Double Trouble: Twins and How to Survive Them. Emma Mahony

in women who do not take folic acid.

      The official advice is still for women to take 400mcg of supplemented folic acid before conception and for the first three months of pregnancy (see also www.hsis.org – Health Supplements Information Service).

      I took 12 times the recommended dosage because my first baby was born with a cleft lip and palate, so I read the study with interest. But, then again, I also fell into all of the other categories that made me more likely to have twins: I was over 35, taller and heavier (charming) than your average British mother, a twin myself who had already had one child.

      TWIN PREGNANCY VITAL STATISTICS³

       Natural conception:

      

The chance of having twins rises steadily as the mother gets older.

      

The peak age is 35 to 39 for European women.

      

Women are more likely to have twins the more children they have, independent of their age.

      

Fraternal or non-identical twins are more common if there is a presence of twins on the mother’s side of the family (contrary to popular opinion, the father’s side makes no difference).

      

Identical twins are random and occur in one in three of all twin births (although scientists are still trying to explain why they occur more in some families).

      

You can insure against the extra cost of having twins before your 14th week of pregnancy, providing you are not having IVF treatment and have yet to be scanned by your doctor. At the time of going to print, insurance company Marcus Hearn (0207 739 3444) will pay out £1,000 for a minimum premium of £42.

       Assisted conception:

      

Since the very first test-tube baby Louise Brown was born in Britain in 1978, in vitro fertilization now accounts for around 8,000 babies born every year in Britain.

      

One in four IVF pregnancies results in twins.

      

The number of triplet births has risen from 91 in 1980 to 262 in 2002.

      

The number of twin births has grown from 6,400 in 1980 to 8,500 in 2002.

      

In Britain alone, the number of cycles of treatment has risen from 28,000 in 1991 to 44,000 in 2002.

      

A quarter of infertile couples succeed with IVF.

       THREE Eating and Exercising for Three

      Make no mistake: one good thing about a twin pregnancy is that you get to eat a lot, and most of the weight will go on the babies. All of us who have had guilt issues surrounding food can now look forward to nine months of bingeing, and even longer if you hope to breastfeed. For a twin pregnancy, you are not only invited to eat one-and-a-half times more than for a singleton pregnancy, it is practically a responsibility.¹

      There is also enough evidence now to support the welcome news that in a twin pregnancy there is a direct correlation between higher maternal weight gain and better birth outcomes.² So, what are you waiting for? Order that Fortnum & Mason hamper now. This should be the rekindling of a long love affair with food.

      During my own twin pregnancy, which was remarkably trouble-free and ran the whole course to term at 40 weeks, I went food mad. I decided to allow myself absolutely no restrictions on the amount of food I ate, and arrived at work having visited the deli with two plastic bags from the greengrocer and the baker en route. For all my no-holds-barred approach, I was very picky about the type and quality of food I ate. In my first pregnancy, I had put on a lot of weight by eating badly, pretending that my penchant for crisps, cider and Maltesers was a craving. It took me 18 months to shift the excess stone (or two).

      Second time around, I had learnt my lesson about office vending machines and was careful about the type of food I ate. I would bring in as much fruit and raw veg as I could carry – carrots, cucumber, tomatoes, cauliflower, apples, bananas and grapes. Added to this would be a mixture of cheese, quiches and whatever else shouted ‘eat me!’ from the deli that day. Should anyone ever question you on the size of that cheese sandwich you are about to put in your mouth, just remind them that you are ‘eating for three’.

      The first three months

      The most important eating time is the first three months, when the babies are, literally, being created. This is when the nutrient factor is most crucial. Do not fret if you are among the many twin mothers who suffer from morning sickness. Multiple mothers tend to have a higher level of pregnancy hormone in their blood so they experience more nausea and vomiting than their singleton friends.³ Paradoxically, if you suffer from bad morning sickness and can’t keep the food down for long, this won’t affect the babies’ eventual birth weight. It’s the nutrients they are after, not the fat. And they will take the nutrients from your own body’s supply if you don’t provide them (get used to it, it goes with the territory). Mothers with morning sickness should be heartened by the research showing that sufferers have babies with better overall outcomes. Studies suggest that vomiting may stimulate early placental growth.

      If you feel tired and sluggish in the first three months, but not nauseous, remember that your body is making two babies and extra blood volume. For twins you can expect a 75 per cent increase in your blood volume (for triplets there’s a 100 per cent increase).⁴ Add to this the fact that a mother pregnant with twins can carry up to 20 pints of water more than a mother of a singleton during her pregnancy, and you can see why you have a perfect excuse to take to your bed at 8pm. Things will ease up in the second trimester, your metabolism will go into high gear, and the weight you gain will all go towards making healthy babies.

      Just say ‘no!’ to the calorie counters

      Personally, as a poor maths student, the calorie-counting view of the world has never appealed. It turns a sensuous experience, eating, into a tax return. Also, for twin pregnancies, I’ve noticed that the number of calories suggested by ‘experts’ varies wildly. In my own twin book library, the figures range from 2,700 calories to 3,500 per day. However, if calorie counting helps you to feel in control, aim for somewhere in the middle.

      My main beef against calorie counting is that it puts you in the frame of mind of dieting, which is the wrong thing to do when pregnant. Also, anything that limits your intake of food (‘I’ve eaten my 3,500 calories today, I should stop now and just drink water’) should