My only complaint about this book is that it was published in 2003 and I hope that a new edition will be published soon. It is very much based in research and I am certain that even more research has been done in the past eight years to support some of her points of view.
The book is extensive and covers everything from health in pregnancy to bonding with your babies to coping with infants with disabilities and even the death of a baby (which is more common in multiple pregnancies).
For the purposes of this post, I will pull out just a few of the ideas that struck me as interesting and that are useful to me as a doula, supporting pregnant women and families with new babies.
Pregnancy
Noble shows that the single most important factor that results in a positive outcome for twins (and more) is the health of the mother. Good nutrition, hydration and moderate exercise are the most important things pregnant women can do to ensure the delivery of full term, healthy babies. Certainly, this is also true for single babies. This is great news, because it is something that pregnant women have control over. We can decide to eat well, drink lots of water and go for a walk around the block once a day.
I have recently started taking yoga again, which I previously did when I was pregnant, and I am amazed at the effect it has on me physically and emotionally. I would highly recommend prenatal yoga classes for all pregnant women. If you can't afford classes or they are not available in your area, check the online Prenatal Yoga Centre for free videos on yoga to do during pregnancy.
Birth
One of the reasons that taking care of yourself during pregnancy is important is to avoid preterm birth, meaning birth of your baby(ies) before 36 weeks gestation. According to Having Twins And More preterm birth is by far the major cause of complications and infant deaths. In fact, 75% of all infant deaths in the U.S. are babies born before 36 weeks. Some babies are born premature regardless, but good health and nutrition does reduce the chances of preterm birth and therefore can improve outcomes for babies.
Another thing that was interesting to learn from this book, is that prolonged bed rest during pregnancy, does not reduce the chances of premature birth and it greatly increases the potential for health issues in the mother. A NASA study shows that one week of bed rest results in the equivalent of one year's worth of ageing on the skeleton!
Often with twin or higher multiple pregnancies, doctors will recommend elective cesarean section. Mothers agree to this because they believe it will result in better outcomes for their babies. But the research shows that multiples (and singletons) delivered vaginally have lower mortality and morbidity overall, as do their mothers. There are certain situations where a c-section is necessary, but most pregnant women (regardless of how many babies they are carrying) should be able to deliver vaginally. Also, taking care of newborn babies is much more difficult when recovering from major abdominal surgery.
Parenting Multiples
Having Twins And More has great information about bonding with twins, their relationships with each other and with their parents and other siblings. One interesting thing that Noble points out is that with more than one new baby the number of new relationships within the family increases. She provides suggestions on how the parents can help foster those relationships. There is a lot of focus on the importance of recognizing the twins as separate individuals, rather than as a unit.
Overall, I would highly recommend this book for anyone expecting multiples or anyone who works with multiples and their families.
