SINGAPORE: A nightmare. That’s what first-time mum Wendy Cheong, who gave birth to triplets two years ago, remembered of her pregnancy.
“It was so stressful. No one in my family had triplets, so I didn’t know what to expect,” said the33-year-old supply chain manager in a pharmaceutical company, who was ordered strict bed rest from the fifth month of her pregnancy.
“I was asked to stop work to rest, but ironically, I couldn’t sleep well because my tummy hurt and my back ached when I lay down. I had to sit up most of the time.”
To make matters worse, Wendy developed high blood pressure during the later part of her pregnancy. Severe high blood pressure during a pregnancy can be fatal to both mother and child.
Her harrowing experience encapsulates some of the stress mums with multiple-birth pregnancies go through.
Multiple-birth pregnancies make up about 1.5 per cent of all pregnancies, according to Dr Tony Tan, a specialist in obstetric and gynaecology at Raffles Hospital. They pose higher health risks to both mothers and their babies, he added.
Natural multiple-birth pregnancies are rare but have become more common these days with the increased use of fertility treatments such as IVF and fertility drugs.
According to Dr Tan, the chances of conceiving twins naturally is only 1.25 per cent, and about 0.02 per cent for triplets. Wendy – one of 24 in Singapore who delivered triplets in 2006, according to the Registry of Births and Deaths – conceived triplets after taking fertility drugs that stimulate ovulation.
“Multiple-birth mothers are generally more prone to the exaggerated symptoms of pregnancy like nausea and vomiting. They are also more prone to severe pregnancy and labour-related complications such as miscarriage and pre-term labour,” said Dr Tan.
Complications such as gestational diabetes and high blood pressure are also more likely to develop.
Stretched, strained and stressed
And then there’s the physical strain of a severely-stretched uterus, especially in the later stages of the pregnancy, said Professor Christopher Chen, CEO and medical director of Christopher Chen Centre for Reproductive Medicine at Gleneagles Hospital. He is also the director of Gleneagles IVF Centre.
Referring to the recent high profile octuplets case in the United States, Prof Chen said: “The uterus can stretch to accommodate up to even eight babies. But such a stretched abdomen can be a great discomfort for women carrying multiple foetuses.”
Prof Chen, who delivered Asia’s first IVF sextuplets (that’s six babies in one go) here in 1998, explained: “Because of the extra load she is carrying and the size of her abdomen, the expectant mother will have problems keeping her balance.
To maintain balance while standing and walking, she would have to lean backwards and this can cause back pains.”
A severely-enlarged uterus can also make breathing difficult. “In a singleton pregnancy, the uterus starts to press on the diaphragm at week 40 and that causes some breathing difficulty. In twin pregnancies, this occurs earlier, at 32 weeks,” said Dr Tan.
The discomfort of an overly-stretched belly is something Wendy identifies with. “During my pregnancy, it felt like my three babies were struggling for space all the time. My belly was also so huge that I could hardly move. To move around, I had to use both hands to support my tummy and take small steps.”
Postpartum, multiple-birth mums also have to grapple with an extra dose of stress. “Most multiple births are delivered via C-section, so mothers will probably take three to four weeks longer to recover,” said Prof Chen.
Dr Tan added that these mothers are also at greater risk of postpartum depression. After childbirth, surging pregnancy hormones will experience a sudden drop, so it is not unusual for mothers to feel down.
With a multiple birth, the hormonal changes can be worse because the mother would have had a higher dose of hormones, Dr Tan explained.
Plus, it’s tough to handle one crying baby, so you can imagine how much harder it is with two or more.
Two years on, with lots of patience and family support, Wendy is easing well into her role as a mother of three lively and rambunctious toddlers.
“It’s been tough. Sometimes, I’d think about how much easier it would have been for me to have just one child, but with three babies, it’s also triple the joy. When they kiss and hug me, I have no regrets at all,” said Wendy. – (CNA)
