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This section discusses pregnancy with twins and triplets. We will look at some statistics and learn about the conceiving of multiple pregnancies, the different types of pregnancies and the monitoring of multiple pregnancies in the Finnish health care system. We will also follow the life of Jarmo and Emmi, a couple expecting twins.

video: Jarmo and Emmi are expecting twins

The extremely interesting and usually unique journey towards giving birth to and parenting multiples begins when the ultrasound scan shows that, instead of one baby, there are two or three little ones growing in the mother’s womb.

Each year, twins are born into about 850 Finnish families and triplets in 10–15 families. Twins occur when a single fertilised egg splits into two separate cells or when two eggs are released at ovulation, the latter case being more common. Triplets may start from a single egg (very rare), two eggs (the most common case) or three.

video: 1,5 % of all births in Finland are twin births

The tendency to have fraternal (dizygotic) twins seems to run in the family; in some families, women have a tendency to produce multiple eggs simultaneously. Twins have a higher probability of having twins themselves. In addition, the probability of a multiple pregnancy increases if the mother has already been pregnant at least twice or if she is older or taller than average. The probability of a multiple pregnancy is also increased by the consumption of a high quantity and quality of food.

The factors contributing to the occurrence of monozygotic (identical) twins are still largely unclear, even though the occurrence of identical twins may be exceptionally high in some families.

In addition, assisted reproduction treatments increase the probability of a multiple pregnancy.

How are multiple pregnancies monitored?

Most multiple pregnancies progress without any problems. Nevertheless, they are always classified as at-risk pregnancies by health care professionals.

Once the ultrasound scan has shown that there is more than one foetus growing in the womb, the next thing is to examine whether or not the foetuses share a placenta and whether or not they share a chorion and amnion. Fewer shared structures indicate a safer pregnancy. Furthermore, the doctor will examine the position of the foetuses and placentas in the womb.

All these factors, combined with the health of the expectant mother and the couple’s situation in life, contribute to the required degree of monitoring during pregnancy. If a public health nurse or doctor says that you should go on sick leave, you should always take it seriously.

video: How are multiple pregnancies monitored?

Video: What to expect when expecting twins? Executive director Ulla Kumpula, Finnish Multiple Births Association

In some cases, it is possible to determine during pregnancy whether twins are identical or non-identical. If the monitoring of the pregnancy clearly shows that the babies share a placenta and a chorion, the twins can be determined as being identical. Non-identical twins always have separate placentas. This, however, does not prove that the babies will be non-identical, as identical foetuses can also have separate placentas. Full certainty can be reached after delivery, through a DNA test (subject to a charge to you).

One-third of all pairs of twins are identical. As for triplets, the most common combination is two identical babies and one non-identical.

The duration of a multiple pregnancy is usually shorter compared with a single pregnancy. On average, twins are born in the 36th week and triplets in the 32nd week of pregnancy. Therefore, the babies may be very small at birth and need treatment in the intensive care unit after birth. Full-term babies may also need intensive care. On average, 40 per cent of twins are treated in the ICU after birth for a while, and the percentage is even higher for triplets.

video: Information of the follow up when you expect multiple pregnancies

Questions and assignments:

Do you know whether or not the foetuses share a placenta or chorion? Why is it important to find out about this?

Write a list of your questions and concerns to take with you to the next appointment with the doctor or midwife.

What do you think of the possibility of having identical babies? Should the individuality of multiple children be supported in some way?

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