
5. Delivery: The choice of delivery depends on the number, size, position, and health status of the babies. Often times, a Caesarean section is advised for women with multiple pregnancies.
6. Placenta Abruption: Most times, multiple pregnancy affects placental function. A placenta abruption occurs when the placenta becomes separated from the inner wall of the womb before delivery.

How Will They Be Delivered?

Most twins in recent times are born by a pre-planned Cesarean section. Less commonly, depending on the weight of the babies, health status of (mum and babies), and position, they can be delivered vaginally.

How Do I Feed Them?

It is perfectly possible to feed twins exclusively on breast milk with the right support and positioning. Most twins are nursed in tandem using a rugby position. Here mum positions babies with their heads in front beside her breast and legs pointing backwards under her armpits. This mimics how one carries a purse or rugby ball.

You will need nourishing food, hydration, and good social support. Don’t hesitate to request for what you need. Get a good breast pump so others can help with feeding. It is not uncommon for families to supplement with formula.

In Conclusion,

Having twin babies is a delightful experience although it comes with its own peculiarities. Read our other article on positive signs of embryo transfer.

While expecting multiple babies, it is advisable to attend clinics regularly. This allows your doctor to monitor the health of you and your babies effectively.

Finally, the complications of multiples can be reduced and managed better when you visit your physician regularly.

COVID-19 AND PREGNANCY: WHAT YOU NEED TO KNOW

Pregnancy can be stressful, we know this.

Of course, being pregnant during the spread of a global pandemic can definitely be overwhelming. If you are currently pregnant, we understand how worried you may feel.

Your mind has most likely been tossing and turning with questions about how COVID-19 would affect you and your baby.

As usual, we are here for you. Here are some vital things about COVID-19 and your pregnancy that you need to know.

What Is COVID-19?

Pandemic… Coronavirus… COVID-19.

We have heard these terms almost a zillion times these past few months. But what exactly is the COVID-19?

Simply put, it is an infectious disease caused by a newly discovered coronavirus called SARS COV-2

And yes, it is very, very real.

No, it is not a “white man’s disease”. Neither does it affect only “rich people”.

Anybody can get infected because it spreads through human interaction. One can get infected by staying close to an infected person who is coughing or sneezing. The virus can even be contracted by touching an infected person or surface, then touching one’s eyes, mouth or nose.

What do you feel if you get it?

Most signs usually appear within 2 – 14 days after exposure. The common symptoms of covid-19 include;

• Fever
• Cough and/or sore throat
• Shortness of breath
• Chills
• Body pain
• Headache
• Loss of taste or smell
• Diarrhoea

If you or anyone around you has any of these symptoms, please stay at home and contact the NCDC (Nigerian Center for Disease Control) as soon as possible.

Note that some people may be infected and not show symptoms. These people can still spread the virus.

COVID-19 and Pregnancy

A lot is still unknown about the new coronavirus, although a lot of research is ongoing.

It is already known that people with underlying health conditions are more likely to have complications. However, no evidence suggests that pregnant women without underlying health conditions face such risks.

Furthermore, there are a lot of unknowns about how COVID-19 affects pregnancy. As an expecting mom, you are strongly advised to adhere strictly to the social distancing guidelines. Also take extra care to follow proper hygiene by regular hand washing and sanitizing.

COVID-19 And Your Birth Plan

Yes, we know. You already have a lot of plans in place, from your hospital, to your doctor, to your birthing partner, to your birthing videos and pictures, and many more.

Unfortunately, some of these plans may have to change. The level of change may be different for each hospital or birthing center, but here are a few things that you should prepare you mind for;

• Change of birthing location or center.
• Unavailability of your preferred doctor or nurse
• Compulsory screening for COVID-19
• Your birthing partner being restricted from entering the delivery room.
• Your doctors, nurses and you may be required to wear protective gear. `
• Restrictions on your movement
• Restrictions on the amount of visitors you can have

COVID -19 and Your Unborn Baby

It is still uncertain whether or not coronavirus can be transferred from mother to child.

Current research however suggests that it is very unlikely. In some countries it is advised though that babies born to mothers who have COVID-19 be separated from their moms for 14 days. This may have negative effects on breastfeeding. If you are well enough and choose to have skin to skin and/or breastfeed and your baby is stable, nothing stops you from doing so following these precautions.

Wash your hands before touching your baby, breast pumps or bottles

Try to avoid coughing or sneezing on your baby

Wearing a mask or face covering when carrying baby

Follow recommendations for pump or bottle cleaning before and after use

Express your breastmilk and consider asking someone who is well to feed your baby

RCOG. Corona Virus Infection and Pregnancy: Information For Pregnant Women and Their Families. Uhttps://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/#suspected Accessed 13/8/2020

The benefits of breastfeeding outweigh the risks.

We know, we know. This is a very distressing thought. However, it is only for a short period of time, and it is for the ultimate benefit of you and your baby. 

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How Can You Protect Yourself?

The best way to do this is to practice social distancing, especially if you are pregnant. Even if there is no confirmed case in your area, please stay at home as much as possible.

Stock up on essential items if you can. If you must go out in public, always wear your face mask and never forget your hand sanitizer at home.

The COVID-19 pandemic has left the world at large in a state of shock and uncertainty.

These are stressful times, and we wish the pandemic would just go away. However, for as long as it is here, we need to do our part to live through it. This is only possible if we follow all guidelines that have been laid down for us.

Wash your hands regularly. Sanitize frequently touched surfaces like door handles, tables, stairways, etc. regularly. Practice social distancing, avoid physical touch as much as possible. Doing this would not only protect you, but would protect everyone around you, including your unborn child.

It is our honest hope that you stay safe during these trying times. Once again, please remember to wash your hands and sanitize!

    

Cynthia was too busy to be pregnant.

In fact, she just couldn’t be. It didn’t matter that she had missed her last period or she’d started to doze during those long, boring meetings at the office.

All that matters is that she just couldn’t be pregnant.

Or Could She?

Many women consider a missed period and/or morning sickness to be the hallmark of being pregnant.

However, there are other signs to look out for.

In this article, we’ve compiled 10 of these ‘other signs’ for you. They should prompt you to consider doing a pregnancy test.

1. FATIGUE

Most women tend to get tired faster during the early stages of pregnancy.

This is caused by increased production of a certain hormone called Progesterone. In addition, pregnancy causes the heart to work harder as it pumps more blood to send necessary nutrients to the growing baby.

2. MOOD SWINGS

Pregnancy comes with a lot of hormonal changes.

Sometimes, these hormones affect your mood. Most pregnant women claim to have started experiencing sudden mood swings as early as the first week of pregnancy.

3. WEIRD FOOD CRAVINGS

Many husbands dread this part.

Sudden food cravings are quite common throughout pregnancy. In some cases, it is even difficult to eat a meal that you craved for just minutes ago. Certain food cravings can even last all through the period of pregnancy.

4. TENDER/SWOLLEN BREASTS

This symptom can arise as early as the second week of pregnancy.

The hormonal changes during this period can make the breasts sore, swollen or even ticklish. In many women, the breasts feel heavier or fuller.

5. Headaches

Of course, no one likes this.

Once again, the hormones released during pregnancy can result in periodic but annoying headaches.

6. Slight Bleeding

This is different from the usual menstrual bleeding. In this case, the blood is slightly lighter in colour than menstrual blood.

The slight bleeding that occurs in the early stage of pregnancy is called Implantation Bleeding; this happens when the developing baby safely attaches to the walls of the womb.

7. Frequent Urination

Has the need to pee suddenly tripled?

You probably need to conduct a pregnancy test. In the first few weeks of pregnancy, the pressure to urinate increases drastically. This is caused the action of a pregnancy hormone called Human Chorionic Gonadotropin (HcG).

8. Morning Sickness

Nausea or Morning Sickness usually begins in the 2nd or 3rd week of being pregnant. It is also important to note that this feeling of nausea or irritation can be experienced at any time of the day.

9. CRAMPS

Again, the hormones are responsible.

Rapid hormonal changes in the first few weeks of being pregnant sometimes result in mild cramps. Although they are not as intense, women often write them off as the regular menstrual cramps.

10. VAGINAL DISCHARGE

During pregnancy, there are noticeable changes to this normal process.

Some women begin to notice an increase in the volume of vaginal discharge as soon as they get pregnant. Most times, this discharge is clear or milky white.

Eventually,

Cynthia bought a regular home pregnancy test kit from a nearby pharmacy. Within minutes, she confirmed that she and her long-term partner were indeed expecting a baby!

Although these symptoms are closely associated with early pregnancy, they can also mean something else. In some cases, they may result from stress, medication change or lifestyle modifications.

If you really think you’re pregnant, the smartest option is to actually conduct a pregnancy test.

Hauwa started feeling the pain in her tummy two days ago. It started as a dull, ache. It gradually got worse even after taking some tablets of over the counter medication.

Her period was two weeks late.

She hadn’t given it much thought until now, although questions like “Could I be pregnant? I have some of the signs kept on popping up.

What’s causing this pain and why wouldn’t it go away?” Eventually, she decided to visit the general hospital near her house.

During the consultation, the gynaecologist asked a number of questions. One of which was, “Had she any history of Sexually Transmitted Infection?” to which she affirmed. She explained that she was prescribed antibiotics. However, this was after several weeks of failed self-medication and worsening symptoms.

The doctor examined Hauwa. Furthermore, she asked her to get a pregnancy test and ultrasound scan done immediately. The pregnancy test came in positive but the ultrasound showed an empty womb!  Where then was this pregnancy?

After a detailed search, an abnormal sac was found close to her ovary. There was a heartbeat.

The diagnosis was a ruptured Ectopic Pregnancy.

Hauwa was truly pregnant but the pregnancy was not in her womb!

What’s An Ectopic Pregnancy?

From double lines on test strips to early morning nausea. From missed periods to positive blood tests. The news of conception is one that is often wrought with mixed feelings. In some cases, tears of joy, in others, absolute shock and disappointment.

Regardless of the mode of reception, conception has occurred and more often than not, the fertilized egg has attached to the mother’s womb before she is even aware of it. This attachment provides a means for the growing baby to get the oxygen and nourishment necessary for its survival.

Any pregnancy in which this physical connection, between mother and child, occurs in any other site outside the womb is regarded as an Ectopic Pregnancy.

The most common site of ectopic pregnancy occurrence is the fallopian tube. Other less common sites include the ovary and the abdominal cavity.

Causes & Sites

Ectopic Pregnancies are caused by any factor which prevents or causes a delayed transport of the fertilized egg through the fallopian tube. This leading to its attachment to the any part of the abdomen, ovaries, various parts of the fallopian tube, or cervix instead of the womb.

These factors may be inherited from parents or acquired at a point during a woman’s life.

Some of these factors include:

• Complications of sexually transmitted diseases (STIs) (e.g Pelvic Inflammatory Disease),
• Masses or tumours of the ovary
• Poorly done abortions
• Smoking
• Fertility treatments and
• Previous ectopic pregnancies.

What Does It Feel Like To Have An Ectopic Pregnancy?

In Nigeria, Ectopic Pregnancies make up 2-5% of all women’s health related emergencies. This statistic rises with every day. As it is with some health conditions, ectopic pregnancies don’t show symptoms till a rupture happens.

The common warning signs of an ectopic pregnancy are:

• light vaginal bleeding
• lower abdominal pain.

As the pregnancy goes on, other observable symptoms like:

• Observing you have missed your menstrual period
• A swelling in your tummy may occur

In extreme situations of tubal pregnancy, the tubes may rupture, resulting in heavy bleeding. Other symptoms of this life-threatening situation may include lightheadedness, fainting spells and shock.

Is It Preventable?

It is essential to note that depending on the location, an ectopic pregnancy cannot proceed normally. In fact, the embryo cannot survive and the growing tissue may result in life-threatening bleeding if left untreated.

As a precaution for mums, it is advisable to conduct a scan. This determines the actual pregnancy site, especially if you have a history of ectopic pregnancy.

There is no hard and fast rule for prevention. The key to reducing its incidence lies in reducing the risk factors. Certain practices that have proven to be effective include:

Safe Abortion Practices

This serves to reduce the risk of an infection occurring after an abortion procedure. Whenever an abortion is necessary, a government certified hospital with qualified medical personnel is the best option.

Safe Sexual Behavior

Limiting the number of sexual partners and proper contraceptive education/use would help women like Hauwa reduce the risk of contracting certain STIs which may eventually result in Pelvic Inflammatory Diseases that can increase the chances of an Ectopic Pregnancy.

Safe Contraception

Every woman who aims to reduce her predisposition to ectopic pregnancies should consult qualified gynaecologists before selecting a plan. Furthermore, progesterone-only pills, as well as Intra-Uterine Devices (IUDs) may increase the risk of Ectopic Pregnancies.

Lifestyle Modifications

Smoking has been observed to increase the risk of an ectopic pregnancy by up to four times. Therefore, women of reproductive age (12- 51 years) are advised to refrain from smoking².

Seeking Medical Care Early

When infections arise, women are advised to promptly seek proper medical care. Proper treatment would ensure that the risk of a recurrence is minimal and the threat of an ectopic pregnancy in the future is greatly reduced.

Can Ectopic Pregnancies Be Managed?

An ectopic pregnancy, especially in the fallopian tube, is an emergency. Most ectopic sites are not wired to house and sustain a growing baby. If left undetected, it can rupture and cause heavy internal bleeding. This is totally different from threatened abortion.

Although it can lead to death in severe cases. Once discovered, the way Hauwa’s condition will be handled depends on the stage of the pregnancy as well as her physical condition at the time of diagnosis.

The most probable options include medical management with the administration of abortion medications, like Trophotoxics, at the site of the ectopic pregnancy. In addition to this, surgery might be required, especially in severe cases. Depending on the location of the pregnancy, a damaged ovary or tube may be removed.

 You are not alone in this

Sadly, this condition is not unique to Hauwa, as a number of women in our society suffer this from time to time. In most cases, the pain is obvious to the people around them and family and friends may be at loss for what to do and how to help.

Therefore, everyone needs to have information on how to handle this situation as it takes a great toll on the emotional and mental health status of an affected woman.

Fortunately, a diagnosis of Ectopic Pregnancy is not a death sentence if discovered on time. With one tube and ovary you will still go on to have pregnancies in future .

The true cause of 25-60% of pregnancy losses is unknown. Where it is known the causes could vary from medical conditions affecting the baby itself to those affecting the mother.

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Thereafter,

• structural or functional abnormalities with the body of the mother’s womb or placenta or cervix,
• pre-existing medical conditions in the mother such as sickle cell disease, poorly controlled diabetes or hypertension, pre-eclampsia and thyroid disease,
• hormonal imbalances,
• incompatibilities with the mother and baby’s blood group (eg. Rhesus incompatibilities),
• immune diseases such as antiphospholipid syndrome,
• infections and
• trauma are common causes of stillbirth.

Some of these conditions may threaten the ability of the mother’s body to sustain the pregnancy to its completion. They do this directly or cause abnormalities in the unborn baby that may not be compatible with its survival.

The true cause of 25-60% of pregnancy losses is unknown. Where it is known the causes could vary from medical conditions affecting the baby itself to those affecting the mother.

Why Is Finding Out the Cause Important?

The essence of exploring the causes of pregnancy loss with your health provider (where possible) is to set in motion a plan of action. The aim is to permanently correct any abnormality, manage any chronic condition proactively. Thus, we may be better prepared to forestall a repeat pregnancy loss the next time the mother conceives.

With the guilt that follows miscarriages, some individuals believe that sexual intercourse, strenuous exercise or work can lead to miscarriages. On the contrary, there is no known evidence to support this notion.

What do you Feel When a miscarriage Occurs?

Sometimes a pregnancy loss may be silent ie. the mother may not observe any obvious signs coming to the knowledge of what has occurred during a routine check or after a missed period.

Common symptoms include:

• bleeding of various degrees,
• passage of the fetus or bits of tissue from your vagina,
• abdominal cramps of various degrees, fever,
• lower back pain and loss of previously felt symptoms of pregnancy such as breast fullness, nausea.

Once a total or imminent pregnancy loss is confirmed, your health care provider will need to ensure that your womb is completely empty. This is verified through a series of tests which would include an ultra sound scan as well as give you medication and/or perform a surgical procedure on you.

You are seeing all the signs of pregnancy. Your period is late, your breasts are tender and swollen and you have gained a few kilos. Let us not even talk about the morning sickness. Are you pregnant?

The internet says all these are symptoms of pregnancy. For some, this news may be a reason for joy. For others, however, it is a cause for alarm. Regardless of which side of the fence you are on, you may begin to make some preparations.

Wait!

What if I told you that you may not really be pregnant? That the pregnancy signs you are having may not be because a baby is growing in your womb?

In here, we have compiled 5 signs of pregnancy that may actually be symptoms of something else!

1. Missed Period

There is a reason why doctors always ask when you had your last menstrual period. This is because a missed or late period is one of the most common signs of pregnancy. However, your period might also not come for a variety of other reasons:

• Hormonal Imbalance: Having irregular periods is a common sign that your hormones are off. At times, this may confuse you into thinking you are pregnant. Hormonal imbalances can be caused by stress, medications, and some medical conditions.
• Stress: This is a common cause for late periods. You may even miss your period entirely. Are you preparing for your finals? Working extra time to bag that promotion? Well, do not be surprised if “madame” comes a little bit late!
• Medical disorders: Some medical conditions can also make your period late. Especially ones which affect your thyroid gland or ovaries.
• Weight Changes: Your menstrual cycle may be affected if your weight changes too fast. Experts suggest that gaining or losing about 20% of your body weight can cause you to miss your periods.
• Contraceptives: Some types of birth control can also affect your period. Discuss with your doctor about your concerns if any about contraceptive options.

2. Tender or Swollen Breast

This is also another sign that is usually associated with pregnancy.

Still, having aching or swollen breasts do not necessarily mean you are pregnant. It could just be a sign that you are about to have your period. Or it could mean that you are working too hard at the gym and you need to slow down a bit, especially with the heavy lifting.

3. Nausea

Morning sickness is widely regarded as the hallmark sign of pregnancy. Truth be told, this is not unusual because it occurs in about 70% of all pregnancies.

Yet, puking your guts out is still no sure sign that you are pregnant. Vomiting or stomach upset can also be as a result of:

• Intense stress
• Intestinal issues
• Some medications
• Viral infections
• Ulcers
• Food poisoning, amongst many others.

4. Drowsiness and Fatigue

Everybody knows a pregnant woman is a tired and sleepy woman.

Especially one in her first trimester. This is because of hormonal changes. However, exhaustion and drowsiness may be caused by other reasons such as:

• Increased physical activity
• Reduced sleep
• Overeating
• Extreme weight loss diets
• Some medications
• Some medical conditions e.g low blood levels, depression, e.t.c.

 

5. Mood Swings

Feel like your emotions are all over the place? Well, that could be a sign that you are pregnant… or not. Mood swings could also be as a result of:

• Menopause
• Menstruation
• Anxiety & Depression 
• Certain Diet & Exercise Plans

Regardless of what the internet or other mothers may tell you, the only actual way to know if you are pregnant is to take a pregnancy test.

You can even use a pregnancy test strip at home.

Even with that, do not jump to conclusions yet. Go to the hospital. Get a blood test. Have your doctor confirm whether you are pregnant or not. Only then can you be.