Ahead of Schedule

What to Expect When Your Multiples Are Premature

By Amy E. Tracy

Early labor began 24 weeks into Mara Stein's pregnancy, prompting an emergency trip to the hospital. Expecting twins, Stein, a clinical psychologist in Chicago, Ill., knew she was at risk for preterm labor, but never did she expect to be put on strict hospital bed rest and contraction-controlling medications so early into her pregnancy.

For the next six and a half weeks, Stein's medical team successfully prevented her from going into labor. But on May 30, 1996, the contractions couldn't be stopped. Ten weeks before they were due, Gavriella and Layla, identical twin girls, were born. Each weighed little more than 3 pounds.

Among multiple pregnancies, early deliveries like Stein's are not uncommon. At least half of twins and 90 percent of triplets are born prematurely (before 37 weeks gestation). Preterm babies, particularly those born very early and very small, often face medical and developmental issues.

The good news is multiple preemies have an advantage over singletons. "In the womb, multiple babies typically mature faster than singletons because the mother's body knows what the babies need," says Patricia Malmstrom, founder of Twins Services and author of The Art of Parenting Twins (Ballantine, 1999). Multiple preemies, therefore, are often better prepared for breathing and developing in the outside world.

Also, premature delivery and low birth weights of multiples are often a result of crowding in the womb and not a mother's health problem, according to Malmstrom, who has researched twins for more than 20 years. "Babies born small and early because of multiple gestation and not for other reasons are often healthier," she says.

"A key factor in how well a baby grows and develops is the parents' participation," says Pat Grunwald, a clinical nurse specialist at The Center for Perinatal Care at Meriter Hospital in Madison, Wis. Learning to love and care for your tiny, fragile babies will take time, patience and practice.

Want to see more?

• Are You Prepared for a Preemie? A Guide to Preterm Babies
• Talk about it!
• Nurturing Your NICU Baby
• Going Home Alone: When Preemies Need to Stay in the NICU
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