When I recently found out I’m pregnant, it was a pretty big shock. Only because of how long it took to get pregnant and I had somewhat given up, of course, not because I’m somehow unaware of how babies are made. Finding out shortly after that I was expecting twins was a…well double shock I guess you could say. The surprises were going to keep coming of course as I quickly learned that when it comes to twin pregnancies, things can be drastically different compared to singleton pregnancies. So even if you’ve had babies before and think, “I know what to expect,” there’s a very good chance that No, no you don’t know what to expect.
The next unexpected bit of news that came along was at my first appointment with my new OB, when he informed me that it turns out my twins are what is called monochorionic diamniotic twins (mono-di or MCDA twins) which essentially means they are each in their own sac, but sharing a placenta. This can come with it’s own set of complications, the main one that was explained to me is the risk of something called Twin to Twin Transfusion Syndrome.
I’m going to pause here briefly to state I am in no way a medical professional or an expert on this topic in any way shape or form. Everything I write here is purely what I have learned from my own searching, paired with some of what my doctor told me and wrapped up in a little bow of my own feelings and experiences. I make no assurances that any of this is completely accurate at all. I strongly advise anyone dealing with this same issue, or even just curious, to seek out their own information from a reliable source as this blog is meant to be a collection of my thoughts and experiences, and should not be mistaken as containing medical advice or medical knowledge.
How I understand it, Twin to Twin Transfusion Syndrome (TTTS) is essentially an imbalance in the nutrients each twin is receiving via the placenta. One twin (the donor twin) gives away more than it receives and the other twin (the recipient twin) receives too much, and so both twins are at a risk of various complications.
That’s the most simple version. I could elaborate but to be completely honest going into all the various scenarios makes me feel a little uncomfortable. As I stated above, I encourage anyone curious to know more to seek out details from a more reputable source to get the full picture.
One big change this causes for this pregnancy compared to when I was pregnant with my daughter is that this one needs to be monitored a LOT more. When I was pregnant with my daughter I had a grand total of two ultrasounds. With this pregnancy I’ve already had three, and I have two more booked, and there will likely be several more in our future. Pretty much every two weeks, I need to have another ultrasound. Basically they need to be able to keep a close eye on the twins to ensure they’re growing at the same rate and to watch for signs of TTTS or various other complications.
Carrying these types of twins also can potentially require more specialized care. Being pregnant with twins at all is often enough to put the pregnancy in the “High Risk” category from what I understand. But adding this into the mix means we’re definitely there. I had to be referred to a different OB more specialized to handle delivering twins, as well as another specialist focused on high risk pregnancies. In the last week I’ve been getting multiple calls a day to schedule various appointments at multiple different places and it definitely made my head spin a little. Unfortunately for me, all of this new medical support team aren’t actually located in the town I live in but rather the nearest large city so I’ll be doing some commuting to ensure these babies are safe. Absolutely worth it of course, but definitely something I wasn’t expecting.
On the plus side, I should get very familiar with the hospital I will eventually have to deliver at, so that’s nice.
Twins often come early. I did a bit of Googling and found that about 36 weeks is the average pregnancy length with twins. If the twins start showing signs of TTTS, one of the potential courses of action is to deliver early. There’s no definitive answer on how early as it’s all entirely dependent on how the babies continue to grow, but there is a good chance my Expected in October babies might just grace us with their presence sometime in September instead.
Obviously early delivery can also result in it’s own set of unexpected issues such as longer hospital stays or various health issues and concerns. I’ve basically already come to terms with the fact that I will very likely need a c-section and that the babies might need to stay at the hospital longer than expected. Neither of those things make me particularly happy but I’m realistic enough to know that it’s a possibility and if that’s what it comes down to, there’s a valid reason why it’s necessary and I’m ok with that.
When I first heard all of this, I will admit I did start to panic. I was so scared and completely overwhelmed, especially for all these new details, concerns, risks, specialists and appointments. I’ve since done some (A LOT of) reading and I’ve found a lot of great articles and resources that reassured my fears somewhat. I discovered that the chance of both babies being perfectly fine and healthy is much higher than I had originally thought, and that was very comforting. Additionally, the sheer fact that the twins are going to be monitored as much as they are makes me feel pretty hopeful that we’re all going to be in good hands and well cared for.
I have yet to meet any of these new medical professionals I’ll surely be getting to know very well over the next several months, but I’m choosing to be optimistic about the whole thing. There’s really not much else I can do to take charge of the situation, and I happen to believe in the power of positive thinking at least to a certain degree.
Columbia University Department of Obstetrics and Gynecology explaining what monochorionic diamniotic twins are.
This comprehensive guide and information of all things related to Mono-Di twins and TTTS (and other conditions I found over on Wiley’s Obstetrics and Gynecology Hub.
Leave a comment if you’d like and let me know your thoughts. I’d especially love hearing from other twin parents who might have encouraging stories to share.
Stay safe everyone!