First off, I want to congratulate you on being pregnant with twins. That is so exciting! But you have some concerns about complications, specifically, preterm labor and gestational diabetes. And the fact that you’re pregnant with twins just puts you into a high risk category, because when you’re pregnant with twins, you’re at higher risk for just about every complication there is. There aren’t really ways to prevent complications from happening, but there are ways to get it diagnosed early, and to treat it and address it so that it increases the chances of you and your babies being as healthy as possible. To do this, make sure that you make and keep all of your suggested prenatal appointments. If your doctor recommends testing, make sure that it’s done when the doctor wants it to be done, and also make follow-up appointments with any other specialists they might want you to see, like a perinatologist.

Now, you had questions about preterm labor and gestational diabetes, specifically. Let’s talk about preterm labor first. Basically, when you’re pregnant with twins, your belly gets bigger faster, and that makes your body thinks it’s down before the babies are done growing. It’s kind of like the turkey timer pops early and your body thinks it’s done – you go into preterm labor. And most twins are delivered prematurely. And sometimes it’s just due to preterm labor, sometimes it’s due to other complications that necessitated induction for those complications. Either way, you should be prepared for a preterm delivery. If you go closer to full-term, then that’s just going to be great, and you can pat yourself on the back and appreciate just how awesome that is.

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You can expect to have a few contractions each day as your uterus grows and stretches, but if you start to notice that they’re becoming more regular, pay attention. And if you’re having them every 10 to 15 minutes (which is only 4 to 5 an hour), it’s time to go to the hospital and get checked. Contractions feel like lower abdominal cramping, lower backache, abdominal tightening, pressure, and sometimes, pain in your thighs associated with all of those sensations. You may also have bleeding, leaking of fluid, and an increase in vaginal discharge. So again, if you have any of these symptoms, go get checked out. There’s no way to tell if what you’re experiencing is concerning or not unless you’re seen by a nurse and doctor in the hospital. And again, the earlier we catch it the better the chances are that we can keep you pregnant longer.

As for gestational diabetes, the best way you can prevent this is by starting the pregnancy out at a healthy weight and taking care of your body by eating healthy foods and exercising. But ultimately, that, in and of itself, is also not going to prevent a woman from getting gestational diabetes. Genes have a lot to do with it, so certain racial groups are more likely to get it, women who are older than 25, women who have had abnormal blood sugar tests before or have family members with diabetes are at greater risk, and then women who start pregnancy being obese, and so again, that’s really the only part that’s in your control.

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Around 28 weeks of pregnancy, your doctor will recommend testing, and it involves drinking a sugar drink and getting your blood sugar tested afterwards. And if your blood sugar is higher after that, then sometimes they want to do a follow-up test that involves taking your blood sugar more frequently, like over a 3 hour period. And if you fail this test and they say that you have gestational diabetes, then they’ll recommend regular blood sugar testing. And sometimes, diet control is enough to keep blood sugars within a healthy range, but sometimes, oral medication or insulin is necessary. So really, again, it’s just important to screen for it and test for it if there’s a problem, but there’s not much you can do to prevent it at this point.

It would also be good to start thinking about other things that are associated with twin pregnancy. It’s very possible that you might have to be admitted to the hospital and watched for a prolonged period of time before you have your baby, just because, again, twins put you at higher risk for complications, and so we need to sometimes admit people and monitor and treat those conditions. Also start thinking ahead about a C-section, because 60% of twins are delivered by C-section. And it usually has to do with their position, sometimes the gestational age at which they’re born. So when it comes time to deliver, the doctor will determine if you’re eligible for a vaginal delivery or if a C-section would be safest for you all.

If you have any other questions or concerns, talk with your OB provider at your next prenatal appointment, and they’ll be able to give you the best advice based on their knowledge of your circumstances. And if you have more questions for me in the future, feel free to ask them on our Facebook page and recommend us to your friends and family too.

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