20 week twin update

I’m twenty weeks along now, which for most pregnancies, signals the halfway point to full term.  However, since mono-di twins should be born by 36 weeks 6 days, the official halfway point for me was at 18 weeks 3 days.  It’s so strange to think that I am more than halfway done already!  It’s gone by quickly….yet slowly.

At 20 weeks into my other pregnancies, I felt absolutely fantastic.  The nausea was gone, I had tons of energy,  my belly was still quite small , and I had minimal aches, pains, or complaints.  When I was pregnant with Roland, I was a server at Red Lobster, which was an extremely physical job, lots of rushing around and lifting heavy trays.  There is NO WAY I could even consider working like that during this pregnancy.

Being pregnant with multiples is truly a whole new ball game.  Before this experience, I figured being pregnant with twins would be somewhat harder, simply due to getting so much bigger toward the end.  But I did not realize the toll that growing two babies takes on your body.  It just takes EVERYTHING you have to give, all your resources, all your energy.  Interestingly, I have met several mothers online who have previously had di-di twins and are now pregnant with mono-di twins, and they’ve all said that their mono-di pregnancy was much more difficult physically, even compared to another type of twin pregnancy.  It’s something about that ONE placenta that has to do the work of nourishing TWO babies.

It’s been very humbling to experience my physical limitations.  I’m only 20 weeks.  I am not that huge yet; it’s not size related.  It doesn’t seem like it should be this hard yet.  Doing absolutely ANYTHING makes me just utterly EXHAUSTED.  I walked around Target for an hour the other day to set up a baby registry, and afterwards my entire body hurt and I was just bone tired.  When I do household chores, I need to take a break and lie on the couch, sometimes for hours, before I can even think about doing anything else.  My back aches, and my hips throb all the time.  My uterus feels heavy, and I have a lot of pelvic pressure.

Granted, I’m considerably older than I was 9 years ago when I was pregnant with my first child.  And I was also recovering from a fractured L1 vertebra when I fell pregnant with twins.  So I guess I should cut myself some slack.  I mean, come on Amber.  Did you think this would be EASY?!  haha

Besides the ever-increasing physical discomforts, things are going extremely well.  The babies have had visible bladders and well balanced fluid levels at my last two ultrasounds, meaning there are still no signs of Twin to Twin Transfusion Syndrome (the biggest danger to monozygotic twins, and my biggest fear).

I had my 20 week anatomy scan a few days ago.  I was advised that it could take two hours or more, since they have to check every single part of two babies.  Lying flat on your back for that long can cause some mothers to pass out, but luckily I didn’t have any issues.  It actually did not take that long, since both babies were very mellow and cooperative for all the measurements.  The ultrasound tech said they were the “best behaved twins she’s had in a long time.”  All I could think was, “PLEEEEEASE let that continue after they are born!”  LOL

The tech was one of the midwives that I’ve had for my first three pregnancies.  She loves me and is so excited for me.  I always enjoy getting her for my ultrasounds because she’s so friendly and enthusiastic, and takes the time to try to get cute pictures for me.  I’m sure once the babies come, the midwives will come up and see us in the hospital, which will be wonderful.  I’m hoping they will provide support with breastfeeding, which I may need.  There will surely be a learning curve with tandem nursing two newborns!  I love that although I am not actually under the midwives’ care for this pregnancy, they still want to be involved.  I walk into my appointments and feel like a celebrity.  All the nurses and midwives want to talk to me as I walk by their desks.  It’s super fun!

This midwife/sonographer made the anatomy ultrasound very enjoyable.  I watched the screen, mesmerized and amazed, as always, to see two babies.  Each time, it hits me all over again.  I AM REALLY HAVING TWINS.  THERE ARE REALLY TWO IN THERE.  It still feels surreal!

I watched as she checked the positioning of the babies.  This time, they were both head down, with their heads both extremely low, so it took her a moment to figure out which was Baby A.  She was on my left with her head just slightly closer to my cervix than Baby B’s.  The two girls were face to face and appeared to be snuggling one another.  It was literally the cutest thing I’ve ever seen.

The babies are separated only by a paper thin membrane, so wispy that we can rarely even see it on ultrasound.  They can easily reach out and touch each other through it.  They can interact together in the womb much more than di-di twins, which are separated by both their amniotic sacs and their separate chorions, which form a much thicker, multi-layered barrier.

I let my mind drift for a bit, thinking about how amazing it is that these babies have been interacting with each other in the womb since day one.  My other babies were completely alone in there, but these babies have always had a womb-mate.  I wonder if that ability to begin their lives interacting with another human being influences their brain development somehow?  It’s interesting to consider.

I snapped out of my lucid daydreaming once I realized the tech was beginning to inspect all of Baby A’s little parts.  I watched as she measured the head circumference, belly circumference, and leg bones, paying close attention to the estimated gestational age shown at the bottom of the screen.  I was 20 weeks 1 day pregnant, so I was hoping the measurements would be calculated in that range, which would indicate that the babies’ growth is on track for their gestational age.  All of Baby A’s measurements were between 19 weeks 5 days and 20 weeks 3 days, so it seemed to me that the average would be on target for 20 weeks 1 day.

I watched as she recorded Baby A’s organs: stomach, kidneys, bladder, etc.  She looked at the femurs and the lower legs, the feet, the arms, the hands, making sure she had 5 fingers including a thumb.  She looked closely at the heart, noting that it has four chambers, and recording a heart rate of 148.  She looked at where the cord inserts into the baby’s abdomen, and also where the cord inserts into the placenta.  Typically, the cord will insert right into the middle of the placenta, but sometimes with mono-di twins, because two cords have to insert into the same placenta, one or both will have a “marginal cord insertion” which mean it’s attached on the outer edge rather than in the middle, which can lead to slower growth.  It appeared that both my babies’ cord insertions were toward the middle, which was great to see.  They also each have a 3 vessel cord (a 2 vessel cord can also lead to slower growth).  These were questions I’d been wondering about, and I was able to get the answers just by careful observation during the ultrasound.

After she finished with Baby A, she did the same thing again with Baby B.  Again, all parts and organs were accounted for.  This may just be my anxiety and paranoia talking, but at the last two ultrasounds, I thought something looked slightly different about Baby B’s heart.  I don’t know….the shape of it, or the way in which the chambers were moving while it was beating?  No one has expressed any concern, and Baby B was also noted as having a four chamber heart, with a heart rate of 153, so all appeared to be good.  I will have a fetal echocardiogram at 24 weeks, which is a special ultrasound to look specifically at the babies’ hearts.  I will be watching closely at that echo for my own peace of mind that Baby B’s heart is functioning properly.  Monozygotic twins have ten times the rate of congenital heart defects (reason unknown, perhaps something to do with the egg splitting process?) so this is a big concern of mine.

But for now, all appeared completely normal and no problems were noted.  The midwife informed me that both babies were estimated to weigh 12 oz, which is the 44th percentile, and a good size for twins.  I later found a growth chart for gestational ages of twins, and the average size for twins at 20 weeks is 11.6 oz., so my babies seem to be growing quite well.  The fact that they are both exactly the same size is really great news!

After the ultrasound, Jacob and I met with the MFM (high risk doctor) to go over the ultrasound results.  He entered the room, and said, “Your daughters are perfect.”  It was a powerful moment for me, because the MFM is a very serious man who does not mince words.  He would not say this if there was even a glimmer of any issue right now.  He said that so far, we are making his job easy.  Everything looks literally perfect, the babies’ growth and their fluid levels are even.  They seem to be sharing their placenta quite well.

I left the hospital feeling like my feet were not even touching the ground.  I felt giddy with happiness and an overwhelming sense of relief, knowing my babies are ok, at least right now.  The next ultrasound will be in two more weeks, at 22 weeks.

Now for the best part: PICTURES!  We got amazing pictures of our babies this time.  I could not believe the detail we were able to see in their perfect little faces at only 20 weeks gestation!  Since both babies were head down and facing each other, we got priceless shots of them cuddling and hugging one another.  ❤ ❤

 

Image is a collage of four 20 week ultrasound photos, which have been edited to remove my name. The left two photos are close-ups of Baby A's face in 3D. In these photos you can also see the back of Baby B's head as she's face to face with her twin sister. The right two photos are two different views of Baby B with her hands up by her face.
Image is a collage of four 20 week ultrasound photos, which have been edited to remove my name. The left two photos are close-ups of Baby A’s face in 3D. In these photos you can also see the back of Baby B’s head as she’s face to face with her twin sister. The right two photos are two different views of Baby B with her hands up by her face.

 

Image is a 20 week ultrasound photo, which has been edited to remove my name. This photo shows Baby A and Baby B appearing to embrace each other. They are face to face and ear to ear.
Image is a 20 week ultrasound photo, which has been edited to remove my name. This photo shows Baby A and Baby B appearing to embrace each other. They are face to face and ear to ear.

 

Edited post to add belly pics!  🙂

 

Image is a photo of me standing to the side, sporting my 18 week twin bump!  It says "18 weeks - baby is the size of a sweet potato x2"
Image is a photo of me standing to the side, sporting my 18 week twin bump! It says “18 weeks – baby is the size of a sweet potato x2”

 

Image is a photo of me standing sideways, showing my 20 week twin bump, which has grown considerably!  It's labeled "20 weeks - baby is the size of a banana x2"
Image is a photo of me standing sideways, showing my 20 week twin bump, which has grown considerably! It’s labeled “20 weeks – baby is the size of a banana x2”

 

 

 

 

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16 week twin update

So, I didn’t want to jinx it, but I think I can safely say my nausea is finally better!  The day I hit 16 weeks, I noticed I didn’t feel nauseous at all that entire day, and the pattern continued the next day, and the next.  I’ve been slowly weaning off of Diclegis (prescription strength unisom + B6 that I was taking 4 pills of daily just to take the edge off, so I could make it through my days).  I am so happy to be feeling better!  I was really struggling from 5 weeks to 16 weeks.  I was sick during my pregnancy with Juliette until 16 weeks as well, but this time was literally twice as bad.  I’ve had a sneaking suspicion that the similarities between my pregnancy with Juliette and this one could mean that I’m carrying twin girls…

And apparently, I was right!

reveal
Image is a collage of two photos. The top one is in black and white, and show my mid-section with Juliette’s hands over my belly. It reads “The Torres twins are…” The bottom photo is in color and shows my midsection, with me wearing a pink shirt, and Juliette’s hands taken off my belly to reveal two bright pink painted hand prints. It reads, “BABY GIRLS!”

 

We found out the sex of the babies at my first of many biweekly ultrasounds to monitor the babies for Twin to Twin Transfusion Syndrome.  The riskiest time for developing TTTS is between 16-28 weeks, and I was nervous to be entering that phase of my pregnancy.

Luckily, there were no signs of TTTS!  Both babies were active with strong heartbeats (150 and 143 bpm, respectively).  Both babies’ bladders were visible (an undetectable bladder is indicative of TTTS).  Their fluid levels were both 4.  A high discordance between the fluid levels is a sign of TTTS, for example, if one was 2 and the other was 9.  Both their fluids being exactly the same level is a very good sign!  So far, everything with this pregnancy has been almost “textbook perfect.”  Of course, my anxiety likes to rear its ugly head and tell me that everything is TOO perfect and something is bound to go horribly wrong…

For now, I am just reveling in the afterglow of a wonderful MFM appointment.  My babies are doing great in there!  Here are some pictures of my sweet baby girls:

 

Image is two 16 week ultrasound photos, edited to remove my name. The top photo shows Baby A's profile, the bottom is Baby B's profile.
Image is two 16 week ultrasound photos, edited to remove my name. The top photo shows Baby A’s profile, the bottom is Baby B’s profile. They look identical already!

 

Image is a collage of two 16 week ultrasound photos, edited to remove my name. The top photo shows one of Baby A's feet, and the bottom one shows both of Baby B's feet.
Image is a collage of two 16 week ultrasound photos, edited to remove my name. The top photo shows one of Baby A’s feet, and the bottom one shows both of Baby B’s feet.

 

Image is a collage of two photos showing the sex of the babies. The top one shows Baby A, and the bottom Baby B. They are both labeled "GENDER: GIRL"
Image is a collage of two photos showing the sex of the babies. The top one shows Baby A, and the bottom Baby B. They are both labeled “GENDER: GIRL”

 

And here is my most recent belly picture, at 16 weeks.  I don’t see any real difference between my belly size at 14 weeks and 16 weeks, but I certainly FEEL like I am growing every day!  I think by the time I take my next picture at 18 weeks, there will be a big difference.  My fundus was measuring 21 weeks at 16 weeks, so I am definitely bigger than I would be if I were carrying a singleton baby!

 

Image is a photo of me, standing to the side, showing off my 16 week twin bump, with the caption "16 weeks - baby is the size of an avocado - x2"
Image is a photo of me, standing to the side, showing off my 16 week twin bump, with the caption “16 weeks – baby is the size of an avocado – x2”

 

One thing that is starting to concern me is my weight gain – or lack thereof.  Early on, when I was so sick and could not stomach anything except Mrs. Grass soup and toast, I lost some weight.  Around 12 weeks, even though I was still very sick, I started to feel more hungry and was able to eat more.  I started gaining the weight back.  At my 16 week MFM appointment, I was up to a total weight gain of 2 lbs.  This morning I saw my regular OB for a quick checkup, and found out I had lost another pound, which means I have gained a grand total of 1 lb.  In a normal, low risk singleton pregnancy, this would not be a big deal whatsoever.  But with twins, it’s much more important to gain a considerable amount of weight.  I should be gaining 1.5 pounds per week.  For someone with my petite stature, I should shoot for a total weight gain of 40-50 pounds.  I’ve gained anywhere from 17-21 lbs with each of my singletons, so I should at least double those gains this time.  Studies have shown that for twin moms who gain the majority of their weight during the first half of the pregnancy, the twins end up larger and with much better outcomes.  According to the American Pregnancy Association, “If a mother of twins gains 24 pounds by the 24th week of pregnancy, she reduces her chance of preterm labor.”  Now, my OB and MFM have not voiced concern over my weight – yet.  But it’s definitely something that is weighing on MY mind.  The nurse who weighed me today made an offhand comment that I had lost weight and I should eat more.  Sooo, I left the appointment and got a McDonald’s breakfast sandwich, haha!

But don’t worry, I’m not eating fast food and junk all the time!  I’ve actually become quite conscious of what I’m putting into my body.  The single most important aspect of a twin mom’s diet is PROTEIN.  I’ve read some differing info on the topic, but the general consensus seems to be that 150-175 grams of protein per day is a good goal to shoot for.  That is A LOT.  I don’t think I have ever consumed that much protein in a day, in my entire life, before this pregnancy.  I am focusing on high protein snacks: hard boiled eggs, nuts, cheese (this one’s not hard for me to do, obviously!), yogurt, apples or bananas with peanut butter.  I’m addicted to this string cheese that I get in a giant bag from Costco.  They contain 6 grams of protein each, and I will sit and eat 4-5 in a row.  I eat protein bars that contain 20 grams each.  I’m eating burgers and steaks, chicken, any kind of meat I can get my hands on.  Normally I survive on cheese and carbs, so this is different for me.  Hopefully this will all pay off, and I will start piling on the pounds soon and have two big babies!  I never thought I would look forward to gaining 40+ lbs in a matter of a few months, LOL.

I am looking forward to my next MFM appt next week, when I will be 18 weeks pregnant.  Hopefully we will hear good news again of no signs of TTTS!