Speaker 1: You're listening to Amma Mia podcast. Mamma Mia acknowledges the
Speaker 1: traditional owners of land and waters that this podcast is
Speaker 1: recorded on. We pay our respects to elders past, present
Speaker 1: and emerging, and feel privileged to continue the sharing of
Speaker 1: birth stories and knowledge that has been a fundamental part
Speaker 1: of Indigenous culture.
Speaker 2: Hi.
Speaker 1: I'm Cassania Lucid and this is Diary of a birth.
Speaker 1: I'm fascinated by identical twins. One embryo splits to create
Speaker 1: a perfect copy, two babies genetically the same, but with
Speaker 1: their own identities and personalities. Occurring in roughly one in
Speaker 1: two hundred and fifty berths in Australia. They're relatively rare,
Speaker 1: but let's be real. Any parent of multiples will tell
Speaker 1: you how challenging it is. The nappies, the feeding, and
Speaker 1: let's not forget the actual pregnancy. After undergoing IVF with
Speaker 1: their first baby, Today's mum was left with one viable embryo,
Speaker 1: and when it came time to add to their family
Speaker 1: two years later, she and her partner had one last shot.
Speaker 1: Fortunately for them, the embryo took they weren't expecting was
Speaker 1: a high risk pregnancy with identical twins so let's meet
Speaker 1: today's mum.
Speaker 2: Hello, my name is Laura and this is the diary
Speaker 2: of my birth with Alex and Riley.
Speaker 1: So, Laura, can you tell us a little bit about
Speaker 1: your life before you fell pregnant with your twins?
Speaker 2: Life was pretty busy and I guess interesting. My husband
Speaker 2: and I were both working, working full time. There was
Speaker 2: lots of travel, lots of holidays, lots of fun times,
Speaker 2: lots of going out and eating out. Yeah, we were
Speaker 2: also renovating our house, planning and starting to renovate, meeting
Speaker 2: with the architects, the builders, and yeah, life was busy,
Speaker 2: just traveling. I work in Melbourne, but traveled to Sydney
Speaker 2: quite a bit and we were able to get to
Speaker 2: Greece of what where my husband's family is from. And yeah,
Speaker 2: it was good. We had time. We had a lot
Speaker 2: of time for four kids.
Speaker 1: You had a baby before you fell pregnant with the twins.
Speaker 1: Now I know that you went through IVF with both
Speaker 1: of your babies. Can you tell us a little bit
Speaker 1: about that process of falling pregnant with your first.
Speaker 2: My husband and I I guess we decided, you know,
Speaker 2: we wanted a family, we wanted kids. We tried for
Speaker 2: a little bit, and I naturally didn't get anywhere. I
Speaker 2: was son to get really impatient. I was still fairly
Speaker 2: young at the time, but you know, I wanted things
Speaker 2: done kind of now. We decided to embark on IVF. Actually,
Speaker 2: before IVF, we did a few cycles of a varying induction,
Speaker 2: which didn't work after two rounds, and went straight to IVF. So,
Speaker 2: you know, did the hormones, did the injections, the egg collection,
Speaker 2: which was a huge process. And this was in the
Speaker 2: middle of COVID winter lockdowns, so not a fun time. Yeah,
Speaker 2: it was really really tough. To be honest, The injections
Speaker 2: not nice and I'm not very good at them. My
Speaker 2: husband actually couldn't be in the same room when I
Speaker 2: was doing them. Injection after injection after injection into a
Speaker 2: collection of which I don't know if this is a
Speaker 2: good number or bad number, but I was fortunately, I
Speaker 2: guess to get nine eggs collected in the end, and.
Speaker 1: All those nine eggs you got how many embryos.
Speaker 2: Out of the nine every day kind of dropped off,
Speaker 2: dropped off, dropped off down to two embrus that were
Speaker 2: I guess day five blastsicists that were ready and appropriate
Speaker 2: to be implanted.
Speaker 1: Yeah, and you got really fortunate with your first and
Speaker 1: you feel pregnant with him straight away?
Speaker 2: Yes, yes, very fortunate the first round. What and we
Speaker 2: got beautiful Lucas.
Speaker 1: So Lucas comes along and you know you're ready to
Speaker 1: try again and you've got your one embryo left. So
Speaker 1: what was going through your mind when you were ready
Speaker 1: to implant that embryo?
Speaker 2: Gosh, it was full on. So look, yeah, as you say,
Speaker 2: we had one embry left, it had been frozen for
Speaker 2: two years. There was a lot of hope and a
Speaker 2: lot kind of writing on that final one emberor I
Speaker 2: really didn't want to go through IVF again, the whole
Speaker 2: hormones and egg collection. I also got a very hyperstimulation
Speaker 2: and ended up in the emergency warard for a night.
Speaker 2: And yeah, it was one embror and one final one
Speaker 2: and all our hopes and dreams we kind of resting
Speaker 2: on this one embrew that had been frozen for two years,
Speaker 2: and we're just hoping that one worked.
Speaker 1: You had your transfer, you went home. Now, for those
Speaker 1: who haven't been through IVF, when you get an egg transfer,
Speaker 1: you're not guaranteed to be pregnant. There's about a ten
Speaker 1: day window that you have to wait, and then they
Speaker 1: do a blood test and they can tell you if
Speaker 1: you're pregnant or not, and it is the most excruciating. Wait, yeah,
Speaker 1: how did you feel going into that blood test, because
Speaker 1: I know that you waited, which a lot of women
Speaker 1: don't wait.
Speaker 2: It's a waiting game, right, It's like at the end
Speaker 2: of your pregnancy, when you're waiting for baby to come.
Speaker 2: It's a waiting game. Between that implantation and the blood test,
Speaker 2: it's a waiting game. And then from that blood test
Speaker 2: to the phone call, it's it's huge. What probably helped
Speaker 2: was I went on holidays, So after the implantation, I
Speaker 2: went on holidays, just up to write for a few
Speaker 2: days with my husband and son. I also got acupuncture,
Speaker 2: which has shown to support and help that implantation. And
Speaker 2: I just waited, and I tried to be really patient.
Speaker 2: I got the blood test and then just waited from
Speaker 2: the phone call from the fertility clinic.
Speaker 1: What was that phone call?
Speaker 2: Like tears of happiness and joy. I still remember it.
Speaker 2: And I remember getting the phone call first with Lucas
Speaker 2: exactly where we were, exactly the time, and exactly feeling
Speaker 2: of just you know, hope and want and longing and
Speaker 2: this real, like I don't know, it's somewhat desperate feeling
Speaker 2: that you just so want this baby and so want
Speaker 2: this child, and relief, complete relief just washed over me
Speaker 2: because they call you and you know the call is coming,
Speaker 2: and you know you know they're going to either tell
Speaker 2: you the best news or the worst news. And both
Speaker 2: times they were very quick and just said straight away, congratulations,
Speaker 2: you're pregnant.
Speaker 1: Did you go for a dating scan?
Speaker 2: If you went through, We did go for a dating scan.
Speaker 2: I think about week seven. I remember calling up my
Speaker 2: obstetrician at the time and said, oh, look, I'm pregnant.
Speaker 2: I'd love to come in and see my ob and
Speaker 2: they're like, oh, no, no, you're earlier to ORR. You
Speaker 2: know week seven, you know, come back in a few
Speaker 2: more weeks, come back at week ten. And I said,
Speaker 2: oh no, no, I really want to go, like I
Speaker 2: just want to make sure that it's a viable pregnancy
Speaker 2: and it's healthy and safe. And they're like, okay, sure,
Speaker 2: never always come in. And so I in at that
Speaker 2: week seven for that first dating scan.
Speaker 1: And your partner was with you, yes, Yehannie was with you. Yes,
Speaker 1: So a spoiler alert, you have twins, so we know
Speaker 1: that we had twins here, But what I really want
Speaker 1: to stress is you have identical twins, right, yes, so
Speaker 1: they only implanted one embryo, so this wasn't a case
Speaker 1: of you know, IVF putting multiple embryos in and that's
Speaker 1: why you have twins, like you had identical twins. So
Speaker 1: at some point during your early weeks, this embryo split
Speaker 1: into your identical twins. I want you to kind of
Speaker 1: paint me a picture of being in that ultrasound room
Speaker 1: with your husband to find out that you are actually
Speaker 1: having twins.
Speaker 2: So we get in the room. It wasn't a long
Speaker 2: wait and very quickly I was up on the table
Speaker 2: and the obstetrician you know, put the gel on, put
Speaker 2: that ultrasound one thing on, and very very quickly and
Speaker 2: very clearly we can see what we can hear and
Speaker 2: see your heartbeat, healthy, bible, normal pregnancy relief here tears,
Speaker 2: a cry, tears of joy, happiness done, obviously positive pregnancy
Speaker 2: and blood test. You know it's good and baby at
Speaker 2: week seven, very strong heartbeat, wonderful and I was just
Speaker 2: crying and crying and crying, but positive, good tears and
Speaker 2: then the obstetrician at the time. I just remember this
Speaker 2: so clearly. He got the sonography, I don't know the
Speaker 2: wand the thing, and he very quickly moved it from
Speaker 2: one side of my uterus to the other and up
Speaker 2: popped another embryo on the screen, the black and white
Speaker 2: sonography screen, very clearly another embryo moving, and automatically said
Speaker 2: there's two. He didn't say anything, he was silent, he
Speaker 2: was still. He is normally a very talkative ob and
Speaker 2: he didn't say a word. At the same time, I've
Speaker 2: got my husband in one corner of the room, engaged,
Speaker 2: but probably like also not that engaged. I have a
Speaker 2: student midwife in the other corner. Again, I don't think
Speaker 2: she was paying much attention at the time. And then
Speaker 2: all of a sudden, everyone was like watching and looking
Speaker 2: at the screen and looking at me and looking at
Speaker 2: my tummy, and my robe looked at me, looked at
Speaker 2: my tummy, looked at the screen, looked at me, looked
Speaker 2: and I just kept saying, there's two, there's two, like
Speaker 2: I could read and interpret the ultrasound that, you know,
Speaker 2: the black and white screen, and I knew what I
Speaker 2: was seeing. And again he doesn't say anything for a
Speaker 2: long time, and I was like, oh my god, just
Speaker 2: talk to say something for such a normally talkative guy.
Speaker 2: He looked at me, looked at the scan and said, congratulations,
Speaker 2: you're having twins. And more cries, more shock, more tears,
Speaker 2: more laughter. It just was a huge, huge, huge shock.
Speaker 2: Any profanities, Yes, I'm sure, yes, I think so. I
Speaker 2: think I swore yes, I remember the shock. I don't
Speaker 2: remember what I said, but I remember the shock. And
Speaker 2: then just like both like laughter but tears.
Speaker 1: So you and your husband get in the car. You've
Speaker 1: just found out this very shocking news. What's that conversation sound?
Speaker 2: Like? God, that was really tough. I'll be honest with you,
Speaker 2: Like this was just obviously not expected at all. Like,
Speaker 2: we don't have twins in the family. It's not a
Speaker 2: genetic link. They were completely random, identical twins. We get out,
Speaker 2: I'm meant to get back to work, Jani's meant to
Speaker 2: get back to his work, and we just like are
Speaker 2: still processing the news and still processing the information. And
Speaker 2: I must say it took weeks and months to process
Speaker 2: it and come to terms with that. You know, just
Speaker 2: a lot of questions I think, like are they healthy.
Speaker 2: Is it going to be a viable pregnancy? Can I
Speaker 2: carry twins? How are we going to feel? How will
Speaker 2: I emotionally cope? How will I physically cope? You know?
Speaker 2: Can I actually carry twins to term? Well? Will that look? Like?
Speaker 2: What does this mean for my career? What does this
Speaker 2: mean for Lucas our son? You know, we're giving him
Speaker 2: two siblings. We're renovating our house. Does it fit another room?
Speaker 2: Do we have to get a new car? You know?
Speaker 2: Three car seats? What does this mean for our family?
Speaker 2: And this wasn't on the cars, This wasn't planned. We
Speaker 2: wanted like this normal kind of two parents, two kids,
Speaker 2: and very quickly we're outnumbered three like that, And.
Speaker 1: To add complexity to this twin pregnancy, which is already
Speaker 1: a challenge, you know, we know that sort of risks
Speaker 1: increase with multiples. With a twin pregnancy. You actually had
Speaker 1: a very rare type of twins and they're called MCDA twins.
Speaker 1: Now I won't try and pronounce the actual name of it,
Speaker 1: but basically you told me that that means that they
Speaker 1: had a single placenter with two amniotic sacs, which means
Speaker 1: that they were sharing nutrients from one placenter, correct, can
Speaker 1: you tell us what the doctors told you about what
Speaker 1: that actually means.
Speaker 2: So in that first stating scan, ob very clearly could
Speaker 2: see the type of twins that they were and very
Speaker 2: quickly said, look, this is a high risk twin pregnancy.
Speaker 2: They're sharing a placenter. Drew diagrams and kind of drew
Speaker 2: what it looked like. But effectively positive news is that
Speaker 2: they're in two separate amniotic sacs and there was the
Speaker 2: membrane between them. However, sharing a placenta, as you say, like,
Speaker 2: they're sharing nutrients from that one plus center with two
Speaker 2: umbilical cords, and so there's a potential risk. I mean
Speaker 2: a lot of risks for twins, but one of the
Speaker 2: most concerning ones they worry about is twin to twin
Speaker 2: transfusion syndrome, which is where one twin gets more nutrients
Speaker 2: than the other and it's really a problem for both twins.
Speaker 2: Because of that, I had to be monitored and scanned
Speaker 2: every fortnight from I think week fifteen, just to make
Speaker 2: sure that the babies are growing kind of normally and
Speaker 2: healthy and equally and they're kind of getting equal amount
Speaker 2: of nutrients, of which they were very fortunate and I
Speaker 2: never had They call it t TTS twin to twin
Speaker 2: transfusion syndrome.
Speaker 1: Basically that could mean that one twin's growing much faster
Speaker 1: the other ones not getting any nutrients, and you can
Speaker 1: really risk the life of the baby yourself. It's pretty serious. Yes,
Speaker 1: So obviously that's a big concern for you throughout pregnancy.
Speaker 1: And I also understand that you were very unwell through
Speaker 1: your pregnancy as well. So what was it like, sort
Speaker 1: of juggling a toddler, a high demand position at work,
Speaker 1: being pregnant with twins.
Speaker 2: It was rough. It was really rough, And I compare
Speaker 2: in contrast, I think a lot to my first pregnancy
Speaker 2: that I was told was very boring, a very normal pregnancy,
Speaker 2: not many issues, and this song was just very, very challenging.
Speaker 2: I was nauseous, severely nauseous for mass every day. I
Speaker 2: was fortunate I didn't throw up at all. But it
Speaker 2: was just like, think of the worst hangover you've ever had,
Speaker 2: mixed with travel sickness and motion sickness. It was rubbish.
Speaker 2: It was really rubbish. And looking after my toddler, who's
Speaker 2: two at the time, and here, you know, Terrible twos
Speaker 2: was challenging, and then work and then travel to Sydney,
Speaker 2: and yeah, it was a lot.
Speaker 1: Did you have anything any particular foods or drinks that
Speaker 1: really got you through when you were feeling nauseous?
Speaker 2: Yes, Oh my god, ginger and just ginger beer and
Speaker 2: fresh ginger.
Speaker 1: Okay, so let's move along. You're feel naughtously, feeling horrible,
Speaker 1: But family's obviously very excited.
Speaker 2: Yes, yes, And in fact it was interesting because no
Speaker 2: one knew were pregnant. We hadn't told anyone until we know,
Speaker 2: had that dating scan, and so it was like double
Speaker 2: the news, like oh we're pregnant and we're having twins,
Speaker 2: kind of two in one, yeah, I think. Yeah, both
Speaker 2: sides of the family very very happy. A bit of
Speaker 2: a shock obviously, because as I said, like, twins don't
Speaker 2: run in the family either side, and again it's not
Speaker 2: a genetic thing at all. Yeah, a lot of excitement
Speaker 2: from the family.
Speaker 3: Yeah.
Speaker 2: I remember actually one early on in the pregnancy justice,
Speaker 2: we found the news and as I told my sister,
Speaker 2: as remember crying, crying with her, Yeah, because I was
Speaker 2: still processing the news and still processing what it meant
Speaker 2: and again it wasn't planned, and she just held me
Speaker 2: and I just cried. It was a beautiful moment, but
Speaker 2: it was still hard to kind of come to terms
Speaker 2: with it. Yeah, yeah, it still is a little bit.
Speaker 2: I know the voice that over a year, but it's
Speaker 2: wild to think we've had.
Speaker 1: Twins coming up.
Speaker 2: I was already a few centimeters dilated and Raley's feet
Speaker 2: were coming.
Speaker 1: Out well, I mean, one is still so little. Like
Speaker 1: I feel like once you get through that first year
Speaker 1: it is, that'll sort of start to get a little
Speaker 1: bit easier. But true first birthdays should be the celebration
Speaker 1: of mum and dad, particularly mum, but mum and dad.
Speaker 2: Oh, I agree for sure.
Speaker 1: Obviously with twins again high rise pregnancy of twins often
Speaker 1: gestation is often a little bit shorter. But your doctor
Speaker 1: didn't want you to go past a certain time. Can
Speaker 1: you talk to us about that.
Speaker 2: With the twins, kind of coming to term is around
Speaker 2: thirty seven weeks. For the type of twins I had,
Speaker 2: it was about thirty seven weeks, and we had a
Speaker 2: planned cesarean. Well, no, we had planned for a vaginal delivery,
Speaker 2: and my ov was very happy for that. Given the
Speaker 2: kind of the first physiological vaginal delivery with my first son.
Speaker 2: We're working towards that and aiming towards that. It was great,
Speaker 2: all on board. However, at week thirty two, my first son, Riley,
Speaker 2: twin one, he flipped, so from being head down he
Speaker 2: was now fit down and breach. And as soon as
Speaker 2: that happened, that through, you know, a vaginal birth plan
Speaker 2: alt the window because there's not much you could do
Speaker 2: with like I know, with one spinning babies and you
Speaker 2: can kind of get them to try and flip again.
Speaker 2: You can't do that with twins. And so every week
Speaker 2: and every scan I was just hoping like Riley had
Speaker 2: flipped again and flipped back to head down, but he hadn't,
Speaker 2: and he didn't, So then we had to think about, okay, well,
Speaker 2: plan B cesarian and we had booked a cesarian for
Speaker 2: kind of mid March, so that was booked in and
Speaker 2: all good and all fine. And from that moment I
Speaker 2: did a lot of research. I spoke to a lot
Speaker 2: of girlfriends, particularly friends with twins and who had gone
Speaker 2: through a cesarean, spoke to a lot of friends with
Speaker 2: both negative and positive experiences of air cesarean. I did
Speaker 2: a lot of research, a lot of information. I spoke
Speaker 2: to a lot of people to kind of really get
Speaker 2: me ready and prepare me for that moment. But that
Speaker 2: planned Cesarean date didn't happen because the boys came early.
Speaker 2: The boys came at thirty four and four, because I
Speaker 2: went into spontaneous labor. Well, as you'd jumped back a step, Riley,
Speaker 2: we think it's Frailey, chicky bugger. He kicked and broke my.
Speaker 1: Waters lot a little so and sound a little chicky
Speaker 1: monkey had day.
Speaker 2: No because he was fit down and he was breach.
Speaker 2: Like my ob says to me, he probably kicked kick
Speaker 2: too hard and broke your waters. And one afternoon, I
Speaker 2: remember i'd you know, been that day like shopping and
Speaker 2: washing and cooking and cleaning and all the things as
Speaker 2: you do as a mum and managing a family. I
Speaker 2: had like a five minute break, and I remember lying
Speaker 2: on my bed with my husband and my son and
Speaker 2: we put on like Bluey or something for my son
Speaker 2: to watch it. Oh perfect, I can literally just lie down,
Speaker 2: get off my feet and watched this with him for
Speaker 2: like half an hour and lye in bed. Within literally
Speaker 2: like two minutes of putting on that show, my water's
Speaker 2: broke and water went everywhere all over the bed My
Speaker 2: husband actually was talking to another friend who's a twin
Speaker 2: dad at the time on the phone, and Yanni had
Speaker 2: thought I had actually like wet my pants all like
Speaker 2: worse because I was holding my bump like I was
Speaker 2: holding my backside. I was on the bed and I
Speaker 2: like literally said, oh, and how my backside. He's like,
Speaker 2: oh my god, have you like wet yourself or what's happened?
Speaker 2: He was on the phone and he's like, oh, mate,
Speaker 2: I'm gonna have to like drop off because I think
Speaker 2: Lauren's just her waters are broken. Got off the phone call.
Speaker 2: I was lying bed still with my son. All of
Speaker 2: a sudden, we were like up and off the bed,
Speaker 2: but there was water everywhere and it kept gushing and
Speaker 2: gushing and gushing. Went to the toilet, waters coming. I've
Speaker 2: got a like a maternity pad, put that in my underwear,
Speaker 2: and very quickly I just said, okay, it's on like
Speaker 2: waters are broken. We need to get to hospital.
Speaker 1: And this is a Sunday too, Sunday afternoon. Yeah, so
Speaker 1: you basically had to call the whole new team in Yes.
Speaker 2: Yes, so my obi wasn't on call that weekend, and
Speaker 2: I got a whole new team because it ended up
Speaker 2: becoming an emergency s asaian and a whole new team
Speaker 2: greeted us in hospital and you pay all the penalty
Speaker 2: rates because it's a Sunday afternoon. So that was fun,
Speaker 2: all new people. But look, we knew the hospital, we
Speaker 2: knew the plan. My Obi. I was very lucky because
Speaker 2: I spoke to him on the phone actually in hospital
Speaker 2: about what was about to happen, and the saesarean and
Speaker 2: you know, as discussed, you know we're going to be
Speaker 2: doing s Y and zaid, So did have continuity of
Speaker 2: care from him, and I knew what I was going
Speaker 2: into and it was still to plan. It was just
Speaker 2: a little bit early.
Speaker 1: Yeah, you get in there, get spinal tap, you're in
Speaker 1: the theater and they take out the first baby. Yes,
Speaker 1: what was that experience like? Did they have to go
Speaker 1: straight to special care?
Speaker 2: They did shock again, a lot of shock because it
Speaker 2: happened I think so quickly from when my waters broke
Speaker 2: to then going into labor to then arriving.
Speaker 1: How long was it between when your waters broken when
Speaker 1: the babies came?
Speaker 2: About three hours?
Speaker 1: It's very quick.
Speaker 2: Yeah, it's pretty fast. We got off pretty quick. And
Speaker 2: then what they were hoping to do, was hoping to
Speaker 2: keep me in for another day or two, even though
Speaker 2: my water said broke. They were hoping I wouldn't start
Speaker 2: contracting and kind of go into labor. But I did,
Speaker 2: and I went pretty quickly, and the contractions wrapped up
Speaker 2: bloody fast and hard, and boy, I didn't have my
Speaker 2: Tenis machine or pain relief or anything planned, and gosh,
Speaker 2: it just brought me back very quickly to that first
Speaker 2: labor of my son, very quickly, ye three hours. And unfortunately,
Speaker 2: because I then contracted when to labor, there was no
Speaker 2: choice but to get the babies out because basically their
Speaker 2: hope would have been to put steroids in to help
Speaker 2: with GN development, to try and grow the lungs a
Speaker 2: little bit faster. So their hope was to try and
Speaker 2: keep those babies in for maybe a day or so extra. Yeah,
Speaker 2: but because you started contracting, you had to go straight
Speaker 2: to theater. I had to go straight to theater.
Speaker 3: Yeah.
Speaker 2: They would have liked another day or two, which would
Speaker 2: have been good because my ov would have been back,
Speaker 2: but it didn't happen, and luckily I was in hospital,
Speaker 2: and luckily we got there quickly because in theater, I
Speaker 2: was already a few centimeters dilated and Raley's feet were
Speaker 2: coming out.
Speaker 1: And can you imagine if you had tried to deliver
Speaker 1: vaginally you would have that would have been really really dangerous.
Speaker 2: Yeah, there's a thing. It's called twin blocking centro and
Speaker 2: it's a really really dangerous and risky procedure where they
Speaker 2: try and deliver. Well, I don't think they do it
Speaker 2: or even attempt it where twin one. So twin one
Speaker 2: is the twin close to your cervix meant to come
Speaker 2: out vaginally first. That's an issue that they can't feed
Speaker 2: first breach because the head can get locked with the
Speaker 2: other twins head anyway. So they don't even attempt that
Speaker 2: at all, and that was never an option and hence
Speaker 2: the cesarean Yeah, that wouldn't have been an option and
Speaker 2: it's very dire outcomes.
Speaker 1: Yeah, okay, so the boys come out and they go
Speaker 1: straight to special care. How big were they They were little?
Speaker 2: So thirty four and four premature. There are about two
Speaker 2: kilos each.
Speaker 1: That's pretty good.
Speaker 2: Yeah, look for their gestation age, it's not bad. I
Speaker 2: think one was just over two killers. One was just
Speaker 2: under two killers, but like literally fifty grams apart, pretty
Speaker 2: equal weight.
Speaker 1: No, that's not. I mean I've heard people with full
Speaker 1: term babies were at two and a half killers, so
Speaker 1: it's not that's not. I know, five hundred gram is
Speaker 1: a lot in the space of a baby, but I
Speaker 1: mean you did an amazing job to keep them in
Speaker 1: that long, and you know they got a little bit
Speaker 1: extra support their special care.
Speaker 2: Yeah, well you think about it, but it's like a
Speaker 2: four kilo baby, yeah, exactly, and the placenta and.
Speaker 1: Yeah, so how long were the boys in special care?
Speaker 2: They were in for nineteen nights? Wow, so five nights
Speaker 2: we were in there with them, and then we had
Speaker 2: to go home, which look is hard obviously living your
Speaker 2: babies at the hospital while you go home, but also
Speaker 2: okay too, because it meant that I could recover and
Speaker 2: I could actually, you know, recover and heal from emecessaria,
Speaker 2: which was major surgery, and I could rest at home
Speaker 2: and be in my own bed and see our son
Speaker 2: and be home and really recover.
Speaker 1: It was your son, like, where are these babies, Mum,
Speaker 1: what's going on?
Speaker 2: I don't think he could put two and two together
Speaker 2: at the time. I think of all the positives, right,
Speaker 2: and I think we came home without them we could
Speaker 2: spend one or one time with him, and he got
Speaker 2: a lot of attention and quality time with us. He
Speaker 2: didn't know any different, and we got used to basically
Speaker 2: caring for three kids, but with a lot of help
Speaker 2: and support while they're in special care.
Speaker 1: And how is life now with your three babies? The
Speaker 1: boys are now just over one?
Speaker 2: It is wild? Yeah, chaos and crazy. It is nuts.
Speaker 2: I swear three kids, it's beautiful. You just leave them
Speaker 2: and they play together. They hold each other's hands, they hug,
Speaker 2: they cuddle. They also you know, rip the hair and
Speaker 2: pull the shirt and whack each other and literally crawling
Speaker 2: over one another for like a toy, and they take
Speaker 2: in stell toys. Again, there's beauty and there's chaos. It
Speaker 2: we get both worlds.
Speaker 1: Okay, I can't let you go before I ask you
Speaker 1: the typical twin questions, which I know that I'm sure
Speaker 1: you get asked all the time. Did you mix them
Speaker 1: up by any point when you first brought them home?
Speaker 2: Oh? Constantly, constantly? Who's who? I still do it?
Speaker 1: You can obviously tell the difference now, I'm sure your
Speaker 1: partner can. Is there anyone that is like still struggling
Speaker 1: like you're in laws or your parents.
Speaker 2: Oh look, most people when they come over, they're just
Speaker 2: still a bit of a check, like, oh, this month's Friday.
Speaker 3: Right.
Speaker 2: Half the time they're right, half the time they're wrong.
Speaker 2: But look fifty so well that's it.
Speaker 1: That's your probability though, isn't it.
Speaker 2: Yeah, yeah, yeah. We do tend to dress like Alex
Speaker 2: in a particular color, generally like blues, and Riley in
Speaker 2: kind of greens or red orange.
Speaker 1: They've got a color Palada, which I love that they do.
Speaker 2: They do.
Speaker 1: Well, Laura, Thank you so much for sharing your story.
Speaker 1: Fascinating to hear about this kind of twin.
Speaker 2: Thank you. Yes, it's a crazy ride and I think
Speaker 2: it's nuts every day, and we are blessed every day. Really,
Speaker 2: it is a gift to have twins, and they're beautiful
Speaker 2: and healthy and well. And Lucas is very lucky boy.
Speaker 2: He gets two brothers. Yeah, two for the price of one.
Speaker 1: Thank you so much for joining us today, Laura, thank
Speaker 1: you so much for having me on the show. Now,
Speaker 1: given today's birth was a very technical one, we wanted
Speaker 1: to bring in our resident expert obstitution and gynecologist, doctor
Speaker 1: Bromin Devine to give us some insights. So what can
Speaker 1: doctor Devine tell us about MCDA twins?
Speaker 3: So MCDA twins are always identical twins. They are the
Speaker 3: identical twins that occur when the split of an embryo
Speaker 3: occurs relatively early in embryo development, so somewhere between about
Speaker 3: day two and day six of post fertilization life, round
Speaker 3: about day three to day five, the embryo starts to
Speaker 3: form its placenter part and its baby part, which is
Speaker 3: known as the inncel mass. And MCDA twins form when
Speaker 3: the inncell mass splits into two, so that you end
Speaker 3: up with two separate babies that are genetically identical, but
Speaker 3: they share a placenta and they share a big membrane
Speaker 3: called the choreon, So they're in one choreonic sack, but
Speaker 3: they're in two separate amniotic sacs because there are two membranes,
Speaker 3: the choreon and the amnion. The amnions the inner membrane,
Speaker 3: and so these twins have two separate inner membranes. They're
Speaker 3: in their own little inner membrane sack. They share a placenter,
Speaker 3: and because they share a placenter, you can get connections
Speaker 3: of blood vessels between the two and that's quite common,
Speaker 3: but with a particular type of blood vessel connection, you
Speaker 3: can get a situation where one twin gives all its
Speaker 3: blood or a lot of its blood across to the
Speaker 3: other twin. What that means is that one poor little
Speaker 3: twin ends up giving all its blood and the other
Speaker 3: twin receives all the blood. So the twin that's the
Speaker 3: giver the donor can end up very small and skinny
Speaker 3: with hardly any amniotic fluid around it, and the recipient twin,
Speaker 3: which is often the sicker twin, ends up with way
Speaker 3: too much blood, way too much amniotic fluid. Its poor
Speaker 3: old kidneys get over profuse and it makes a lot
Speaker 3: of urine, and its poor old heart gets really overloaded
Speaker 3: with fluid and they can go into heart failure. So
Speaker 3: twin twin transfusion occurs about a third of the time
Speaker 3: in monochoreonic twin pregnancies, certainly twin pregnancies, and of those third,
Speaker 3: about half of them are associated with really severe outcomes.
Speaker 3: So it's one of the reasons why we need to
Speaker 3: deliver MCDA twins earlier, but also twins can come earlier
Speaker 3: as well, that people can go into labor earlier with twins,
Speaker 3: they can up to their membranes early and things like that.
Speaker 3: So twin twin transfusion can be quite mild and we
Speaker 3: can just keep an eye on it, or it can
Speaker 3: be very severe and there are things we can do
Speaker 3: to help it. But when we see people come to
Speaker 3: us with MCDA twins, we usually warn them quite early.
Speaker 3: You'll be having a lot of ultrasounds every two weeks.
Speaker 3: We're going to be keeping an eye on these bubs
Speaker 3: and keeping an eye on the fluid difference between them.
Speaker 3: And there are certain very subtile things that we can
Speaker 3: see very early on that give us an indication that
Speaker 3: twin twin transfusion might be developing.
Speaker 1: And is there something to identical twins being more common
Speaker 1: in IVF.
Speaker 3: Interestingly, we have definitely moved away from putting back multiple embryo.
Speaker 3: Sometimes people will come along and say, look, I just
Speaker 3: want to get this all over and done with. Can
Speaker 3: you just put two embryos back from the get go,
Speaker 3: And we're really reluctant to do that because twin pregnancies
Speaker 3: are definitely more complicated. Even if there's two separate sacks,
Speaker 3: two separate percenters. So in general that means non identical twins.
Speaker 3: But even in that situation, you're more likely to go
Speaker 3: into labor prematurely. You're more likely to have one bubby
Speaker 3: grow at a faster rate than the other one. Not
Speaker 3: so the twins are always going to be more complicated.
Speaker 3: Birth can be more complicated. You're more likely to have
Speaker 3: an intervention like a caesar or an instrumental birth. So
Speaker 3: we don't want to increase people's complications. So the movement
Speaker 3: away from putting back two embryos is very well established
Speaker 3: now in Australia, and we almost exclusively put back a
Speaker 3: single embryo where we do IVF, but because we want
Speaker 3: to know that the embryo we put back is a nice,
Speaker 3: hearty embryo. We grow embryos on now till they're five
Speaker 3: days old. Certain circumstances will put them back earlier, but
Speaker 3: generally we'll put them back when the embryos five days
Speaker 3: post fertilization, and embryos at that stage, as I mentioned earlier,
Speaker 3: are starting to form. The percent of heart and the
Speaker 3: inncel mass and the innercell mass in IVF is a
Speaker 3: little bit more likely to split, and that might be
Speaker 3: to do with the fact that we're culturing embryos on.
Speaker 3: It might be to do with the culture media, it
Speaker 3: might be to do with other things that happened. But
Speaker 3: the chance of having monochoreonic twins is increased slightly with IVF,
Speaker 3: So even if we put back a single embryo, there
Speaker 3: is a slightly increased chance with IVF that you're going
Speaker 3: to end up with a twin pregnancy if you did
Speaker 3: have a single embryo put back and you didn't conceive
Speaker 3: a spontaneous pregnancy at the same time, which can happen
Speaker 3: as well. If you did put a single embryo back
Speaker 3: and people come along with twins as long as they
Speaker 3: didn't conceive a natural pregnancy at the same time, those
Speaker 3: are going to be identical twins because a single embryo
Speaker 3: is not going to make non identical Twinssolutely, IVF does
Speaker 3: increase your risk of having monochoryonic twins.
Speaker 1: Diary of a Birth was hosted by me Cassenia Lukitch
Speaker 1: with expert input from Dr Bromwin Divine. If you have
Speaker 1: a birth story, we'd love to hear from you. Details
Speaker 1: are in the show notes. This episode was produced by
Speaker 1: Tina Matalov and myself, Cassanie Lukitch with audio production by
Speaker 1: Leoportos