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    Double Trouble or Twice as Nice

    The baby days can be hard enough when there is just one little bubba to look after, so what is life like for the ever-increasing number of mothers of multiples? Rachel Kenney finds out.

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    Any expectant parent who has been given the thrilling news of a healthy baby at their first scan will experience an avalanche of emotions. Excitement, relief and joy mingle with worry and nervous anticipation. But when the news is that you are expecting twins, triplets, or even quadruplets, it can be an even more complex proposition to get your head around.

    With multiple births, there are potential extra health concerns for both mother and babies, practicalities such as feeding, sleeping and squeezing everyone into Hong Kong’s already squeezed apartments to consider, the logistics of getting out and about with two (or more) babes plus all their attendant paraphernalia, worries about ever getting back to work, all topped off with the headache of how you are going to afford to buy double (or triple) of everything.

    But more families than ever are receiving the news that they are expecting not just one, but two – or even three or more – precious bundles of joy. The incidence of multiple births is on the rise, and this increase is due, in part, to factors such as older maternal age, increased use of fertility drugs, and more assisted pregnancies. Worldwide, there are at least 125 million living multiples.

    Mixed emotions

    So what does it feel like to find out that you are expecting twins? Mandy Jones, who has been an expat for 15 years, and is mum to Jessie, 11, and five-year-old twins Ben and Polly, says, “I was delighted, but also worried. Worried about them not being healthy, about complications, about premature labour.”

    Nicola Buswell, who is mum to two-year-old twins Maxwell (a girl) and Harley (a boy), echoes this worry. “My first reaction was panic, mainly about how I would physically carry two babies inside me,” she says. “I hadn’t even considered that I would actually have two babies to look after. Being my first and second, I was blissfully unaware about what was in store.”

    For mum-of-five Fiona Destexhe Lodge, from Discovery Bay, the news was overwhelmingly exciting. “I was just grateful to see one beating heartbeat, never mind two,” she says. “That was a blessing after a previous miscarriage.” And for Meg McGrath, who is mum to Tia, 10, and seven-year-old boy/girl twins Joshua and Jordan, the news that she was expecting twins was no surprise as there are lots of twins, and even triplets, in her family. She says, “We were relieved when we found out there were only two!”

    Healthy pregnancies

    The vast majority of women who are expecting twins have healthy pregnancies and healthy babies, and serious complications are rare. However, some complications, such as premature birth, are more common for twins. Pregnancy-induced high blood pressure is also more common with multiples, and pre-eclampsia, a complication related to high blood pressure that can happen later in pregnancy, is also three times more likely in twin pregnancies, and nine times more likely in triplet pregnancies. Gestational diabetes is another complication that is more prevalent with multiples. Consequently, mothers expecting multiples will be offered extra antenatal care and monitoring.

    Mandy’s fears about premature labour became a reality at 29 weeks, when she was admitted to hospital with contractions and bleeding. She says, “Thankfully, they managed to stop the labour, but after that I had to go on total bed rest until I gave birth. The doctors were great, though – they really took care of me, and we managed to keep the babies inside until 37 weeks, and they were born completely healthy.”

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    Getting good medical care during pregnancy and for the birth is crucial. In Hong Kong, you have the choice of going through the public system, or the private system (if you can afford it or your insurance covers it), or a mixture of both. For Meg, the obstetrician she chose only delivered at the private Matilda Hospital, so the decision on where to give birth was made. Nicola wanted to go to the Queen Mary Hospital, so she went through the public system but saw a private obstetrician so she could have additional scans. It is also worth remembering that if there are any serious complications during the delivery or after the birth, your baby will be transferred to the nearest public hospital with a neo-natal intensive care unit.

    Unfortunately, Meg experienced this emergency transfer as one of her newborn twins was born with medical issues. She explains, “Our paediatrician transferred our son to Queen Mary Hospital on a gut feeling. Our son wouldn’t have made it through the night, and to this day I have the greatest respect for him. We had a hard and stressful 14 months, as it was touch and go on many occasions, but today we have a lovely little seven–year-old who brings us joy every day.”

    Birth and beyond

    When it comes to the birth, Caesarean sections are more likely (but not inevitable) for twins than for singletons, and triplets are almost always born by Caesarean section. Mandy, Nicola, Fiona and Meg all had Caesareans, for a variety of reasons, including difficulties with delivering their twins and complications from previous births.

    Most twins and multiples will be delivered earlier than singletons. For single babies, full term is considered to be 40 weeks, but for twins it is 37 weeks, and for triplets 34 weeks. Consequently, as babies have had less ‘cooking’ time, their birth weight will generally be lower. The average birth weight for singletons is 7lb 7oz, but the average for twins is 5lb 5oz, and for triplets it is 4lb. But just because twins are generally delivered earlier and smaller, it doesn’t necessarily mean that this is always the case. Fiona’s identical twin daughters were born (in Belgium) at 39 weeks, one at 7lb 11oz, and one at 6lb 7oz. She says, “I was HUGE, but still walking, and felt great right up until the end.”

    Once the babies are delivered and back home, looking after two or more newborns simultaneously is obviously going to present plenty of challenges, especially if there are older siblings to add to the mix. Nicola’s advice is, “Take help from anyone that offers as the first three months are tough (but amazing!)”

    Just keeping the babies topped up with milk can be a full-time job. Fiona (who already had a five-year-old and a three-year-old at home) was up feeding the babies every two hours at night in the early days, and Meg was breastfeeding and expressing milk constantly, with one baby in the ICU ward and one at home.

    Mandy adds, “I seemed to be constantly feeding. I breastfed exclusively for the first few months, and my midwife was quite disapproving when I introduced a bottle for Ben (Polly wouldn’t take one). Other people kept telling me I was doing it wrong as I didn’t feed both babies together – that just didn’t work for me. The best advice I can give anyone is to ignore what everyone else says and just find a way of doing things that works for you.”

    Getting out and about

    As many Hongkongers rely on public transport, getting around with multiples can seem like a bit of an obstacle course challenge. Hong Kong’s packed pavements can be uninviting to the pram-pusher, and MTRs, ferries, buses and taxis can be an equally daunting prospect when you only have one pair of hands but a double (or even triple) buggy and/or car seats to manoeuvre.

    In the early days, many mums of multiples use a baby carrier and buggy combo, and many, like Mandy, get used to bringing a helper, friend or husband along to lend a hand. This might be a good call, as Nicola says that even if you can manoeuvre your double buggy into the metropolis, you might not be able to get it into a baby changing room… And once her twins were toddling, Mandy says she still needed a hand as they would often run off in different directions. Meg says that getting out and about was a complete nightmare, not for logistical reasons, but because strangers kept wanting to touch the babies, and they had to be extra careful about germs.

    But although Hong Kong might not be the pram-friendliest city in the world, there are a few hidden gems of walks that allow you to stride out with a stroller. Check out these buggy friendly hikes for a great day out.

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    Counting your blessings

    Having babies is an expensive occupation, but when there are twins (or more) there are even more financial implications. For starters, there’s the fact that you have to double up with lots of the kit and caboodle, but, like Mandy and Nicola, you might need to move to accommodate your rapidly growing family. You might also feel you need to employ people – such as maternity nurses or helpers – to relieve some of the pressure, and you might find it trickier (and more expensive) to sort out childcare if and when you go back to work. Medical insurance might only cover you for one baby, and if, like Mandy, you have serious complications, the bills can skyrocket. She says, “Obviously we wouldn’t change a thing, but my husband calls the twins ‘Porche’ and ‘Mercedes’.”

    There is no doubt that being a mother of twins, triplets or more is going to be phenomenally hard work at times, but multiples also bring a multitude of positives. Fiona says, “I feel blessed to have experienced twins, and lucky too. It was tough, of course, in the early days, but to see two little people growing up so close with a bond that no-one can ever come between is very special.” Mandy agrees, saying, “The bond between them makes it all worthwhile, and even on my completely exhausted days they make me smile when they are plotting and scheming.”

    So what advice do the ‘been-there, done-that’ mums have for those about to embark on their mother-of-multiples journey? Meg says, “Enjoy the experience. It is a bit different, but beautiful memories are to be made.” And Nicola sums it with these words of wisdom. “Don’t let people scare you. It’s twice the joy. It really is!”

    This article appeared in Playtimes November Issue 2016 and was updated in February 2020.

    FEATURED

    Rachel Kenney
    Rachel was born on a stormy night in Bristol in the south west of England, and grew into a quirky child who used to clean the bottoms of her shoes and hold her breath until she fainted. Aged three, she said she wanted to be a cow when she grew up (which, hopefully, did not come true!), but later settled for a career in journalism and has since worked for a variety of publications. Rachel loves travelling (which is strange, considering her extreme fear of flying) and has managed to pack a two-and-a-half year backpacking stint, nearly five years of expat living in Hong Kong, and as many holidays as practicable into her life so far. Married with two children, Rachel spends her spare time drinking too many lattes and planning her next escape.

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