I didn’t suspect that I was carrying yet another twin pregnancy. I had the same relentless nausea and exhaustion during the very early weeks as I had experienced with my first twin pregnancy but as it was the last thing I expected to happen I didn’t associate the symptoms as being twin related only pregnancy related. I started to show fairly early but as I hadn’t with my first twin pregnancy I made no connection to the possibility of another twin pregnancy.

I first discovered I was carrying twins for the second time when going for the first ultrasound. This had been offered to us early because of the previous twin pregnancy and a previous miscarriage. So at 8 weeks pregnant armed with my Dad for support as my husband was away working I found out that yet again I was having twins.

If I am perfectly honest, I was absolutely delighted to be having twins again, I couldn’t have been more pleased. It felt perfectly natural to me, I didn’t know any different.

Of course my Dad was surprised and when we rang my husband he just didn’t get it. I said “Its Twins” about three or four times but he just assumed I was rambling on about our 5 year old twins.

I rang my Mum and Step Dad who were holidaying in South Africa with my brother and his girlfriend. She had to hang up and call me back. I don’t think it sunk in either. Nobody could quite believe it. My friend had been pulling my leg before the appointment with jokes about another set of twins so just didn’t believe me when I rang and broke the news. On the whole, everyone was happy if not totally surprised that it could happen again.

Once the initial euphoria faded reality started to hit home. There was none of the blissfully unaware state of mind enjoyed during the first twin pregnancy as I knew exactly what was coming. I was under no illusions surrounding the challenge of having twins except this time we already had the older twins to look after. I found myself focusing on the difference in types of twins and reading everything I could about Identical Twins and the Pregnancy. I didn’t think there was enough information out there and I was also very curious to others having conceived two sets of twins – it appears to be rare.

My husband was away working for about a month from the initial discovery of the twins. The nausea and exhaustion was too much for me and I was glad when he came home.

At around 12 weeks we had an appointment at the Harris Birthright Centre within Kings College Hospital in London. We had a dating scan and a consultation with one of the professors. They confirmed that I was carrying a monochorionic twin pregnancy, in other words an identical twin pregnancy with the twins sharing a placenta but having their own amniotic sacs – or sheds as we liked to call them! We were told that we would need to make fortnightly visits back to the unit for close monitoring and more scans. If I am honest, I was a little put out that it would be necessary to make the journey to London for regular visits and told the consultant as much. They must have thought I was completely ignorant or mad and highlighted the point that they were probably the best fetal unit in the world and the care we would receive would be second to none.

From my point of view, I had already carried a successful twin pregnancy to term and beyond and had two healthy twins so I couldn’t grasp why this should be any different. At this point the consultant explained in greater depth the associated complications, especially the condition known as Twin to Twin Transfusion Syndrome. Suffice to say, I left the hospital feeling a little more concerned about the pregnancy than I felt when I arrived. This was now a very different pregnancy to my first twin pregnancy.

It became apparent that my husband was going to need to make some changes to his working schedule and it was necessary that my own work load be reduced just to cope with the demands of this complicated pregnancy. A visit to Kings took a whole day which meant my husband had to take time out from work. The journey was bad enough but often we were waiting for 3 hours after our appointment time was due because of the hospitals back log and running late due to day to day emergencies. The appointment itself could take 1 to 2 hours depending upon the twins positioning. We never knew when we had to return until we had the scans and the consultants made their informed opinions on how to proceed next. We really had to be flexible plus we had to rely on my parents to have our older twins and cover the school runs.

The nausea had started early and carried on relentlessly to around 16 weeks. I won’t call it morning sickness as it was with me for as long as I was awake. At times I simply couldn’t face the kitchen. Opening the fridge door was enough to send me running for air. I often had complete loss of appetite. It was particularly difficult to manage this time around as I still had two young children to feed.

I tried to eat breakfast immediately and my husband would often bring me something before I got out of bed. I tried to nibble on anything plain or dry throughout the day, snacking on biscuits, crackers, toast and crisps. I found that listening to my body’s cravings helped. If I fancied an Apple then I would eat one. If it was scrambled egg then so bit it. I couldn’t stick to a three meals a day diet I just ate when and what I could. Sparkling water was easier to drink than still water. I often craved a sugary fizzy drink but instead of succumbing to the can of coke I chose to combine a sparkling water with a fruit juice. Suffice to say I was happier when the sickness stopped.

Just as one pregnancy symptom subsided another reared its ugly little head and at around 17 weeks I began to suffer during the night from uncomfortable sleep. I knew from experience the problems a twin pregnancy can present when it comes to sleeping positions so I decided to do something about it early on and purchased a “Dream Genii” Pregnancy Support Pillow.

Obviously I couldn’t lay on my front, I couldn’t lay flat on my back because it induced nausea and there is only so much sleeping sitting upright a girl can take. The problem with a twin pregnancy is both sides of your stomach have a baby occupying the space so there is never really one comfortable side to lie on which also means you need to manoeuvre from side to side throughout the night which becomes increasingly difficult as you get bigger.

By 19 weeks pregnant my uterus measured the sized of a 24 week singleton pregnancy. I was still feeling enormously tired. There is every possibility that this was due to age and circumstances. I already had two children to take care of so couldn’t simply rest when my body needed to. I was 5 years older; my muscles were already stretched from carrying the first twins.

So, the maternity pillow which helped initially was ditched by week 24 and I reverted to as many regular pillows as necessary placed underneath my whole body giving me a cushioning effect relieving some of the pressure. Much of the time I slept sitting upright mainly to combat the heart burn that came on after my evening meal.

At around 20 weeks and back to the Harris Birthright Centre for yet another scan, they told us they thought we were having twin girls. A special type of scan known as a ‘colour Doppler flow’ was also performed which tracks the blood flow through the placenta and umbilical cords to help diagnose the condition Twin to Twin Transfusion Syndrome.

These visits continued on a fortnightly basis with the odd weekly visit thrown in if they were unable to get a reading. One particular visit, they couldn’t take one of the Doppler readings for the blood flow on one of the babies. A consultant was sent in to see us and double check. We were told to come back in one week. It was a long week and full of apprehension. When we returned to our enormous relief all was as should be.

Throughout the pregnancy, the twins were on the small side but Twin Two was the smaller twin. As the growth was consistent and fluid levels normal there was no need for concern. The fetal medicine specialist was of the opinion they were just small twins.

On top of the visits to Kings, we were seen by our local hospital on a fortnightly basis. Our consultant who was planning to deliver the girls liked to see us the week in between the scan visits to Kings. The appointment went like this, blood pressure, urine sample courtesy of the midwife, followed by a scan by the Sonographer and finally a discussion with our consultant. Our consultant was a very positive doctor who specialised in multiple births. I had stressed that I really wanted to have a vaginal delivery and despite the fact that I had already had one twin delivery by C-Section she was still positive that we could give it a try. However, she made it very clear that we had to be flexible and see how the pregnancy proceeded. She often reminded me that identical twins like to come early and despite my previous experience she insisted I be ready for hospital by 30 weeks.

At 31 weeks I had been discharged from Kings Hospital having had a lecture from one of the professors regarding the advised delivery of the girls and a fantastic 4D scan. The 4D scan was like looking at a photographic image, it was amazingly real. They were happy that there were no signs of Twin to Twin Transfusion Syndrome and said if TTTS was going to be present it normally happens before now. However, we were advised to opt for an elective C-Section for delivery of the girls because labour can bring on acute TTTS and this was something we definitely needed to prevent.

Now we had been discharged from the specialist care at Kings we had weekly appointments with our consultant at our local hospital. The local hospital took the responsibility of our scans just to keep an eye of the indicators for the onset of TTTS and the growth of the girls.

At around 32 weeks my consultant ordered steroids to be given to help with the development of the babies lungs just in case premature labour was imminent. These are given in a course of two injections over a two day period. I had been experiencing tightening of the twin bump and to be honest I looked washed out. My consultant was afraid I wasn’t going to last another week. I had a cervical check to see what was going on but all was in our favour, apparently I have a long cervix!

Still very much pregnant at just over 34 weeks I was at one of the weekly visits to my local hospital for a scan and it appeared that Twin 2 was a lot smaller than Twin 1. My consultant wasn’t happy with the results of the scan so we were immediately referred back to the Harris Birthright Centre at Kings College Hospital in London to get a second opinion. Our appointment was for the very next day.

The Harris Birthright Centre has all the latest sophisticated equipment as well as the specialist knowledge of fetal medicine. They decided that Twin 2 was measuring on the small side of small and we were strongly advised to opt for delivery by C-Section and they recommended no longer than 35 weeks which was only days away. They were sure there were no current signs of TTTS but they felt that a natural birth would be too much for Twin 2. Basically, they felt that Twin 2 was too small to endure two labours and rather than risk the onset of premature labour it was agreed that an elective C-Section be the safest route. We discussed everything thoroughly with one of the hospitals Professors to weigh up all possible options but the safest route had to be the choice despite my own preferences. My consultant at my local hospital was contacted immediately and we were booked in for a 35 week delivery which was only 4 days later.

The day of delivery came and my husband and I said goodbye to our two children and my mum without making any fuss. It was a Monday and we arrived at the hospital and were given a place on the ward. I had showered that morning in the special antibacterial gel they give you prior to surgery. It wasn’t long before we were visited by a midwife and routine tests and observations were made on me and the babies.

The nerves were building during the wait and then our consultant came to visit us and explained that there wasn’t enough staff on the special baby care unit to take delivery of the twins. So that was that, no twin girls for us today! Our consultant checked the babies and was satisfied that we could wait until Wednesday at which time we would be treated as an emergency as the pregnancy could not be allowed to continue any longer as per the advice from Kings.

On Wednesday, we tried again. I was prepared for theatre and my husband got dressed into the theatre greens. The theatre staff paid us a visit to reassure us and once the consultant had seen us we were taken to the delivery suite. I was experiencing a mixture of nerves and rationality. I was nervous because I knew the procedure but could rationalise because I had already been through one successful twin delivery by C-Section. The theatre staff made comforting small talk and of course the fact that we were on the second set of twins made up most of the conversation. You can expect lots of people in the delivery suite when giving birth to twins; it’s not a private occasion! During this time, the epidural is administered and I climbed up onto the operating bed. Screens in place and after much tickling of my lower body parts and reassurance that I wouldn’t feel a thing (except of course a bit of pulling and tugging) Twin 1 came out.

Tiny Twin 2 came out within a minute after and she was screaming – a very good sign. Both babies were placed on their awaiting resuscitation cabinets with an assigned paediatrician and neonatal nurse. Twin 1 was in need of some assistance with her airway and breathing but the machine allocated to her malfunctioned so her noisy little sister was wrapped in a towel and promptly handed to my husband so as Twin 1 could use her machine. She was soon sorted out and another machine was brought in for Tiny Twin 2. Ironic really when all the concern for delivery was based on the size of Twin 2 yet it was the bigger Twin 1 who was in need of assistance. I wasn’t actually aware of the problems due to the drugs I had been given so my husband filled me in on these details much after the event. I am glad I wasn’t aware of the incident because a panicking mother unable to move still waiting to be stitched up was the last thing needed in an already manic delivery suite!

Twin 1 weighed in at 5lb 4oz and Twin 2 weighed in at just 3lb 10oz. The girls were briefly passed by my face so I could see them and then whisked off to the special care baby unit. I was pretty amazed at how quickly the procedure had been. It was a far smoother procedure than the delivery of my older twins. I was fixed up and wheeled off to the recovery room and monitored for an hour or so.

In the recovery room, my husband sat next to me and the nurse in charge of my care chatted away about celebrity baby names all the while monitoring me closely. After about an hour we got the ok for someone to wheel me to SCBU to meet our new babies.

The first real meeting with our new twin girls was very short and was more like a viewing than anything else. I was in a fairly horizontal position on a hospital bed and was just able to glance into their respective incubators. They were being kept warm and had various wires and pads stuck to their tiny bodies. We were lucky; both girls just needed to be kept warm, monitored closely and fed via a nasal tube. I am glad my husband and I had visited SCBU during the pregnancy as it definitely prepared us for our own babies stay there. The girls were incredibly long but very skinny, especially tiny twin 2. She was just like a little chicken. Their little premature nappies swallowed their tiny bottoms.

I took comfort in the thought that at least my husband had held Twin 2 and he was at least able to place his hands through their incubators and touch their little bodies. For me, it was back to the ward to recover. I was the only mother on the ward without a baby (or babies in my case!). To be honest, I didn’t mind. I knew how hard it would be to care for the twins whilst trying to recover from the C-Section as I had already been there before. I decided that as the girls were in the best place for them right now the best thing I could do was rest and recover quickly so I could get up on my feet as soon as possible. We could all breathe a sigh of relief; the girls were delivered safely into our world.

The story of our stay in SCBU and those first few difficult weeks will follow……….