Tips for Choosing the Right Prenatal Class – Part 1 of 2

PPL_logoThanks to Alba Aguanno, RN, BScN, LCCE and Director of Childbirth Education at Port Perry Lamaze for inspiring and contributing to this blog post on the important topic of choosing the best prenatal class for you!

Expectant parents sometimes wonder if they should take childbirth classes at all. With a range of childbirth education options available, choosing the right class can be confusing, especially for those expecting twins or triplets!

Here are some tips to consider when choosing a childbirth preparation class.

1. Credentials

certificateFirst, inquire about the credentials of your potential instructor. Some have formal medical training or educational certification, while others have none. Are they health professionals (registered nurse, physiotherapist, medical doctor, chiropractor, or midwife), or do they have considerable experience with expectant parents and newborns?

Have they completed a recognized, formal course on childbirth education or education in general: Lamaze International certification (LCCE), International Childbirth Education Association (ICEA), Childbirth and Postpartum Professional Association – Childbirth Educator (CBE), Childbirth International (Dip CBEd), or Ontario College of Teachers (OCT) or a Masters in Education (M.Ed.) with an emphasis on early learning and/or adult education?

The Lamaze-Certified Childbirth Educator (LCCE) credential is the most widely-recognized and respected qualification in this field. It is the only childbirth education credential accredited by the U.S. National Commission for Certifying Agencies (NCCA), a government body ensuring quality in certification programs.

Certification doesn’t necessarily ensure an ideal learning experience, but it can certainly inspire expectant parents’ confidence that they are getting the most current and correct information.

2. Experience

Consider the instructor’s years of childbirth education experience: If they have been doing this a long time, they may offer a wealth of experience, but they may also be “burnt out”. Conversely, a newer instructor may be enthusiastic, but a little too “textbook”, lacking extensive real-life experience with twins, triplets and their parents.

Also, consider the amount of experience in other class content areas such as breastfeeding and early parenting support, especially with multiple births families. The last thing you need as an expectant parent is a child birth educator who has little or no experience with twins, triplets and quads.

3. Testimonials/Recommendations

handshakeDoes the potential instructor publish testimonials and endorsements for their classes? Read the feedback carefully to get a better picture of what past participants have thought of the classes.

Also, consider who is recommending the class. Have you found it on your own, were you recommended by a friend who heard about it or who took the course, or were you recommended by your obstetrician, family doctor, or midwife?

Many providers will collect endorsements from past students, and will publish at least a few of these on their website. If not, ask to see some, or speak to someone else to see what they thought of the class or instructor.

4. Location & Class Size


all-four-300x199Ask where (specifically) the classes will be taught.

Educators teach in a variety of environments. Some teach in hospital classrooms or medical offices, while others teach in community centres; some even teach in their homes or yours! Increasingly, prenatal classes are offered online, even prenatal classes for twins and triplets. Be sure to check the other tips before enrolling in an online class.

Some providers keep their class sizes small to maintain the quality of instruction and to facilitate meaningful interactions with participants. In certain cases, private classes may be offered. This can be ideal if you are in a remote part of town, where there are no other couples expecting twins or triplets, and you don’t want to be the class circus side show with unique prenatal issues particular to your multiples pregnancy.

There can be a lot to think about when deciding to enroll in prenatal classes, but for families expecting twins, triplets or more, the decision is among the first steps to a healthy twins pregnancy, labour and delivery.

More tips coming in Part 2… stay tuned! 

Begin as You Mean to Go On

twin boysI had the delightful opportunity to spend an evening with a colleague’s family, which included their 2-year-old son and his new 10-week-old twin sisters the other night, and I was reminded of the incredible amount of power held by parents, when it comes to paving the way for their children’s future behaviour.

It’s no accident, in my opinion, when children are polite and well behaved, like that night, I witnessed how this magical seed is planted: While we were finishing up the dinner that my partner and I had prepared and brought to the family we were hanging out with, their two-year-old left the table (he was “done”, and wanted to go play).

In their family, these parents have decided they it’s important to eat together, and to ask to be excused when one is finished at table.  So, in gentle yet firm tones, they instructed their toddler to return to the table, and to ask to be excused.

He did so, wiping his hands and face on a cloth they had laid out for him, and then went off to play.

Later that evening, when it was time for bed, parental patience and consistency were once again on display as Mom gave advance notice of the impending bedtime expectation, and Dad went to follow up when Toddler tried out a few tricks to delay the bedtime.  A few removed “Thomas” toys later, Toddler could be heard crankily settling down to sleep.

I marvelled at Mom and Dad’s consistency; each parent had a sleeping newborn in a sling next to their bodies for most of the evening, and even though my partner and I had brought dinner, and tried to do most of the set up and clean up of dishes, it was still busy – between feedings, diaper-changings and, chasing after the family dog and the toddler, there was little or no “down time”.  Not to mention, the sleep deprivation that comes with new twins was evident in their tired eyes.

Yet both parents found the energy to continue to guide their first-born through the mundane but important daily routines that would lead to his becoming a polite, well-adjusted child and young man later on.

Parenting can sometimes feel like a grueling, relentless task, especially when one is facing additional challenges like looking after new born twins or triplets while continuing to parent one or more older singletons.  But it is a task that – if done responsibly and with pleasure – can bring enormous rewards.

Tracking with Twins

logoToday’s blog post is shared courtesy of Lynda P. Haddon, Multiple Birth Educator and creator of the recently released Jumelle app for multiple births.

For parents of newborn twins, triplets, quadruplets, quintuplets or even just two babies close together, many recognize the necessity need of a record of who did what and when and for how long.  Parents need to keep track of number of dirty diapers, feeding habits and duration, naps and bedtimes.   

The more children in the multiple-birth set, the more important accurate tracking becomes.  

Careful recording of each babies’ habits ensures that sleep-deprived parents are quickly on top of any issues with marginal room for error. Tracking minimizes the chances of guesswork: I know someone missed a bowel movement today but which one?

Medicating the Right Twin

An additional important issue to keep track of is if one, more or all infants are receiving medications or even vitamins.  Did I or didn’t I? and which one?  It could be dire if a baby received two doses of medication in error.  Remove the guesswork, anxiety, possible overlap and potential mistakes by keeping a recording schedule.   

Keeping Track Helps the Sitter, Too

A tracking schedule can be very helpful to other caretakers (grandparents, family members, friends, nannies) who come into the house to assist with baby care.  The formal record quickly identifies which baby may be facing a challenge, e.g. constipation, and allows the caregivers to step in a timely fashion to help rectify the situation.

Include the Essentials 

There are a couple of ways to keep track of which baby did what.  Parents may wish to include:

  • dirty diapers/wet diapers
  • breastfeeding [left/right breast]
  • duration of breastfeeding, or quantity consumed, if bottle feeding
  • time and duration of nap [morning and afternoon]
  • bedtime [duration of sleep time]
  • medications/vitamins given
  • teething issues 

Hard Copy or Electronic Tracking?

 Some families like to create a paper printout of a spreadsheet or chart “Birth and Beyond” Class and post it nearby.  Others prefer to track using an excel sheet on their laptops or an app on their tablet.  (One example of the latter is the newly released Jumelle, created by prenatal instructor and mother of twins, Lynda Haddon.)

Whatever your preference, keeping a record of each baby’s teething issues, feeding habits, fevers, and milestones can help you manage with newborn twins, triplets or more, and keep schedules a little more under control.

Twins Baby Boom Hits PEI

Since we’re vacationing in Prince Edward Island, Canada, this summer, we thought we’d bring you the latest multiple births news from Atlantic Canada.

June saw 6 sets of twins born at Queen Elizabeth Hospital, an amazingly high number, when one considers that that is three times the number – in a single month – of the preceding five months! Experts attribute the spike to a possible trend, thanks to women waiting longer to start families here on the Island as they are in the rest of Canada. (Age increases the chances of multiples pregnancies.)

Whatever the reason, an increase in twins pregnancies means an increase in need for multiples-specific prenatal care, and that includes prenatal classes that cater specifically to families expecting twins and triplets. In small communities like PEI, where twins-specific prenatal classes may not be as accessible as they are in larger provinces with one or more larger city health care centres, an online class like Babies In Belly’s can be a helpful resource to those pregnant with twins.

For the complete story, see this article recently published in the Guardian

Infant Massage with Multiples


Image

Recently, I had the good fortune of sharing an evening of infant massage with two other families who had 11-week-old twins.

Infant massage is something I address in Class Four of our Twins Prenatal Course, and since it had been a while since I’d done it myself with newborns, I decided to offer a free class through our local twins club.

There is quite possibly nothing cuter than four little babies all lined up on the floor; the sheer sight of them brought a smile to everyone’s face before we even got started!

The benefits of infant massage are well-documented: From soothing fussy babies to helping relieve gas pains, to boosting muscle development and circulation, infant massage is becoming a more and more mainstream way for parents to support the overall health of babies everywhere.

One-On-One Connection with Multiples

One challenge with having twins, triplets or more is how to effectively bond with each baby. Incorporating infant massage into your daily bath-time or bedtime routine can help you connect with each of your babies individually. For the 10-15 minutes you massage your newborn each day, she’ll have your undivided attention as you look into her face and tell her how much you love her, with your voice and your hands.

For our “class”, both partners came with their twins, so there was one adult per baby. But going to a group infant massage session is a great way for single parents with twins, or two parents with triplets or higher order multiples to get an extra hand with the additional babies. Your instructor or class helpers or volunteers are often happy to take one baby while you take the rest.

Infant Massage & Language Development

There is some evidence to suggest that twins, triplets or more can exhibit language delays. Talking to each baby about what you are doing while you are doing it can help “front load” language input.

For example, while taking a little arm in your hand and rubbing oil on it, you can tell your baby, “Now I’m going to put some oil on your left arm, see? Doesn’t that feel nice? I’m going to rub it together to make it nice and warm first, then I’m going to massage your left arm, one – two – three, and now your hand, like this, and each little finger, 1 – 2 – 3-4 – 5…” and so on.

Consider how many full, rich sentences your little ones are hearing, in context, as you gently describe what you are doing, in a soft, soothing voice.

Grumpy Clientelle

It wasn’t long into our group infant massage session that most of the babies were fussing and crying, but we’re pretty sure that’s because they were hungry… Fortunately, both mothers were breastfeeding their twins, so that problem was quickly and easily solved!

Different philosophies exist about what to do when a baby complains during massage: Some people believe it’s best to stop the massage for now, and give baby a break, while others persevere, using gentle tones to soothe their babies while introducing them to this new and not-yet-familiar sensation. (The thinking goes that once they get used to it, babies will learn to anticipate and enjoy their daily massage routine; that was certainly true of my now-9-year-old twins.)

As parents, you know your babies best, and can decide if or how to proceed when one or both twins decide let you know they’re not yet enamoured with this massage business!

infantmassage1.jpg

Twins Labour and Delivery

As discussed in more detail in Class 4 of our multiples prenatal course, it is often possible and even preferable to have a vaginal delivery with twins.

I recently had an email from a woman 31 weeks pregnant with twins. She was happy to discover that her babies were both head down, and wondered about her chances of vaginal delivery rather than the caesarean section originally planned.

Although recent research confirms that a vaginal birth is often preferable for twins, every multiples pregnancy is different. Some OBGYNs may still decide to deliver twins by C-section. This can happen for a number of reasons. 

If a vaginal birth is planned, once in the hospital, mom and babies will be closely monitored through labour to ensure all is going well.

Does “Head Down” = No C-Section?

While it is certainly true that having both babies head-down can make for an easier delivery, be aware that once Twin A is born, Twin B may flip around in his/her suddenly more spacious womb!

An experienced OBGYN may be comfortable turning one or both babies as needed, to accommodate a head-first vaginal delivery. That being said, if there is any sign of distress, the doctor may elect to perform a section delivery for one or both babies.

One Labour, Two Deliveries

In general, with twins, you (or your partner, if you are the non-carrying parent-to-be!) will have one labour, and two deliveries, probably in short succession (once twin A is born, the stage is already set for Twin B, who will follow shortly thereafter ).

One of Each?

Even with both babies head-down at or beyond 30 weeks pregnant with twins, there is some possibility that one or both babies will turn or move again before or even during labour — even though space is getting kind of tight in there! So even if your twins appear to be head down at this point, don’t be surprised if you end up with a section after all. (Although, as previously mentioned, breech presentation doesn’t necessarily mean a section delivery — many doctors are now very comfortable reaching in and turning babies as needed, so that you can still have a vaginal delivery.)

And yes, you may deliver one baby vaginally, and the other by section.

twinbabies.jpgDo Your Homework

Taking a multiples-specific prenatal class is an excellent way to begin preparing for the “big day”. Reading a good book or checking out a quality website that deals specifically with twins can offer additional information.

Two sites we like are: What to Expect and Baby Centre UK.

The first reviews stages of labour, and gives some different possible scenarios for twins deliveries. I like the second one because it is written in a very accessible Q and A format.

Once you’ve taken a prenatal course and done your reading, you can prepare a list of specific questions for your OBGYN. Coming prepared with intelligent questions that show you’ve done your homework can help the doctor take your questions more seriously, and respond more specifically in language you can understand.

Ask Other Parents of Twins

If you haven’t already done so, attend a meeting of your local twins club. It can be very helpful to chat with other parents who have recently (in the past two years) been through labour and delivery of twins.

People love to share their stories, and in person, you can ask many questions.

I would even go so far as to suggest stopping people in the mall, on the street or wherever you see the tell-tale sign of a twin stroller, to chat. Although we POMs sometimes dislike being irritated by nosy strangers, if you are pregnant with twins, you have instant access to our sympathy and our endless advice!

ImageFocus On The Things Over Which You Have Control

When thinking about labour and delivery with twins, it can be quite overwhelming to consider all the possibilities. For all the build-up throughout your twins pregnancy, the actual labour and delivery of your babies is only one small event in their  (and your) lives, and the truth is that it tends to be an event you have very little control over.

You are already taking good care of your babies by thinking about all this, by reading up on how to have a healthy twins pregnancy, by taking a prenatal course. And you’ve probably made all kinds of decisions during your pregnancy that are positively affecting your babies.

Once your twins are born, and you bring them home, you will have a lifetime to take care of them. So yes, the birth is important, but it is only one thing. Kind of like a wedding day in the life of a full marriage!

Episode 2 – Premature Twin Births, and How To Be a Great Advocate

twins girlsTruong is a father of 3-week-old twin girls and a two year old son. He shares how he and his partner have managed to overcome some of the toughest challenges associated with a premature birth, and preparing their toddler for the arrival of his new twin sisters.

You’ll learn exactly what an advocate needs to do in the absence of a midwife, and later, find out how Truong stopped an unprofessional nurse from stressing everyone out during labour.

Preparing for the Birth of Your Multiples? Here’s What to Pack

third trimester

While browsing “expecting twins and triplets” online forums and Facebook groups, we’ve seen the same question pop up a few times, regarding what to pack for the hospital, especially for the babies. 

Given that twins often come early, it can be helpful to have your hospital bag packed in advance.  That way, you’ll be ready to go when the time comes.

Below are some ideas about what to pack… 

Consider Both Mom And Babies

A large, comfy nighty and robe are essential items – remember that even once the babies are born, the bulge will hang around for a bit.  Don’t pack your pre-pregnancy sleepwear for this outing!  And if you are planning to breastfeed, remember to pack buttoned shirts or other “easily accessible” clothing.

Toiletries such as toothpaste, toothbrush and lipbalm will help make your stay more comfortable.  You’ll also need sanitary napkins, big ones!  (Sorry, ladies, you didn’t think your old friend was gone forever, did you?!)

Chewing gum or mints can help make the early stages of labour more manageable, and your breath more bearable for others, later, if you are having a C-section and just can’t get yourself from your bed to the washroom to brush your teeth that first night or the next morning!

For the babies, consider some small sized sleepers and/or onesies.  Some gentle wipes and several newborn sized diapers will also be a necessity, as most hospitals do not provide these.

paperwork for multiple birthsPaperwork, Paperwork… and More Paperwork

One thing a lot of people forget about is the immense amount of paperwork generated by two, three or more live births.  Each baby needs an application for a birth certificate, health card and SIN (optional).

The hospital can help with a precise list of necessary paperwork for your region. No matter what, be prepared to consume considerable time and ink!

Some forms can be completed online.  Consider having your partner complete some or all of the forms in the hospital, after the babies are born, and before you head home. 

Stamping and pre-addressing envelopes now for forms that need to be mailed off saves time in the hospital, and applications that need to be completed in hard copy can be sent off as soon as they are filled out after the births.

Don’t Forget Your Partner/Labour Coach

Your partner may be spending more time at the hospital than anticipated, so be sure to pack a bottle of water and/or some snacks for him/her as well.  A granola bar can be packed well in advance, and throw a piece of fruit in the bag on your way out the door, too! 

Consider packing change for the vending machine and/or parking meter, so that your partner can take care of those things easily.  

If you are past 26 weeks pregnant with twins, hopefully this blog post has given you a head start as you think about what to prepare for in the weeks ahead. 

A more comprehensive guide to when and what to pack for giving birth to twins, triplets or more at the hospital is included in Class Four of our online prenatal course for multiples

 

Ideas for a Twins Baby Shower

twins baby showerOur guest blogger today is Charlene from Having Twins and the mother of monozygotic twin girls.

Planning a baby shower twins can be great fun. Here are some awesome ideas for organizing the perfect twin shower.

Twin Shower Theme

Theme ideas for a twin baby shower are endless, from “two peas in a pod” (or three, if it’s a triplets baby shower!) to Dr Seuss’ “Thing One and Thing Two”. Just think about anything in twos, pairs or even things that go together.

You may like to start with what sort of cake you would like then base your theme around that. Many people choose specific colours as part of their theme, and there is no need to stick with traditional “pink” or “baby blue” — get creative!

Gift Ideas

Here are some great gift suggestions for parents expecting twins…

A “diaper cake” is a fun gift, and you can make it yourself. A diaper cake also makes a great center piece for the shower.

In addition to using diapers (which is essential when building a diaper cake), you can include things like:

a)  Twins baby clothing and face cloths.
b)  Treats for mom in the middle of the diaper cake is a really nice surprise. Maybe her favorite chocolates, a voucher for a pregnancy massage, or paid subscription to her favorite magazine.
c)  Baby lotions and soaps.
d)  And top it off with a rattle or booties.

Some other great gifts for the twins parents-to-be depend on how much you want to spend. For instance the bigger ticket items are a great way to help out, like a twin stroller, twin nursing pillow, cribs or car seats. Keep in mind mom(s) or dad(s)-to-be may have preferences, so one idea is to give a voucher; you could even take them shopping.

Things like rompers or sleepers are always a useful item and you can get some really cute ones, even rompers aimed at twins, like “she did it” and “he did it” printed on them.

Games for a Twin Shower

With games at a twin baby shower you can basically twin up any game you want, but here are a couple of ideas for you:

a) Play celebrity twins and match the babies to the celebrity, whether it be just names or by using pictures.
b) A pairing baby socks race, the fastest time wins.
c) Another race, place diapers on twin baby dolls – but you must be blindfolded. 

There are many other things to organize for a twin baby shower, like invitations (which you can decide on based on your theme). Shower favors could be something “paired”, like a pair of earrings. And food can be made all in double like mini double chocolate muffins or two cheeses cheese board.

Whatever your theme, enjoy your twins baby shower, and have fun planning it!

For more twins baby shower ideas from Charlene, check out her girl twin baby shower.

Episode 1 – Surprise, You’re Pregnant With Twins!

bibpodcastCover

In this first episode of the Twins and Multiples Podcast, Vera C. Teschow talks about how her life changed the moment she found out she was pregnant with her monozygotic twin boys.

She reveals how she went on to become a multiple births prenatal consultant, and later, how was able to reach and educate more parents around the globe with the launch of her online course at BabiesinBelly.com.

Enjoy, and we’re looking forward to your feedback!