World Prematurity Day: Supporting our multiple birth families beyond the NICU
By Carolyn Leighton-Hilborn
Recent research indicates that 1 in 12 Canadian babies are born premature and 1 in 10 worldwide. The rate of Canadian premature birth in 2011/2012 was approximately 7.8%. What does that mean in actual numbers? That works out to about 29,000 babies born prematurely per year.
Prematurity has three categories and in basic terms they are: Extremely preterm; less than 28 weeks gestation, very preterm; 28 to less than 32 weeks gestation, and moderate to late preterm; 32 to less than 37 weeks gestation. Multiple birth pregnancies often are completed preterm. Approximately 56% of twins are born preterm and the majority of triplets and higher order multiples arrive early.
While Canada has some of the best hospitals providing neonatal care to these premature babies, there is still room for improvement. It has been identified that while we have excellent healthcare for our most vulnerable babies, we currently lack in the area of ongoing peer support programs to assist the families of babies living in and out of neonatal intensive care units. Often the focus in on getting the premature babies well and able to go home and the parents’ feelings get put on the backburner and parents go into what many call, “survival mode.” Many hold the mentality that if they can just get through this trying time and get home, “everything will be okay.” But this is not always the case. Often changes in a parent’s mental health are quietly starting while in the NICU, but not clearly evident until a few weeks to many months after going home. Once parents are home reality sets in and the parents, often the mom during the daytime, are carrying on similar routines as to those in the hospital, but without a backup team of professionals for support and advice. Feelings of extreme fatigue can be written off as normal “twin parent” fatigue. Frustration, despair, and crying can be mistakenly chalked up as the same thing – being a new parent to multiples is tiring, frustrating and sometimes maddening. These are sometimes also symptoms that something more is happening, such as Post Traumatic Stress Disorder, Post-Partum Mood Disorder or Post-Partum Depression. Post-Partum Depression has been found to be 5 times more likely in mothers of multiples than mothers of singletons.
New mothers often complain of feelings of isolation during the first year of their multiples’ lives. Eventually their partner goes back to work, some short term help that may have been there in the early days has had to return to their regular lives, and the parents are left to learn the ropes of raising twins or more on their own.
This is where the importance of peer-to-peer support comes in. There are many multiple births groups across Canada, some MBC chapters have representatives who have been trained to support expectant and new parents, as well as to watch for the signs of different types of depression or anxiety. We also have the Preterm Birth Support Network here at Multiple Births Canada, but without the support of our chapter members and the spreading of awareness of these opportunities for families to connect, many new parents will struggle during their first year or more.
To join or recommend the Preterm Birth Support Network on Facebook, please click here. You do not require a membership to join this network for families of preterm multiple births babies.
For access to our 3 new preterm birth fact sheets, please visit our Publications webpage.
For a full report on prematurity in Canada please see Canadian Premature Babies Foundation’s Premature Birth in Canada: An Environmental Scan.
World Health Organization - page on Preterm Birth http://www.who.int/topics/preterm_birth/en/
Canadian Premature Babies Foundation http://cpbf-fbpc.org/
Multiple Births Canada - Preterm Birth Support Network http://multiplebirthscanada.org/index.php/parents/support/preterm-birth-support-network
Posted by Elaine Mayea on November 17, 2014
An Article by Nancy L. Segal, Ph.D
Balancing twins’ individuality and friendship is a true challenge for parents, educators and anyone concerned with twins’ health and well-being. The dramatic increase in twinning in recent years means that we all need to pay closer attention to the abilities, talents and preferences of each individual child. We have moved passed the days when twins were treated as a single unit and distinctions among twin types were considered trivial. The current goal is toward helping multiples shine as individuals, the brilliant theme of ICOMBO’S Multiple Birth Awareness Week 2014.
This means knowing the zygosity of one’s twins, paying careful attention to each child’s interests and letting twins’ behaviors guide you as parents. In other words, twins will often let family members know in their own way what is best for them. It is so important to appreciate that the twin situation differs significantly across twin types. Identical twins generally look alike, behave alike and share many interests. However, even though they share 100% of their genes, they do not show perfect similarity. Any number of environmental events, from prenatal nutrition to school experiences, can lead to differences in health and behavior. Same-sex fraternal twins share half their genes, on average, and show similarities, as well as differences, just like ordinary siblings. However, they are often “lumped” together by people outside the twinship. Finally, young male-female twins are often at different developmental stages, because females tend to mature physically, socially and intellectually ahead of males. Young male twins often enjoy the “supervision” of their sisters, a situation that should be monitored to enable them to feel confident and secure on their own.
Twins can certainly share bedrooms and classrooms and still acquire a strong sense of individuality. Children can decorate their side of the room in ways that appeal to them. They can sit in different places in a classroom, developing special friends and having experiences apart from their twin sibling. Some school officials maintain mandatory policies for separating twins, for fear that they will not develop fully as individuals. This is a misguided and simplistic approach to an important and complex issue. As indicated, twins can be in the same location (e.g., classroom) and have very different experiences within that location.
College-bound high school seniors face an especially trying task—deciding to go the same or different schools. Some twins choose to go school together, but live apart, while knowing that their twin brother or sister is close by. Unfortunately, science lacks studies and statistics on how many twins choose the same or different colleges, how they arrive at these decisions and the outcomes of their choices. Even if twins attend the same university they should follow the same major if that is what they prefer. If both are interested in math or in history or in psychology there is no reason that one should change just to differ from his or her co-twin—to do so would be to deny individuality!
There should never be a single policy for raising twins because all pairs have unique needs and situations. Furthermore, defining individuality is somewhat subjective. Some twins may spend a great deal of their time together, but still display independence and self-confidence. The primary goal is to raise twins who are content both in the company of their twin and on their own.
Nancy L. Segal, Ph.D.
Professor of Psychology
Director, Twin Studies Center
Posted by Elaine Mayea on November 13, 2014