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Diet and Exercise
A woman expecting twins, triplets or more will gain more weight during her pregnancy than during a singleton pregnancy. Weight gain will vary according to how your babies are growing, how well you are eating and what size you were before your pregnancy.
A number of studies suggest that recommended weight gain should be:
- Twins - a total gain of 18-23kg (40-50lb), preferably 11kg (24lb)by week 24 and then 0.6kg (1.25lb) a week until birth.
- Triplets - a total gain of 23-27kg (50-60lb), preferably 16kg (36lb) by week 24 and then 0.6kg (1.25lb) a week until birth.
- Quads - a total gain of 31-36kg (68-80lb), with most of the weight increase by week 24.
It is believed that early weight gain is essential during pregnancy as this is the vital time when organs are formed. If you are suffering from nausea and sickness during the beginning if your pregnancy it will make it harder to keep weight gain constant. For this reason, it is important that when you can eat you choose foods that are have a high nutritional value. However, as your babies receive their nutrition in a very basic molecular form of carbohydrates, proteins, fats, vitamins and minerals your body can break down body tissues to supply your babies with adequate nutrition. This means that if you are low in a nutrient it is you that will suffer rather than the babies.
It is recommended to take a dietary supplement of folic acid with multivitamins as early on in pregnancy as possible (Boylan 2005). This helps to prevent neural tube defects such as spina bifida.
You should eat a varied diet and follow the guidelines of the Food Pyramid provided by the Health Promotion Unit, Dept. of Health and Children.
Avoid alcohol as it has not been scientifically proven that 'small amounts' have no effect on a baby. You should not smoke or be around smoke during your pregnancy as this has been proven to be harmful and there is a higher rate of miscarriage in smokers.
You should consult your doctor about which exercises, if any, they feel are suitable for you during your pregnancy. The following are some of the preferred exercises for during pregnancy
Swimming and aqua-natal classes
Swimming will feel more comfortable than land-based exercise, as the buoyancy of the water helps to support the extra weight you are carrying. The water supports your joints and ligaments as you exercise, preventing injury, and can protect you from overheating. Swimming can also help with swelling and the discomfort caused by varicose veins, a common side-effect of a twin pregnancy.
If you suffer from backache or pelvic pain, talk to your midwife or a physiotherapist before you start swimming. You may find that breaststroke is uncomfortable, and she will be able to advise you of alternative strokes or exercises in the water.
Aqua-natal classes are becoming increasingly popular in many areas and are usually run by midwives. Ask your midwife for details of classes near to where you live.
Yoga can be useful if you are carrying twins as it is a gentle way of maintaining fitness. It can also help with flexibility and muscle toning. Avoid upside-down poses while you are pregnant and any movements which require you to lie flat on your back. This decreases blood flow to the uterus (womb). Never force or strain during any pose or stretch, especially during movements that stretch the tummy muscles. If you experience back or pelvic pain, you may have to modify some of your postures. After 28 weeks, some of the poses may prove difficult. Check that your doctor and yoga teacher are happy for you to carry on with your classes after this point.
Pilates is an ideal form of exercise for a twin pregnancy because it targets the tummy and pelvic floor muscles, which are placed under a lot of strain when you are carrying more than one baby. Many Pilates exercises are performed on a "hands and knees" position, and this is a good position to exercise in, as it helps to take a lot of stress off your back and pelvis and may help to position your babies ready for birth.
Before trying Pilates, make sure that you can perform a strong pelvic floor contraction by squeezing in your pelvic floor muscles and holding it for at least 10 seconds. If you can't maintain a "stable core" by tightening your pelvic floor and lower tummy muscles then you may overstress your joints, ligaments and pelvic floor.
Certain positions, especially those lying on your tummy or back are not appropriate for you. If you can, find a Pilates class specifically designed for pregnant women, or make sure that your Pilates instructor is qualified to teach pregnant women and is aware that you are expecting twins.
Pelvic floor exercises
Because of the extra weight you are carrying and because you have more pregnancy hormones in your system, you may find that you begin to leak urine when you cough or sneeze. Exercising your pelvic floor muscles regularly should help to prevent or treat this problem, and if it doesn't, ask your midwife or doctor to refer you to a physiotherapist
“My babies were born on a Tuesday morning at 38 weeks and 2 days. My last swim was the previous Thursday at 37 weeks and 6 days. Would I recommend it? Well I wasn’t really doing more than 20 lengths by the end and I had to stop after every one but I felt like at least I was staying fit and it was definitely great for me for preventing the back pain I suffered with during my first pregnancy. Mind you I was lucky my waters didn’t break in the pool as this was the first sign I got that labour had started!”
“I found pregnancy yoga great during labour. Not sure if it helped things along but definitely helped with relaxation and breathing and doing the exercises at least gave you something else to think about…for a while!”
Boylan, P. 2005. The Irish Pregnancy Book - A Guide for expectant mothers. Dublin: A. & A. Farmar Ltd.
Cooper, C. 2004. Twins and Multiple Births - The essential parenting guide from pregnancy to adulthood. Revised Edition. London: Vermilion.