It's completely moot with us since our child will be our only one but I think it would be better to know in order to take any steps necessary for the health of the mother and children. At least ask if they have a really good ob-gyn. Surely the doctor will know the risk and keep an eye on everything.

Jon , this post isn't so much about the doctors, as it is about we, as women, men, parents, grandparents....those of us who have known the rockbottom of the loss.

I ask this question, as a coworker, who isn't that close to me, is expecting twins.  I see her posts...and her equipping the baby rooms, and her joy....and am pleased for her, but, I also know the risks....and so, i wonder, had people shared with me the risks, would i have been better prepared?   I wonder, and Lastpointe may know, have the %'s of successful terms increased to where the risk is quite small now?

This mom is at 17 weeks (or so) based on the due date she named...

I'm sorry if I was unclear Pinga. I was thinking of a way around the dilemma. I thought that if she had a good doctor he would let her know what if anything needs to be done to make things safer. Likewise if he was unworried about it, if all the medical signs were good, then you could in good conscience not say anything. I would imagine that overall things are becoming safer for multiples but I can't cite anything specific to back that up.

Jon -- doctors , at least our doctor, never shared the %'s or the risk....nor, though i was in good care, was it apparent.   I won't go into the details of the last week, yes there were misses, and yes, there were mistakes made..but hte outcome would likely not have been much better....

so....thinkin' a doctor would let someone know there are risks...or that the expectant mother will hear the information if shared is a stretch.

I know that if someone close to me, say my daughter, was carrying twins or more I would be quite concerned about her health and the odds of having healthy babies.  I wouldn't try to scare her but I would try to arrange for her to get lots of rest, perhaps cut back on work or get household help, and make sure that she was being monitored by a specialist in high risk pregnancy. 

If it was a neighbour, or someone I worked with, I would probably just inquire about how she was feeling, and if she was getting enough rest, and if she was seeing her doctor regularly.  As she chatted about her plans for the babies, I might remark that I hope that everything goes well for her, and try to open the door to mention higher than normal risk. 

I know looking back that both my pregnancies were easy, although I probably should have gotten more nourishment and had my general health monitored more closely during my second pregnancy.  My daughter's first also seemed to be going smoothly, and at pre-natal classes we barely paid attention to the part about C-sections - they were for someone else.  Then, after 24 hours of hard labour - when the C-section happened we weren't quite mentally ready for it.  Fortunately it had a good outcome.  When the initial blood test was questionable during the second pregnancy, my daughter was transferred to a specialist in high risk pregnancy and closely monitored.  Again a healthy big baby but planned C. 

It's better when you know.  Twins, or more, are high risk.  The parents should be aware.  As you know all too well Pinga - it isn't always cute little matching outfits and double the fun.

It's one of htose things Seeler...

I don't share, but then I feel guilty if soemthing goes wrong and they are devastated, having it come at them as a complete surprise.

I will continue to keep my mouth shut..but, I think it is like miscarriages..we don't talk about it..and so women have misconception that get pregnant = health baby...when we know that is not the case.     Ditto with twins.  There are a significant number of twins who have health issues due to being born early, or invitro complications.  Life isn't, as you say, just cute little matching outfits.

When I am near pregnant women I am always asking after their health and I find i often say something like  " really?  perhaps you should call your  doctor about that , tomorrow" 

I agree Piniga that you never want to frighten people but sometimes I worry alot.

Multiples are riskier although twins less so.  I am surprised your doc didn't mention it, although I am also aware that patients don't always take in what a doc says. 

Any multiple has an increase in prematurity risk, although there are different theories as to why that is.

When a mom is huge, close to term with many babies it seems ligical that she would burst out early.  but that logic doesn't hold for say 25 weeks.  After all with twins you only have approximately 2000 gms of baby , not even close to a full term size.

 there are many different factors that lead to higher risk.

I guess the point would be that if you knew you had a riskier pregnancy, but there was nothing you could do about it anyway perhaps it isn't anything to worry about.

Telling someone to take it easy implies that it is within their control , but in many ways it tis out of your control for the average mom. ( some moms for sure have known issues that they can control)

If you have twins, you have them and worrying about the risks doesn't change a thing.

Full term twins don't have higher chances of health issues and most twins now do get to at least 34 weeks so have pretty good outcomes. 

I agree people get caught up ini the cute clothes and forget about the constant feeding, constant clothes washing and constant diaper changing. 

lastepointe - I'm sorry to have to disagree with you, perhaps you are actually more up-to-date on this than I am, but it seems to me that there are things you can do if you know you have a high risk pregnancy.  In my daughter's case it was more closely monitored by a specialist in high risk pregnancy.  Sometimes bed rest is required - again I've known people to be hospitalized, or cared for in bed at home, for the last three months.  Sometimes it may mean just avoiding things you would normally do, like bicycling, or strenuous exercise, or a long trip out-of-town that wouldn't bother you in an ordinary pregnancy.  And sometimes it may mean mental preparation - not only will you need cute outfits, you may need to know that your babies might not come home immediately after birth.  There may be time in an incubator, tube feedings, other complications.  Yes, I think there is a lot you can do if you know you have a high risk pregnancy. 

I don't believe in scaring new mothers, but being forewarned and prepared is another thing.  Most pregnancies have a good outcome, even with twins, sometimes with triplets.  But it doesn't hurt to be prepared.

I think it depends seeler on the individual mom.

Certainly the doc will be checking her more frequently and probably doing more ultrasounds.....  But those things may go totally unnoticed by the mom, we really just go when we are told to go .

As to bed rest.  That is really controversial. 

At it's most basic, pregnancy is a very healthy state.  Multiples are naturally occuring phenomena that are healthy.  ( while most now are more likely fertility drug induced they do totally occur naturally, even triplets,  and run in families.....)

A women who has had multiple miscarriages may be diagnosed with an incompetent cervix ( isn't that a terrible diagnostic term?)  Basically meaning that her cervix isn't able to stay tightly closed as the uterus expands.

Those women , in general have lost a few babies.  Those women will be treated.  One thing that can be done is a suture can be tied tightly around the cervix neck to stop the dilation.  Then those women are often hospitalized for a few months leading up to a viable date of say 34 weeks.   Bedrest is certainly part of the treatment.

Other women may be advised to limit some activities but it varies.  I have taken an exercise class from a woman who was 38 weeks.  She was in better shape than most of us. 

The risk with a lay person telling someone to stay in bed is that it implies that it will help hold onto the pregnancy when it may not and if the woman doesn't do it and she loses the baby she may then feel it is her fault which it is unlikely to be.

what causes a uterus to start to contract and dilate is much more complicated than just being still.

I always suggest lots of rest and good food but not because I think it will keep a baby in.  More because I know how tiring carrying two or more babies can be on your body.

I doubt, at the begining , many OB/GYN s would talk about the baby staying in hospital.  In many ways it is too much info at a time when you won't take it in and it may not apply.  Certainly all multiples should be seen by OB's.  As the pregnancy progresses though, if the cervix is ripening too early, then the talks will begin about the possibility of a 34 or 35 week delivery and the babies perhaps staying a week or too.

That said, I have seen tons of healthy full term twins and many at 36 weeks that go home with mom. 

Of course i have also seen tons of 26 week twins and triplets.  but we get tons of 26 week singletons too so it is just a risk factor for all pregnancies. 

It isn't something we talk about or worry about but pregnancy is a very risky undertaking.  It is risky for the baby but very risky for the mom.  It is the most dangerous thing most women will ever do and we really just don't realise it.

the miracle is , in such a dangerous undertaking that most women and babies do well.

Oh lastepointe - I didn't say that I as a lay person would advise a person to have bedrest or restrict her activities, or anything else - I would gently inquire if she is seeing her doctor regularly.    I didn't say that all pregnancies for twins were high risk or required special care (after all 50 years ago when I was young people often didn't know they were having twins until the second one came along).   My cousin had twins who were over seven pounds each and I knew of a woman who's twins were over 8 pounds each (she was 5'10'' herself with a big build).  Most twin pregnancies progress well with no special precautions.

My understanding of the question is, 'is it better to know there is a risk?'  and I would say 'Yes'.  I would definitely want to know, just so I could check with my doctor and see what she thinks, just so if my doctor thought it warranted or my instincts told me too, I could request a referral to a specialist, just so if there seemed to be a problem I could be aware of it and do whatever the doctor recommended. 

Of course a lay person shouldn't give medical advice - and of course a person shouldn't take medical advice from a lay person. 

Lastpointe -- my GP felt he was capable of caring for me....and missed signs the ob/gyn wouldn't have missed.  then, when things were awry, he said...oh, you're seeing your ob/gyn next week...we can wait.  I lost them on the weekend.  Again, likely would not have changed the outcome back then...and lots of should have / could have's don't have anyway to change the outcome.

When I worry is when I see folks celebrating at 15 weeks, posting picutres, etc...seemingly oblivious to the risks in front of them...

Then again, I feel the same way when women announce they are pregnant at 4 weeks -- and seem oblivious to the odds. 

I learned the hardway, that it is ok to announce, coz it is good to have friends, but, knowing the probability is also important.

oh I don't know, i think lots of good advice comes from lay people.  and experience is a good teacher.  Oddly, twins, while always a high risk pregnancy can be a very normal pregnancy too.  SO alwasy high risk but also very likely normal.  Odd.

It is a dilemma though.  what to say to someone who is having twins.  Particularily if you notice puffy hands and feet.  I always suggest, as you say, a doc visit. 

We think of twins as pretty normal now but that is because of all the fertility drugs.  In natural pregnancies they are rare but still "normal".

I think that we all learn from the situations of others.  It is just where to put the emphasis is the issue.

If my daughter was having twins, i woudl worry.  Of course that is because of what i do.

In fact, when i was pregnant i was very worried and my hubby, who only heard the stories was really quite frantic, occupational hazzard.  I used to drop by the nursery to see all the sleeping 7 pound babies just to reassure myself that most babies are fine.

i attended a delivery once where the mom was transfered in from a small town because of an observed huge abdominal defect in the fetus on ultrasound.

After delivery the defect was the other twins cords.  I twin was directly behind the other and never seen.

I don't think i would take more care if i was having twins, unless i started having trouble, but i would be more anxious for sure

My wife was told to have bedrest. She was only pregnant with one but had gestational diabetes and toxemia. She sort of did but not as strictly as the doctor liked. Still our baby came out little (4 lb. 5 oz.) but in perfect health.

As a rule I don't tell our story to a pregnant mom.  I don't want to scare them.  Deep down I don't think that anything I say or do will change the situation and I don't want to rain on their happiness.

I suppose I feel that nothing can prepare us for tragedy and it doesn't make sense to live in fear of it. When it does happen it is simply overwhelming and guilt about what we may have done, or not done, is not helpful and likely irrelevant anyway. 

It sucks, but there is little one can do to be prepared for loss and tragedy.  Life is like that and life can be deeply, painfully, profoundly unfair.  However, I would rather try to focus on the parts of life that a joyous whenever possible.  Deep down, I say let them enjoy the excitement and the joy.  We all know that sometimes stories don't have happy endings.

I do believe in being educated about situations (i.e. high risk pregnancies) and advocating on behalf of one's health and one's baby, but in the end much of what happens is out of our hands and in the hands of doctors (hopefully competent) and sometimes, God.

Great post specialmom - so wise.

Right, specialMom.

I guess I am thinking of Mom's who share they are pregnant when they are 3 weeks pregnant, with no knowledge of the volume of pregnancy that are lost....

Or mom's expecting multiple births which start planning and spending early on in the cycle...not aware of their risk.

It is just one of those things...where I hold my breath..and dont' speak.

It is also one of those where I think we do a disservice to women by not speaking of such...which leaves people to only hear the good news..and then be in shock when they hear otherwise.

I am pondering why we don't let people know of risk %'s.... ie..at x weeks your % is ________ at y it is _______, if you have these characteristics your risk is adjusted by ___________

I am new here and have enjoyed reading these threads and so I have joined today. 

I am 30 years old and have thought that I was unable to have kids for the past 10 years.  I had already accepted the fact that I would go through my whole life without being pregnant or giving birth - but a spontanous miracle seemed to happen.  I am now 4 weeks pregnant and am over joyed!

 I am very worried about anything that could go wrong.  My first doctors visist was a joke.  He told me that i could go my whole pregnancy without seeing a doctor and that nature has a way of taking care of things....weeding things out what is best for nature. 

I am seeing a new doctor tomorrow...

I don't even know what to worry about or what kind of questions to ask...any advice?

lover of all life - welcome to the Cafe, and congratulations on your pregnancy.  Remember - things generally go well.  Your doctor was right that many people could go through the whole pregnancy without seeing a doctor - that's what they did for centuries in the past and babies continued to be born.

But why take that risk?  You are right to seek out a new doctor, and continue seeking until you find one that you are comfortable with.  Some questions to ask:  well, its been a long time since I was pregnant but I went through my daughter's pregnancies with her.   First, ask about anything that it troubling you - anything that you want to know.  Ask about the baby's development.  Ask about what you should be doing, eating, exercising, resting, working - how much, when, what is appropriate.  Ask about what changes you should be aware of in your body - morning sickness?  weight gain?  when you will first feel life?   Ask about what you should watch out for, and when you should call a doctor or go to a clinic.  Ask about blood tests, and other tests. 

Be prepared to share your concerns and your medical history - and maybe that of your mother and sisters - how did their pregnancies go?  Are there any twins or multiple births in your family or your husbands? 

Best wishes to you, and that little one growing inside you.

There are some wonderful books out there, which really talk about how your body changes..and the development process.

I can't remember all the names, but maybe Birthstone will weigh in, or one of the newer moms...or older ones with better memories than mine.

i concur, lover of all life...that yes, many pregnancies go thorugh wonderfully.  Yet, if you are older..then you have a bit higher risk of certain things..so why not take care of them...just like if you were 13 you would.

sorry...i had a doctor like the one you are at..and though it works for 80%, for the other 20%. interventions that could have helped are missed.  I still have him as a family doctor, but ensure i go to specialists when i need to and take the energy to.

welcome lover of all life and congrats on the new pregnancy.

My first suggestion is to get a good book.  Penelope Leach one, the total name escapes me, is an oldie but goodie.  It is really fascinating to read the week by week fetal development info.  ( it is something like  "your body, your baby"  maybe?  A book store will have it, it is a classic.  Some things a bit outdated for sure but worth it.

Secondly a doc you like.  I personnally believe in using an OB/Gyn.  Use a person who spends their total times caring for women like you and get the most up to date ideas.  This is also the time to think about which hospital ,if you have a choice.  That may influence your doc choice.  All docs are limited to how many babies they can delivery monthly ( it's a bed space issue for hospitals) so start on which hospital you like.

While they will all offer adequate care, some will have midwives as staff members , or all the RN's may be midwives, or only use birthing rooms except in emergenicies,.....  Others may not have birthing rooms/chairs.  Others may have inadequate anesthetic support, or inadequate nursery support.  ( are pediatricians on staff, does it have a level 2 or 3 nursery if you need it, is the aesthetist in house or on call.....)At this point you may not know if you will use any or all of the things available but you don't want to find out too late.

A month is early in a pregnancy.  I assume that you mean you have missed one period and that you have taken a pregnancy test.  You may be more weeks than you think.   While we talk about problems, and women share problems, the reality is that most pregnancies are normal, healthy, wonderful times. 

But some end badly, some spontaneously abort for unexplained reasons, some women fell ill the entire time......  They are not really too comparable so a big thing is to try to avoid the "horror " stories of others.

i remember after my first, a very long day, my mom came to see me.  I looked at her and said  " I can't believe you had 4 kids!"  She just laughed and said,  " you forget all about it."  She was more or less right.  I didnt' forget but the experience of the hard work of delivery dulled in my mind and i did it again.

Congrats, we will love hearing about your blossoming body and baby.

Thank you all for your great advice.  I am looking forward to every aspect of this incredible miracle of a process...this is literaly the most wonderful thing that has ever happened to me!