3. What does this all mean?

How do multiples happen?

I knew very little about twins and triplets a few weeks ago, but the amount of questions we have had, and people have had for us has made for a very interesting journey. 

Most peoples first question is "do you have twins in the family?" 

The answer is yes, but this is not a case of multiples being passed down. I'll try to explain. 

My understanding was that twins are passed down the male side of the family. My dad's dad was a twin, so it was unlikely that I would be the one to cause a twin pregnancy. What I have since learned is that it's on the female side. A "normal" pregnancy is created by the mother releasing a single egg, and the dad fertilises it. Twin carriers release more than one egg at a time, so the chance of them both being fertilised is higher. It's the body doing it wrong basically by releasing 'too many at a time'. As women get older, women can release more eggs. I'm 37 now, so there was a very small chance of this. 

However, our triplets are identical, which means I released a single egg which was fertilised, then for some unknown reason, split, then split again. There is nothing genetic that has caused this multiple little miracle, just a complete freak of nature. A Monochorionic-Triamniotic pregnancy.

Non identical twins have 2 eggs fertilised, triplets can be 2 identical, one non, which means 2 eggs were fertilised and one split and so it continues.

At our twelve week scan we learned that there are also multiple ways for these babies to grow in the womb, it continues to differ and I don't know the details, but I know ours. 

Our babies have developed their own little sacks to grow in, but they all share one placenta. Some have a placenta each, some share a sac, and so on. 

A risk factor.

Complications are reduced in the case of them having individual sacks, but increased because they share the one placenta. The risk is that one will get more nutrients than the others, or one will get less. From 16 weeks I will have a scan every two weeks to check  that they are all growing at a similar rate. For those who haven't experienced scans before, they get the image of the baby on the screen and measure the length from the top of the head to the base of the bottom, and a width test too. As long as all are within a few mm of each other. At our 12 week scan they  were T1-52.2mm, T2-56.6mm, and T3-53.7mm. If their sizes differ, I will get referred to a clinic to look more closely at my placenta and find out where the problem is lying, and that can be treated with lazer! Amazing!!

They have named our babies T1, T2, and T3, and I have no idea how they are going to be able to know which is which. I had assumed they would float around in there freely. I was asked to empty my bladder after they had done the first lot of measurements, then they remeasured but said they might move around a bit. I'm assuming they will stay in the same place in my tummy and she meant that they might rotate a bit and be facing the wrong way. It's all so amazing! 

Due date?

The other first question is "when are they due?" The answer to that is unknown. Our official due date is 22nd April 2024. That is based on the standard 40 week full term pregnancy. We are very unlikely to reach that stage. If all goes well and they are happy in there, I will have a cesarean section between 34 and 36 weeks. It's much safer for all 4 of us to have an elective c section than to attempt a natural birth. I had a cesarean with Jack so it's fine with me. It was a breeze with him. 

Preterm labour risks.

There's another however here. My body is going to grow a lot bigger, a lot faster, so it's likely that it will think I am at full term and go into early labour. This could happen at any time and it's not unlikely for triplets to be born at 32 weeks or even earlier. I think 32 weeks is the earliest OK time to have them, it gets a bit riskier before that and the babies will need to be incubated and looked after. If I do go into very early labour, I can be given medicine to slow the process down to keep the little beauts in there for as long as possible. So there's lots of risks, but lots of ways to treat them. 

Supplements 

I've been given extra folic acid and extra iron on top of what is in my pregnancy multivitamins. On top of that, I have been give a aspirin to take each day. The reason for the aspirin is to prevent pre-eclampsia. It is unknown what causes it, but in pregnancy it can kick in from 20 weeks and can result in the worst case scenarios of seizures, strokes and heart attacks. Only around 8% of pregnant women develop it, and studies have recently started into the types of women who could be prone to the illness. I will have my BP and urine tested every time we see a doctor to monitor it, but the aspirin just helps with the blood flow and risk of clots. A good, rounded diet is also a good preventative.

Breast-feeding 

You surely can't breast feed 3 babies!! Not true. Breastfeeding Jack was a breeze. He took to it with no issues at all, so I really hope to breastfeed these three for as long as I can. I have been doing some reading and apparently I can establish my supply pretty quickly with the help of a hospital grade pump. I should be able to express enough to allow dad, grandparents and any other helpers to bottle feed the other 2, while I feed one and pump from the other. It's going to be a juggle, and I am very aware of how how time consuming and trapping it will be for me. If it only lasts a few days, then so be it, but the pumping time will be taken up with making up and washing bottles.

There are many types of pumps available. Many simply slot into the bra, so my hands will be free to feed and tend to the other babies. They are not very powerful, so my supply would need to be established before attempting this. 

I have been reading a lot about the juggle of feeding twins and triplets, and the sleep deprevation is the thing they talk about most in the first few weeks and months. It's going to be brutal!! But all the mums on the forums are learning tips and tricks to make it work for them, so I will give it a try. 

If the babies are born really really early, they will not be able to breastfeed, so I will express and hope they take to the boob, but they may just want a bottle from then on. It's apparently easier to use, so lazy babies choose a bottle over a boob. I didn't start Jack on a bottle for a few months because I worried he wouldn't come back to me. 

What about Jack?

Honestly, he is my greatest anxiety at the moment. We have such a great relationship, the three of us, and it frightens me that we are going to rock the boat in such a massive way. It will be such a shock for him as well as us. I'm sure he will be wonderful and will love being able to help us to fetch things. But so much of our time is going to be taken up in those first few weeks while we all settle in. I hope to have a grandparent and friend rota for the first few weeks where he can be taken out, picked up from nursery or even played with here. Possibly even ask someone to come and help us get him up in the mornings sometimes? It's all things we will have to figure out along the way, and I know he will adapt really easily because he is young and brilliant. His nursery said they would also help with his adjustment and look into books and things. 

Dealing with people's reactions.

The majority of people we have told have said "oh my god, you're joking, that's amazing!" But already, we have had a couple who have either said "oh dear, how will you deal with that", or simply laughed and taken the piss out of how difficult it will be. "You'll be exhausted, you're not going to sleep for the next 10 years. You'll be skint. You won't have a social life again. Gosh, isn't it funny how difficult it's going to be for you." I would like to say I can brush these comments off, but right now I'm feeling pretty tired and probably a bit more touchy that I should be, so they are a bit irritating. We will have comments like these for the rest of our lives, so I might as well learn how to deal with it now, right? If someone says or advises something stupid, my comeback will simply be "when did you have your triplets?"

Selective Reduction.

I had forgotten about this until I read a post about negative comments on Facebook. It must've just gone straight over our heads as it's not even something to consider. We were offered selective reduction, which means to terminate one or two of the pregnancies and allow what we want to survive. Like I said, we didn't need to even think about the answer because we consider ourselves incredibly lucky to have been given such a rare gift and opportunity. Of course its going to be 3 times the work, but equally, 3 times the fun!