Return of the Twin Questions and Answers

Let’s get back to some twin Q&A! And if you have a minute, go congratulate Mr. and Mrs. Blonde, who just found out they’re having twins!

Where are we? So far we have:

Twin Pregnancy
Twin Birth, and Going Home
More Twin Questions and Answers
Still More Twin Questions and Answers
Even More Twin Questions and Answers

Could I perhaps have come up with a more intuitive titling system? Such as, perhaps, #1, #2, #3? I mean for heaven’s sake.

Oh. Wait. We don’t seem to have any more twin questions to answer. We do have some miscellaneous questions, though, and I’ll just go ahead and answer them here since they came about because of the twin Q&A posts.

Ruthie: “I have a question that’s not exactly twin related but I hope you’ll still answer. I’m about to have my 3rd C-section, and my doctor has been not exactly adamant, but let’s say strongly recommending, that 3 is the limit. My husband has taken this to mean that not getting my tubes tied at delivery is the equivalent of a suicide mission. You mentioned that the twins were your 3rd C – did your doctor recommend no more children for you after that point? Did you have any problems with your C for Henry (assuming it was a 4th C)? I’ve read your archives and it seems like you weren’t sure for awhile whether you would have more children after Henry … did the C section thing enter into your decision?”

So far all my obstetricians (I go to a practice with 6-8 of them, plus I had another one for my first pregnancy) have answered the “How many c-sections is okay?” question on a case-by-case basis: part of what can make subsequent c-sections risky has to do with the complications that caused the woman to need the c-sections in the first place. But so far all of them have agreed that the default answer is that the risks increase slightly for each one, but that as long as everything is normal (and continues to be normal) you can have as many c-sections as you want. “Sure, be a Kennedy,” said one of my OBs, referring to whichever Kennedy woman it was who had 9 or 11 c-sections or whatever it was.

What my OBs do is check things out during each c-section and tell me if things still look okay for another, and so far it’s always been yes. Definitely it’s not standard to say three is the limit. If I were you I’d tell the OB right before the c-section begins that I didn’t think I wanted any more children but could he/she please investigate while in there and see how things look just in case you change your mind.

During the twin pregnancy I did worry a little about uterine rupture: the uterus gets soooooo stretched for twins, and I’d already had two c-sections. But everything was fine, and then I had a fourth c-section and the OB still says everything looks fine if I want another. So for me, it’s not something I consider an issue; I’m more worried about my increasing age. (In fact, one theory for why the risks go up for subsequent c-sections is that the mother’s age is also increasing.)

Megan: “I have a personal one for you, but I understand if you don’t want to answer….how much weight have you gained with each pregnancy and how much did you lose before getting pregnant again? Did you try to lose weight or did it just happen? I’m overweight and about to try to get pregnant.”

I’ve gained such a different amount with each pregnancy, and had such different experiences losing it. For my first pregnancy I gained 40 pounds and most of it came off quickly but it seemed to take AGES to lose the last little bit. For my second pregnancy I gained 15 pounds and lost all of it fast and then some (and then afterward I gained back the extra I’d lost, and then some). With the twins I gained about 50 pounds and lost it all in a week (a LOT of it was water retention—my legs were swollen up to my hips) and then kept losing. With Henry I can’t remember what happened, perhaps because my brain hit the limit of how many details it could hold. But I seem to remember it going about the same as my first pregnancy. I always think I’ll use an upcoming pregnancy to inspire me to lose weight, but it never works!

Eleanor Q.: “Independence training? I’d like to hear more about that. How did you pick what activities to start with? How did you coerce a toddler into doing something that YOU wanted when YOU suggest it? Did you see any regression of abilities once the babies came home?”

Several of the biggest trainings were things I probably should have already done by then anyway. My friend Astarte and I have oldest kids the same age, and her oldest was already long since showering on her own when I was all, “Oh, hey, I wonder if mine could learn to wash his own hair?” And when I finally got around to teaching William to dress himself, the quickness with which he learned indicated I could have done that earlier.

I don’t remember meeting any resistance. This may be because I was too tired to hear any. Or it could be that they were just the right ages: Rob was 6 and has always liked Being a Grown-up, and William was 4 and has always liked Doing What Rob Does.

I chose activities based on the things I was finding overwhelming during pregnancy. I was spending a lot of time in the morning dozing, so I was motivated to teach them to get their own breakfasts, and this made me think of having them also learn to make their own lunches. I was having trouble kneeling at the tub and getting past my tum pressed against the side, so I was motivated to teach them to wash themselves.

Some of it was just teaching them to PITCH IN. They weren’t really able to gather up the trash, and having them lug it to the porch wasn’t much of a help to me, but having them do it took away some of my I’m The Only One Who Does Any Work Around Here feeling, and that was helpful.

I didn’t see any regression, though definitely the Fun! Of! Independence! wore off after awhile.

13 thoughts on “Return of the Twin Questions and Answers

  1. d e v a n

    I love it when kids are old enough to start helping with chores. My oldest (almost 5) can put away some laundry and it is AWESOME! Just wait till they’re old enough to cut the grass!wooohooo

  2. Shelly

    Jess is on the right track – the gift that keeps on giving INDEED! And Jess, then the older kids start helping with the younger kids! Bliss!

  3. nicole

    Weighing in on the c-section question: I’m about to have my fifth surgery in May. My doctor takes pretty much the same attitude as yours. He checks things out each time to see how things look (scar tissue is a consideration too) and tells me what he sees. There is an increased risk of a condition called placenta acreta with repeat c-sections, but it can be checked out via MRI before delivery, and if it is severe a hysterectomy may be required. Many doctors will say there is a limit because they want to protect themselves from consequences, and given the state of malpractice insurance and our litigous society, it is not surprising they feel that way.

  4. Nowheymama

    “…the quickness with which he learned indicated I could have done that earlier.”

    Just came to that same realization with E. this week. Now I’m all, “Hmm, what else can I teach you?”

  5. Elle

    I have always been curious about your c-sections because I know with my mom, when she got pregnant the third time (requiring a third c-section) her mom actually stopped talking to her because she decided that my mom was committing herself to death (I kid you not). C-sections 1 & 2 were fairly far apart (6 years!) but 2 & 3 were not (18 months). This was a long time ago so perhaps that affects how things were perceived (24 years ago from #3). But she did not have anymore because her doctor felt it would be too risky (plus, kids are expensive, yo). But basically, I’ve always grown up with the idea that 3 c-sections are FAR TOO DANGEROUS. So it’s interesting to read that that isn’t ALWAYS the case :)

  6. Eleanor Q.

    After I read your last Twin Post, I started working teaching him to take off his shoes and socks when he comes home. He’s gotten the velcro opening down pat but somehow hasn’t grasped that he’s going to need to use more than just one thumb to pull off his shoe.

  7. Kristen

    I am intrigued by the c-section discussion as I just had my first baby by c-section 8 weeks ago and I never considered (nor did my doctor ever mention) that there could be a limit. Interesting…

    And I do have a question, although it is not directly twin related. Can we talk about nursing bras?? I am having trouble finding comfortable yet reasonably affordable ones. Any suggestions??

  8. Swistle

    Kristen- The one I liked was a Duo underwire (I know underwire is frowned upon, but I couldn’t stand not having it) from JCPenney, but I couldn’t find it during my last pregnancy.

  9. Ruthie

    Thanks for answering my question, Swistle! Interesing how docs can differ so much in their recommendations. Mine has told me both times that things look good with not much scarring. Hmmm …

    Oh, and Google tells me it was Ethel Kennedy with 11! Yikes.

  10. nonsoccermom

    This post tells me that I should probably start teaching my seven-year-old to start doing stuff for himself. I mean, he gets dressed on his own. And…um. Hmm.

    It may be time for my inner control freak to take a Xanax.

  11. momstinfoilhat

    I will second what Nicole said. Some of the issues with repeat c sections cannot be determined at the end of a previous pregnancy (e.g. during that cesarean section). That would definitely include placenta accreta and other problems with placental attachment, stillbirth, and uterine rupture.

    That being said, it is only a risk increase, not an absolute negative outcome for every woman, or even most women. And, it’s definitely not a death sentence. Ob/gyns are supposed to take into consideration how many children this woman is likely to want in the future when weighing the risks and benefits of cesarean, especially a non medically indicated cesarean, such as a primary elective or repeat-just-to-repeat cesarean.

    But, there is no number that’s even suggested as a soft limit in these position statements, and it should only be one of many considerations in deciding whether to have more children.

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