Russian surgeons saved one twin from another right in the womb. Prenatal life of twins

A few decades ago, scientists could only observe a person's behavior after they were born. However, thanks to the ultrasound method, it became possible to study the fetuses in the womb. Based on the data obtained, scientists have discovered a number of facts that prove the uniqueness of people, even in twin pairs.

Development features

During pregnancy, the intrauterine environment is constantly changing, affecting the development of the fetus. In addition, both the placenta and the amniotic fluid are unevenly distributed among the fetuses, as is the blood flow in the umbilical cord. Weight differences fraternal twins not as dangerous as those of identical ones. If in the first case the difference can be explained by heredity (children are not very similar to each other), then in the second case it is the result of an uneven distribution of intrauterine resources.

With the development of technology, doctors have the opportunity to determine identical twins or fraternal twins in the womb, as well as monochorionic twins (identical with one placenta, but different fetal membranes) or dichorionic (identical with two separate placentas).

Twins can only be observed up to 22 weeks. Later, the doctor can only see certain parts of the body. The fruits begin to react to each other from the 16th week: they intensively begin to push each other, fight for space (although there is plenty of room for them until the 6th month). Future mom already at the end of the 4th month feels their movement. By the 27th week, the twins hear the heartbeat not only of the mother, but also of each other.

If the twins share the same placenta, then there is a greater chance that one will take away nourishment from the other. In the case of two placentas, the fusion of blood vessels between them is possible. It is likely that one fetus will receive more blood than the other. In medicine, this is called the transfusion syndrome, which leads to an increase in the mass of amniotic fluid. Treatment with such a diagnosis is carried out by multiple punctures of the amniotic sac. Despite the unfavorable conditions in the mother's womb, oxygen is primarily supplied to the brain and heart - vital organs.

Character from within

Doctors note that already on ultrasound it is possible to determine differences in temperaments in future babies (both twin and single) by the activity of movements and reactions to each other. Someone strives for communication, someone ignores the co-twin, someone has a routine, someone has irregular states of activity and calmness.

Even before they are born, babies hear sounds, react differently to touch, and have periods of good and bad health. So, stroking the tummy and singing songs to him is very useful.

After the birth of twins on time and without complications, they can easily be placed in different beds. Only a small percentage of twins aspire to each other at birth. Perhaps they are drawn not so much to the co-twin, but most likely to the warmth of his body. And this is clear evidence that even in the womb, the twins already have well-developed skin sensitivity.

Studying the intrauterine life of twins allows us to understand how unique human nature is.

33-year-old American Taylor Muhl felt all her life that she should have had a twin sister. Even as a child, she often asked this question to her parents. Mom was always surprised by such perseverance of her daughter. The girl was born alone. Taylor's mother did not give birth to any twin Taylor, neither dead nor alive. Muehl recalls that in her youth she had a mania for twins. She often played twins in the yard with other children.

In the appearance of the girl there is one small, but interesting feature. The entire right side of her torso from groin to chest is occupied by pink pigmentation - a birthmark. For a long time she was embarrassed by him. On the beach, the girl specially put on closed swimsuit. Her health is also slightly different from the rest.

From the age of fifteen, Taylor often feels constant depression and incomprehensible sadness. Taylor had a special diet, she did less in physical education classes. Mule is more likely than other people to experience fever and nausea, and suffers from severe menstrual pain. An allergic reaction may only show up on one side of her body.

In 2009, while watching TV, Taylor accidentally stumbled upon a documentary. And, as Muhl herself says, she almost fell from her chair in surprise. The film told the story of a girl, with exactly the same symptoms she was experiencing. The heroine of the documentary had a rare disease - chimerism, that is, the presence of genetically heterogeneous cells in the body.

Taylor went to the doctor the next day. Analyzes and medical tests confirmed the girl's assumptions. She had two immune systems. There are two types of blood flowing in her veins. It turned out that even in the womb of her mother, Taylor swallowed her twin.

This explains her strange allergies and colds, which she endured twice as hard as ordinary people. At the moment, about a hundred such diagnoses have been officially recorded in world medical practice.

Having learned the answer to the question that tormented her all her life, Mule became more relaxed about her distinctive appearance. Now she is not shy about wearing a separate swimsuit and even starring in fairly candid photo shoots.

Today we will discuss all the issues of the development of twin pregnancy, the features of the course of pregnancy itself and childbirth. As a pediatrician, I will even say a few words about my observations of the development of twins and pairs of twins after birth in my area.

So, it is customary to call a pregnancy multiple, when two or more fetuses develop. But, since triplets and even more multiple pregnancies are not so common, today we will only talk about twins. If for some of you the problem of triplets is relevant, then I will say that everything is developing in approximately the same way.

Twins vs Twins: What's the difference?

Twins develop when not one egg, but two, matures in a woman's body. These sex cells can develop both in one ovary and in different ones at the same time. Of course, a prerequisite is that both of them will be fertilized by two spermatozoa (of course, different ones).

So it turns out two organisms with different genetic material. They may be of the same or different gender. There is no particular resemblance in their appearance, they are just like brothers and sisters.

Since children develop from different eggs, they may be called fraternal twins. Regarding medical details, I will explain, each of the babies has its own fetal sac, its own placenta.

Twins are called babies developing from one egg fertilized by one sperm, which at a certain time was divided into two parts, and from each part the development of a separate organism began. One egg, one sperm, same genetic material. Thus, twins are always the same sex, have an identical set of genes and the same appearance.

Twins can also have two of their own amniotic sacs and two placentas. Doctors call such twins bichorionic and biamnionic. The earlier the separation of the egg occurs, the greater the likelihood of the formation of a separate placenta and a separate amnion (fetal bladder). So, for example, the above-described variant of twins will turn out if the separation of the egg occurred on the 3rd day from the moment of fertilization.

But more common are twins with one placenta and two separate amniotic sacs (biamnic monochorionic twins). This scenario is possible if the fertilized egg decides to give two lives 3-8 days after meeting with the sperm.

The third version of the development of twins is also common. This is when one amnion and a single placenta are formed (monochorional monoamnionic twins). Usually this option is possible with a fairly late division of the egg - 9-10 days after conception.

Why does multiple pregnancy develop?

Double happiness is not given to everyone to experience. The frequency of twin births in the human population is approximately 1.5%.

The main reasons for the development of twins and, in general, multiple pregnancy are:

• ovarian hyperstimulation by hormones. It is used in medicine as an auxiliary technique for the early conception of a child. Hyperstimulation is indicated for a woman in whom the cause of infertility has been identified, and it consists in a violation of the maturation of female germ cells in the ovary;
• twins are often born after in vitro fertilization. To increase the likelihood of pregnancy during IVF, several embryos are simultaneously fertilized and implanted into the uterus of the expectant mother (in Russia, up to three embryos are possible at once). In the early stages, the death of the embryo may occur, so doctors are counting on the successful fixation of at least one of the implanted embryos.
• Of course, at the request of the parents, the reduction of the embryo is possible if two have taken root. But this is a rather risky step, not to mention a sin. Reduction of the engrafted embryo at the request of the parents after unsuccessful attempts to conceive is infrequent;
• recent withdrawal of oral contraceptives after prolonged ovarian rest also increases the likelihood of multiple oocytes maturing at the same time;
• hereditary factor. Heredity occupies not the last place in this phenomenon. Moreover, this feature is transmitted more along the female line, and more often through a generation. That is, for a woman who has given birth to twins, her granddaughter, and not her daughter, is more likely to give birth to twins. Although not a fact. For example, my mother never had twins in her family. But in the family of the father, having delved into the pedigree, they nevertheless found a case of twins. Few people remembered this case, since only one of the two children survived after giving birth. And the fact that the possibility of multiple pregnancy was passed down the paternal line does not contradict genetic patterns.

Are there early signs of multiple pregnancy?

It is practically impossible for a woman to find out about her multiple pregnancy on her own. More often, pregnant twins note the appearance of early toxicosis. Moreover, a pregnancy test can be with the usual color intensity of the indicator strip. Only at the appointment the doctor can note too big sizes uterus and their inconsistency with the calculated gestational age.

It is not always possible to recognize two embryos on the first ultrasound confirming the fact of pregnancy. But at a gestational age of 8-10 weeks, when it is possible to determine the heartbeat using doplerometry, it is already possible to say with accuracy about the beating of two hearts. And at the obligatory first screening ultrasound, which is carried out up to 12 weeks, the specialist will always notice the development of two babies, since their sizes at this time are no longer tiny.

For more later dates women with twins note more pronounced heartburn, shortness of breath, swelling of the lower extremities. A pregnant woman gains weight more rapidly. Normally, during a multiple pregnancy, a woman can gain 20-22 kg.

After 18-20 weeks, a woman may feel tremors at the same time in different parts belly. And the doctor can feel several large parts, for example, two heads and two butts of babies.

Features of the course of multiple pregnancy

About the earlier appearance and more pronounced toxicosis, I already wrote above. It is understandable that pregnancy with one child puts an enormous burden on all systems and organs of a woman, and with twins, it is even more difficult for the body to withstand the load.

Women with twin pregnancies are more likely to suffer from iron deficiency anemia, since it is incredibly difficult to provide oxygen and iron for the synthesis of red blood cells in the blood of two babies.

During pregnancy with twins, the volume of circulating blood increases. Since the mother's blood has the function of providing nutrients to the fetuses, the blood in the mother's body must circulate more intensively than during a normal pregnancy in order to provide nutrition for two babies.

Fetoplacental insufficiency is a fairly common occurrence during pregnancy with two babies, since two embryos require a more intensive metabolism in the placenta. Because of this, changes in the structure of the placenta inevitably appear, leading to disruption of the blood supply and nutrition of babies.

More often, this malnutrition occurs in one of the babies, which can lead to the fetus freezing on early term. There is another option that is often found - one baby develops more intensively and is born with noticeably more weight than the second.

As a rule, during pregnancy with twins, the size of the placenta is more impressive than during pregnancy with one fetus. That is, it is often partially or completely attached to the baby's path at the time of birth. This phenomenon is called placenta previa. With this development of events, childbirth through the birth canal is contraindicated. Placenta previa is one of the absolute indications for operative delivery.

Since a double burden also falls on the kidneys of pregnant twins, very often edema in such women appears earlier and manifests itself to a greater extent than during pregnancy with one baby.

Excessively enlarged uterus forces to change position internal organs- stomach, intestines, ureters. In this regard, such women have more pronounced heartburn, constipation, and a greater risk of urinary tract diseases during pregnancy.

The expectant mother can hear the movements of the babies already at the 15th - 16th week. Intrauterine development children with both singleton and multiple pregnancy is the same. However, during pregnancy with twins, due to the proximity of the enlarged uterus to the surface of the skin, the woman notices the first movements earlier.

The intensity of fetal movements also differs from their intensity in a more familiar singleton pregnancy. In the later stages, babies push very hard, trying to compete for a more comfortable position in the cramped space of the uterus.

A woman with multiple pregnancy is observed in the antenatal clinic more carefully and examined more often. Until the 30th week, an attendance is prescribed every 10 days, and after the 30th week of pregnancy - once a week.

The condition of the cervix is ​​carefully monitored, since isthmic-cervical insufficiency (prenatal opening of the cervix) due to overdistension of the uterus is a fairly common occurrence in multiple pregnancies.

A woman with twins can receive maternity leave and a disability certificate two weeks earlier than with a singleton pregnancy. That is, at 28 weeks, and not at the prescribed 30 weeks of pregnancy. Payments of benefits after the birth of babies do not differ in terms. But they are charged for each of the kids.

twin pregnancy calendar

Obstetrician-gynecologists count the first week of pregnancy from the first day of the last menstruation, when, in fact, menstruation is still going on and the egg is not fertilized. That is why, with the arrival of a delay in regular menstruation, a woman learns about the existence of pregnancy with a fairly decent period of 3-4 weeks.

We will analyze by week what happens to the kids and mom on different terms pregnancy.

First trimester

• 1-4 weeks

As a rule, a woman does not even suspect that she is pregnant.

After the fusion of the egg and sperm in the fallopian tube, a zygote is formed. This is a single cell, from which a multicellular organism will be formed in the future. If initially there were two eggs, and they are fertilized by two different sperm, then two zygotes are formed, and fraternal twins will develop.

In the process of crushing, the zygote turns into a morula. This is at first 2 cells (one cell split in half), then 4, then successively 8, 16 and 32 cells, arranged in a dense cluster in the form of a raspberry. It is at the morula stage of 32 cells that the proembryo enters the uterine cavity. It can be implanted into the wall of the uterus not immediately, but after 2-3 days.

I will dwell in more detail on the moment when one fertilized egg gives two lives. This happens if, during crushing, the morula at some point suddenly “falls apart” into two parts, and each part begins to develop further independently, forming a separate organism.

If the division of a single fertilized egg occurs in the first three days after meeting with the sperm, twins develop with separate amniotic sacs and separate placentas (second column in the figure).

If this egg division occurs between days 3 and 8 after conception, the twins will have separate amniotic membranes and a shared placenta (third column in the figure).

If the egg decides to separate later than 8 days, but before the 13th day from the moment of fertilization, twins with a single fetal membrane and a single placenta will develop (fourth column in the figure).

Late division of the egg (after 13 days of life) threatens the development of undivided twins (Siamese).

Before implantation, a cavity forms between the cells of the morula, and it turns into a blastocyst - a hollow vesicle filled with liquid contents.

Implantation occurs approximately on the 7th day after conception. At this stage, the process of cell division only progresses. The process of introducing the embryo into the uterine wall can take a couple of days. This is considered the first critical period in the development of pregnancy.

In the second week, the formation of primary and secondary chorionic villi (the future placenta) and the differentiation of the germ layers, which subsequently give all the organs and systems of the baby, take place. This is considered the second critical period in obstetrics.

Up to 14 days, the embryo looks like a vesicle, consisting of three germ layers. From the third week, blood vessels form and grow into the chorionic villi. Due to this, with direct contact of the chorionic villi with the mother's blood, the fetus receives nutrients. Thus, the type of nutrition of the embryo changes to hematotrophic (through the blood).

With the beginning of the third week, all organs are laid down (organogenesis). First, the neural tube, heart and gonads are laid, then the liver, lungs, primary intestine and primary kidney. Starting from the 3rd week, it is possible to determine the fetal heartbeat on ultrasound, if the permission of the apparatus and the qualifications of the doctor allow this.

At the 4th week, the nervous system continues to develop, the rudiment of the brain and spinal cord is formed. At this time, the rudiments of the upper and lower extremities are already visible in the embryo.

Until the end of the 4th week, the embryos will be no larger than 2 cm.

• 5-8 weeks

During this period, organogenesis continues, that is, the formation of organs and body systems of developing children. The structure of all previously laid down organs and systems becomes more complicated. Nerve fibers are formed that connect organs with the central nervous system i.e. the brain and spinal cord. The head of the embryos at this time is disproportionately large.

At the sixth week of pregnancy, the embryos can already bend and straighten the neck, changing the position of the head. Facial features gradually emerge, eyes form, auricles, mouth. A clear difference between the upper and lower extremities emerges, the fingers differ.

At this stage, gender has already been formed, but it is not yet possible to determine the sex. The sexual organs visible on ultrasound have yet to form.

The blood flow in the uterus and placental bed becomes more intense to ensure such intensive growth and development of the embryos.

The eighth week ends the embryonic period of development of babies. At this time, the length of the embryos is usually 4.5-6 cm, weight is about 15-20 g.

• 9-12 weeks

By the ninth week, the babies have everything formed to be called no longer embryos, but fruits. There is a blood type and Rh factor. With the end of the embryonic period, complete differentiation of the brain and spinal cord, central and peripheral nervous system is observed.

The fetuses swallow amniotic fluid. They have a functioning bladder and kidneys. The movements of the fetuses become more diverse - they can cover their faces with their hands, suck their thumbs, move to the sides. The external genitalia are formed. The structure of the placenta becomes more complicated. It begins to perform more and more functions (respiratory, protective, metabolic, hormonal).

At 12 weeks, the length of the babies is approximately 85-90 mm, the babies weigh up to 30 g each.

So the first trimester of pregnancy has come to an end.

What changes await the expectant mother of twins in the first trimester?

The expectant mother of twins in the first trimester may experience an earlier and more pronounced toxicosis, which may also be felt in the second trimester.

The uterus is rapidly increasing in size. By the end of the first trimester, it more often already goes beyond the small pelvis, therefore it puts pressure on adjacent organs and can disrupt their usual work. So, pregnant twins feel frequent urge to urinate already in the first trimester. Constipation is also a frequent (but not mandatory) companion of multiple pregnancy.

In women during this period, the mammary gland actively increases, becomes moderately painful and sensitive. But this sign is typical not only for twin pregnancy, but for any pregnancy.

A woman should visit her doctor once a month. The gynecologist, at his own discretion, can set an individual schedule of visits for you. Up to 12 weeks, women must undergo an ultrasound scan, during which all violations and malformations of babies are excluded.

Second trimester

• 13-16 weeks

The skeletal system of babies is actively developing. The rudiments of the ribs are formed. The bones of the skull become smooth and more dense. You can already observe superficial respiratory movements. It's more like exercising the chest muscles. The digestive system begins to function. There are peristaltic waves of the intestine. The production of bile in the liver of babies begins. Interestingly, it is at this time that taste sensations are formed in babies.

The movements of developing children in the uterus become more and more active. They already have a fairly rich facial expression, but so far it remains involuntary (children frown, smile, open their mouths, perform sucking movements).

The skin of babies is quite thin, blood vessels are clearly visible through it. There is practically no subcutaneous fat. The scalp is gradually covered with the first vellus hair.

The approximate size of 16-week-old babies from the sacrum to the crown is about 12 cm, they weigh about 90 g each.

• 17-20 weeks

Children are actively growing. The growth of the trunk of children at this time prevails over the growth rate of the head.

At the seventeenth week of pregnancy, the size of the babies from the sacrum to the crown is about 14-15 cm, each already weighs about 130-140 g.

Children at this stage of prenatal development already hear and distinguish sounds, react to them with certain movements. With loud sharp sounds, babies move more intensively. Their eyes are still closed, but they already distinguish between light and darkness. On ultrasound, you can observe that the baby, reacting to some external influences, tries to cover his face with his hands, bring his chin to his chest, that is, bend his head.

Twins have been proven to sense each other's presence.

As a rule, women bearing twins hear the first movements of the fetus earlier than usual (16 weeks for nulliparous, 18 weeks for pregnant women again). Since the babies are cramped in the uterus, they are more actively repelled from its walls. At this time, a woman can feel up to ten movements of babies per day. At this time, the blink reflex is formed in babies.

The heartbeat of the fetus can already be clearly heard with a phonendoscope or an obstetric stethoscope. The rudiments of teeth, including permanent ones, are intensively formed. During this period, a cheese-like protective lubricant is also formed on the body of the fetus. Subcutaneous fat is formed.

In the body of babies, immune cells are already being produced. Fetal hemoglobin is gradually replaced by adult hemoglobin.

By the end of the fifth month, the coccygeal-parietal size of babies reaches 21-24 cm, and the weight is already quite decent - 320-340 g.

• 21-24 weeks

During this period, all pregnant women already felt the first movements of their babies. The sleep time of babies gradually decreases, and the time of wakefulness and active movements increases.

There is an active strengthening of bones. The skin is still wrinkled and has many folds, in large folds especially a lot of cheese-like lubricant of the fetus accumulates.

The child actively swallows amniotic fluid containing particles of lubricant, desquamated epithelium, and dark green fetal feces are already accumulating in his intestines. In a normal pregnancy, the emptying of the intestines of babies can occur only after birth.

At this time, the amount of subcutaneous adipose tissue increases, including brown adipose tissue, which will protect babies from hypothermia after birth.

Toddlers are already very good at distinguishing sounds. It is noticeable that for themselves they distinguish sharp, loud, pleasant or unpleasant sounds, react to them in a certain way (by excitement or fading).

By the end of this period, babies reach a height of 26-28 cm, their weight increases to 450-550 g.

• 25-28 weeks

The facial features of the children are becoming more and more clear, they already have eyelashes and eyebrows. The curves of the auricles are gradually formed.

The lungs are actively developing, the so-called air sacs (alveoli) are formed. While they are not yet filled with air, but at the 25th week, a substance such as a surfactant begins to be produced, which will not allow these sacs to subside after birth, when they are filled with air.

Babies actively gain weight by increasing the amount of adipose tissue, muscle growth, growth and strengthening of bones.

During this period, in boys, the testicles begin to descend into the scrotum, and in girls, the genitals continue to form.

By the 28th week, as a rule, the final presentation of the fetus is established, since they are already cramped in the uterus, they cannot roll over from head presentation to pelvic presentation or vice versa.

By this period, the babies are practically formed. When premature birth with proper care, they are already quite capable of surviving.

By the end of this period, the mass of babies is approximately 800-900 g, growth is up to 35 cm.

Changes in the body of the expectant mother of twins in the second trimester of pregnancy

The uterus has already grown enough, the tummy is noticeably rounded. It is already more difficult for a pregnant woman to lead a habitual active lifestyle at this time. But the correct alternation of periods of rest and activity will help to avoid problems with constipation, varicose veins, and swelling.

During this period, the expectant mother Special attention should be given to the diet, namely the sufficient content of protein and calcium in it. It is worth enriching the diet as much as possible with products containing calcium and phosphorus, vitamin D 3 (fish, canned fish, eggs, nuts, hard cheeses, dairy products), since the skeletal system in babies is actively formed. At this time, the future mother may be disturbed by heartburn.

It's time to use a support bandage, since during this period most often a woman still has to work, and back pain and heaviness in her legs are already bothering her. Already the physiologically changing gait (swinging) itself contributes to less back tension and pressure of the uterus on the pelvic bones. But in the case of multiple pregnancy, it is difficult to do without additional support of the bandage.

Often pregnant women complain that it is difficult for them to find a comfortable position during sleep. Experts recommend sleeping on the left side, bending the upper leg at the knee and straightening the lower one. Specially designed pillows for pregnant women are designed to relieve the bones of the pelvis and lower back, to support the already enlarged tummy of a woman.

Actively in the mammary gland, adipose tissue is replaced by glandular tissue. To the touch, the mammary gland has a fine-mesh structure.

The pigmentation of the peripapillary region on the chest, the median line on the abdomen is becoming more and more pronounced. The body may appear dark spots and freckles. This is due to an increase in melanin content in the skin of a pregnant woman.

Before the 22nd week of pregnancy, women undergo a second mandatory (screening) ultrasound. In this study, they may already be told the sex of the babies, if, of course, the position of the twins allows them to consider their gender.

third trimester

• 29-32 weeks

In babies, the brain, the cerebral cortex are actively developing, the number of its convolutions is increasing. The mass of the brain of babies is 25% of the mass of an adult.

Now one of the cerebral hemispheres is already beginning to function more actively, which determines whether the child will be left-handed or right-handed, whether left-hemispheric or right-hemispheric activity will prevail.

The endocrine glands that produce hormones (thyroid and parathyroid glands, pancreas, pituitary gland) are actively working.

Already in the lungs large quantities surfactant builds up and they start test operation.

By the end of this period, the weight of the babies is 1500-1600 g, the length is about 40 cm.

• 33-37 weeks

The skin of babies becomes lighter, as subcutaneous fatty tissue accumulates (about 10-15 g per day). Vellus hair is gradually wiped off. By birth, they can remain on the shoulders and back. There is more and more cheese-like lubricant on the body.

During sleep, the eyes of babies are closed, and during periods of wakefulness, the eyelids are open. The color of the iris of the eyes of all children is the same (deep dark blue) and only after birth can it change. The pupil already reflexively reacts by constriction or expansion to the intensity of the penetrating light.

Pulmonary and digestive system fully formed. The kidneys are fully functional, excrete up to 500 ml of urine per day. Amniotic fluid is updated about eight times a day (every three hours). The bones of the skull are denser, but mobile and pliable, which is so important for the normal passage of the head through the birth canal.

The babies are fully formed and ready to meet their mother. By the end of this period, the weight of babies can vary significantly - from 2200 to 3000 g, height - about 43-46 cm.

Pregnancy at 37 weeks is already considered full-term, and a woman pregnant with twins is being prepared for planned delivery.

Changes in the condition of the mother of twins in the third trimester

Future mothers of twins have the right to finish work early and go on a well-deserved rest. For them, maternity leave starts at 28 weeks. In the third trimester, until the 30th week, gynecologists prescribe a visit to a pregnant woman every 10 days, and after the 30th week of pregnancy - once a week.

During this period, the intensity of the movements of the babies decreases (they are cramped), but the strength of the shocks increases. A greatly enlarged uterus can compress the inferior vena cava in the position of a woman lying on her back. Therefore, in this position, pregnant women often experience weakness, dizziness, and a pre-fainting state appears.

Constipation, incessant heartburn, hemorrhoids are frequent (but again I repeat - not at all necessary!) Companions of the third trimester of multiple pregnancy. During this period, women may notice the first droplets of colostrum from the breast. This is fine. The mother's body is preparing for the birth of babies. The genital tract, the mammary gland are prepared for childbirth and functioning after childbirth, the hormonal background changes.

At 32 weeks, women undergo a third screening ultrasound. Here you can finally see the position of the babies, their presentation, which fetus is closer to the womb. It is possible to assess the state of the placenta, since with the development of twins, it often prematurely shows signs of aging (fast and intense metabolism through the placenta quickly wears it out). This is another reason for earlier delivery of multiple pregnancies.

The future mother of twins is hospitalized in advance in an obstetric hospital. This happens about 3-4 weeks before the expected due date. This is done to finalize the method and term of delivery.

In just the third trimester, a mother of twins can gain up to 6-7 kg. On the recent weeks pregnancy before childbirth, a woman can lose from 500 to 1.5 kg. The body gets rid of excess fluid, the mother's blood thickens, swelling decreases.

Features of childbirth when carrying twins

A woman with twins should be prepared for early hospitalization before delivery. This situation requires more careful monitoring of the pregnant woman in the later stages.

Preterm birth in these women is very common. The reason for this is the overstretching of the muscles of the uterus, which can serve as one of the triggers for the onset of labor. As a rule, if operative delivery of a multiple pregnancy is required, then it is planned for 36-37 weeks.

If there are problems with bearing twins and it is difficult to safely bring intrauterine development to 36-37 weeks, doctors try to maintain and bring the pregnancy to at least the 32nd - 34th week.

During this period of development, children already have surfactant in their lungs. This is a substance that prevents the air sacs of the lungs (alveoli) from collapsing, and the lungs become more or less prepared to perform their function after the birth of babies.

But more often there is a different picture - when one child is in the head, and the other - in breech presentation. It happens less often when one child is located in the head or pelvic, and the other in a transverse presentation.

Natural childbirth with a single placenta of twins is dangerous because at the birth of one of the babies, placental abruption may occur and, accordingly, the nutrition of the other child will be disturbed. In this regard, you still have to resort to an emergency caesarean section in order to save the second baby.

Thus, preliminary hospitalization of a woman with twins 3-4 weeks before the expected date of birth is needed to clarify the obstetric status and additional examination of the future woman in labor, as well as to resolve the issue of the method of delivery. More often the issue is resolved in favor of the planned caesarean section, since the natural birth of twins is much more likely to end in complications for both the fetus and the mother.

My observations on the development of twins and twins after birth

As a pediatrician, watching the development of twins and twins after natural childbirth, I always note that the first born child of twins is larger and stronger for health reasons. It is he who tolerates the period of adaptation after birth more easily.

In children born first, less often transient (borderline) conditions occur after birth (toxic erythema, physiological jaundice, transient neurological disorders: depression or arousal syndrome).

And development in the first year of life, as a rule, shows that the first child of twins develops faster than the second born.

These observations are confirmed by my twins in the family. The twin sister was born larger and earlier than the twin brother by 5 minutes. So, let's say, the brother, like a true gentleman, let the lady go first.

And in life, the sister quickly acquired new skills. She quickly sat down, crawled. She learned to walk much earlier than her brother.

Now I am a mother of two children, the youngest of whom has just learned to walk. It so happened that both of me in different time I had to lead by the hands for a long time before the children themselves went. The little man wants to walk, but his strength is still not enough. So he demands: “Take me, mother, by the hand!” Although there is still a question of who drives whom)) J Rather, the baby drives his mother. He also demands with his hand: “Take me there!”

I asked my mother how she coped with the twins in such a difficult time. It's necessary to drive, keep two. But then nature itself, probably, took care that the twins did not simultaneously enter a new period of development. One is still crawling, the other is learning to walk.

So it is possible to cope with twins, although it is not easy. If, having learned about your double joy, you doubt and are full of fear about the upcoming birth and the future in general, then do not hesitate.

Double happiness is not given to everyone to experience, which means that you are a special person. The time of pregnancy will fly by. The good news is that instead of 18 months pregnant, you will only have 9 months. The result will be two crumbs, your two wonderful little bloods. Double positive emotions and double your difficult happiness await you.

Health and happiness to you and your children!

A practicing pediatrician, twice mother Elena Borisova-Tsarenok told you about the pregnancy with twins.

“Identical or dizygotic? I have heard this question a thousand times. For me it doesn't matter much. But I’m already fed up with questions and would like to finally sort everything out so that I can give a decent answer myself later. ”

What are twins and where do they come from?

First, let's deal with the terms. There are several types of twins, but the most common are monozygotic, or identical, and dizygotic, or fraternal twins. In common parlance, the first are called twins proper, and the second - twins, but in science such designations are not accepted.

Fraternal twins are babies that develop from two different eggs that are fertilized at the same time. They can be of the same or different sexes and differ both in appearance and in the set of genes. There are many thousands of eggs in a woman's body, but only about 500 of them are capable of fertilization. While one of them matures, free hormones prevent the other from fertilizing at the same time. But for some women, this mechanism does not always function. As a result, two eggs can mature at the same time. These women are 10 times more likely to have twins. Thus, the main reason for the birth of fraternal twins is multiple ovulation.

Several factors influence the birth rate of fraternal twins, such as the nationality and age of the mother. Most often, twins are born to black mothers, and least often in Asia. The probability of conceiving twins in women aged 35-37 increases by almost 2 times, and after 37 years it decreases, which is associated with hormonal changes in the female body. In addition, the more children a woman has, the higher her chance of becoming a mother of twins. According to a Swedish study, the first pregnancy is multiple in 1.3% of cases, and the fourth in 2.7%. In Nigeria, the number of twins increases from 2% for the first pregnancy to 7% for the sixth or more pregnancies.

Many parents wonder what role heredity plays in the birth of twins. It depends on the kind of twins. The ability of a woman to simultaneously produce several eggs is hereditary, so the possibility of having twins is passed down in the family from generation to generation. If a woman has a fraternal twin, her chance of becoming a mother of twins is 1 in 58. If a woman's husband has a fraternal twin, the probability of giving birth to this pair of twins is 1 in 116. Therefore, the genetic predisposition of the mother plays a more significant role in the formation of fraternal twins than the genotype father.

Another reason for the appearance of fraternal twins is the mother's treatment for infertility. Ovulation induction medical techniques increase the chance of having twins by 10-40%, depending on the drugs used. Since all these methods stimulate the maturation of the egg, as a result of treatment, not one, but several eggs are released, and when they are fertilized, fraternal twins are formed. Nowadays, most twins are born in women 45-49 years old, who are mostly patients of clinics that treat infertility.

In addition, it has been noted that mothers of twins are usually taller and weigh more than mothers of identical twins.

Here are some more possible factors for the birth of fraternal twins, the effect of which, however, is not so obvious:

Change of seasons. It is believed that the length of daylight hours can affect the production of the hormone gonadotropin. In some countries of the northern hemisphere, where the day length is longer in summer (for example, in northern Finland and northern Japan), fraternal twins are more likely to be born in July.

Nutrition. Malnutrition reduces the chance of having fraternal twins. During economic crises, the number of multiple pregnancies falls. In African countries where there is a large number of twins, some foods (earth potatoes) increase the secretion of gonadotropin.

Environment. According to some data, the high content of toxic substances in water and food inhibits sperm production and reduces the number of multiple pregnancies. On the other hand, in areas with a high content of polychloride hydrocarbons in the environment, fraternal twins are born more often.

Folic acid intake.

Identical twins are obtained when an egg separates into two equal parts shortly after fertilization. Separation of a fertilized egg takes place if the normal developmental processes of the embryo occur late. According to leading scientific hypotheses, this delay is due to impaired conduction of the fallopian tubes, conception shortly after stopping oral contraceptives, and mild trauma to the blastocyst, for example, with certain fertility treatments. The frequency of spontaneous birth of identical twins around the world is approximately the same - 1 out of 250 births. Ovulation induction techniques cause this number to double. Conception of identical twins also becomes more likely depending on the number of blastocysts during artificial insemination.

Identical twins are always the same sex, similar in appearance, they have an identical set of genes, the same blood types, the same hair (color and structure), the same arrangement of teeth, but the fingerprints are barely noticeable, but different. Unlike fraternal twins, identical twins are born equally often in all nationalities and age groups.

Three, four and five twins can be formed from one, two, three or more eggs. For example, triplets might look like this:

Three eggs are fertilized at once.

Of the two eggs: after fertilization, one egg splits, and the second remains in its original state (this is an identical pair of twins and a third twin child).

Less commonly, triple splitting of the egg occurs after fertilization, resulting in identical triplets.

In addition to identical and fraternal twins, there are other types of twins. More about this in Appendix 2.

The development of temperament and features of interaction between twins before and after birth

Myths and facts

The intrauterine life of twins has always been shrouded in numerous myths, legends and beliefs. Their “joint” life during pregnancy is often presented to others as a meaningful and inherently social phenomenon.

One of the first examples of the struggle between twins in the womb is the biblical story of Isaiah and Jacob. We also hear about how twins entertain each other in all sorts of ways and develop complex social relationships among themselves, which, it would seem, only adults are capable of. Such stories are very enduring. Not so long ago, scientists described fights and kisses of children in the womb.

Until recently, studies of human behavior were limited to life after birth - only from that moment it became possible to observe the baby. With the advent of the method in the mid-1970s ultrasound scientists opened a window into the intrauterine world. The ultrasound method is used not only in medical practice. It, although with some limitations, allows the observation and investigation of the spontaneous behavior of the fetus in its natural environment. Research conducted since the late 1970s has made it possible to identify important milestones in the development of intrauterine fetal behavior. The volume of information about the skills and abilities of the fetus is currently quite large and continues to grow. However, to this day, most researchers in many areas of psychology continue to ignore the existence of the intrauterine life of the child, or, conversely, allow lax and far-fetched interpretations of discoveries in this area.

Researchers in the field of prenatal psychology generally bypass twin pregnancies, primarily due to the inability to collect a sufficient number of cases. So do twin researchers. However, the intrauterine activity of the fetus is difficult to deny in any pregnancy, and even more so in pregnancy with twins. The intrauterine environment surrounding the child is by no means static and undergoes constant changes in the course of its development. These changes affect the development of fetal behavior and, in turn, are affected by it. Intrauterine influences are all the more important in multiple pregnancies, because even such obvious components of the intrauterine environment as the placenta, umbilical cord and fetal bladder are rarely shared by twins. But even in such rare cases, they share the placenta among themselves by no means equally, the amniotic fluid is not evenly distributed between them, and the umbilical cord does not carry the same blood streams to them. Differences in weight between fraternal twins can be explained by different heredity - after all, in terms of their genes, they are no more similar to each other than ordinary brothers and sisters. But differences in the weight of newborn identical twins are almost always the result of an uneven distribution of intrauterine resources between them. This unevenness entails many other, sometimes catastrophic consequences.

Until recently, it was possible to determine the zygosity of twins (they are identical or fraternal) in the womb only if the twins were of different sexes. However, recent discoveries in the field of diagnostics make it possible to determine with sufficient accuracy the zygosity of twins even before birth, even in the case of monochorionic pregnancies. Identical twins have different types of placenta attachment depending on the time when the fertilized egg was split. 70% of identical twins have a common placenta and different fetal membranes (they are called monochorionic). The remaining 30% have two placentas and are called dichorionic. Determining the type of placenta attachment is important primarily for doctors. Monochorionic pregnancies are associated with greater risks and therefore are subject to stricter medical supervision. In most developed countries, the diagnosis of the type of placental attachment is no longer something surprising these days. It is powerless only in one case: it is impossible to say about same-sex dichorionic twins whether they are identical or not. Then we'll have to wait, and after they're born, we'll do a blood test from the umbilical cord.

Ultrasound allows you to get a complete picture of the behavior of the fetus only up to 20-22 weeks of pregnancy. At later dates, the equipment allows us to clearly see only certain parts of the body. And yet, what can we learn from an ultrasound of twins in the womb?

Intrauterine life of twins

To understand the characteristics of twins, it is important to study the specifics of their intrauterine development. The uniqueness of the twin relationship originates from the constant neighborhood of children in the womb. Between 16 and 20 weeks of gestation, the twins begin to react to each other through the placental membrane that normally separates them. During the ultrasound, you can see how they push each other. At week 20, the twins, who by this time usually reach 450 grams, often interact with each other and fight for space. Their periods of sleep and wakefulness can either coincide or differ. A pregnant mother can feel the simultaneous movement of eight limbs at once. By the beginning of the 27th week, the twins hear the heartbeat not only of the mother, but also of each other.

Researchers from the Netherlands have assembled a collection of ultrasound images that show different forms"interactions" between twins in the womb. By the end of the seventh week, the fetuses show a reflex response to touch. In the beginning, the reaction is to move from touching the cheek; later, some began to move towards the stimulus. This is in contrast to a singleton pregnancy, where touch can only be elicited by the baby itself and occurs mainly on the face. They observed various forms of "intrauterine communication" in which twins touch each other's arms and legs, as well as their lips.

There is also an amazing study by the Italian psychoanalyst Alessandra Piontelli. She carried out ultrasound observations of the twins at monthly intervals, from the 18th week of pregnancy until delivery. Thereafter, the developmental progress of the twins was assessed weekly during the first year of life and annually during early childhood. The examined twins usually occupied a position on opposite sides of the uterus. Differences in placenta were often found: for example, in the place of attachment and in thickness. The places of attachment of the umbilical cords also varied. Most of the observed twins were separated from each other by a membrane and, therefore, lived in different embryo sacs, each of which formed a unique environment. The difference in these environments leads to differences in movements and tactile sensations in twins. This shows that unique conditions are formed in the uterus for each of the twins.

Twins begin to feel tightness in the womb quite early, but in the first six months of pregnancy they have enough space to move freely. Mothers of twins begin to feel the movement of children earlier (at the end of the 4th month) than others. On the other hand, these jolts are less abrupt - after all, babies do not have enough space for sweeping movements. Many twins develop in separate membranes (only 1% are born in a common membrane), and the amniotic fluid surrounding each of them softens shocks and shocks. Around the thirtieth week of pregnancy, when the twins are growing up, their freedom of movement is limited. They occupy a permanent place in the uterus - in most cases, one on the right, the other on the left. With a triple or quadruple, it becomes crowded even earlier.

Twins share with each other not only a place in the uterus, but also nutrition. First of all, if they have a common placenta, there is a risk that one will “take away” something from the other. But two separate placentas, if they are in close contact with each other, can grow together. Therefore, in any case, the danger is that one twin will live at the expense of the other. In 15% of cases, the blood vessels between the placentas grow together. If at the same time too much blood flows to one of the twins, and too little to the other, this can lead to the death of one of them. This so-called transfusion syndrome leads to an abnormal increase in the mass of amniotic fluid. It is treated with multiple punctures of the amniotic sac.

There are cases when the placenta is located in a part of the uterus that is poorly supplied with blood. Then one of the twins gets less nutrients. Forced fasting during pregnancy can lead to a weight difference between twins, but does not affect fetal development. With a lack of oxygen, the brain and heart of the fetus are supplied with blood in the first place, so these vital organs develop even in adverse conditions.

Dr. Piontelli also noticed differences in temperament among the twin pairs she observed. Each twin has a preferred posture, movements, and repetitive forms of activity. The frequency and forms of body movements of the twins were very individual.

This study also describes the variety of individual reactions of each child to his co-twin. In some twin pairs, the researcher found almost no interaction: for example, when one of the twins made movements, the second did not react to them in any way. On other occasions, she spoke of having " active communication”: if one of the babies made contact, the other responded to him in the same way. Often there was an alternation of active reactions to each other and avoidance of interaction. She notes that in the same pair, one of the twins may actively seek contact, while the other remains neutral or makes only reciprocal movements. Dr. Piontelli also describes the twins' interaction styles, from soft touches on each other's cheeks to more aggressive physical contact (usually when fighting for space). The conclusions made by Dr. Piontelli are as follows: in all examined twin pairs, their own way of interaction is established, which is largely preserved throughout the entire period of pregnancy and early childhood.

Even identical twins always behave differently. From the moment they first start moving, they show marked differences in activity levels. These differences are rapidly growing. Although initially identical twins have more similarities in behavior than fraternal twins, by 20-22 weeks of gestation they become as dissimilar as fraternal twins. In late pregnancy, only approximate studies are possible, but there is reason to believe that these differences also take place here. Observations of children after birth show that these trends persist there, and the twin, who is more active in the womb, remains so. This also applies to the strength of the reaction of the twins to each other, although, as will be shown below, such reactions are not observed at the beginning of pregnancy.

By the nature of the movements, identical and fraternal twins do not differ from each other. Some move their legs more, others move their arms, and so on. If you look at the smaller movements, the similarities that at first glance were found between identical twins now disappear. Each of the twins is more or less active than their counterpart, and these differences persist over time. However, many factors can influence these trends. For example, the movements of a more active twin may become constrained if there is a decrease in amniotic fluid. On the other hand, the relative inactivity of the less active twin disappears with an increase in the amount of amniotic fluid. However, even with the intervention of side factors that accompany twins during their often difficult intrauterine life, differences in behavior between them are an indispensable rule.

The intrauterine environment leaves its mark on the twins, even in terms of their behavior. In the prenatal period, the foundations for the further development of the child are laid and differences between identical twins are formed. These differences are created by intrauterine conditions, individual for each of the twins. Too often, however, what is laid down in the womb is mistakenly considered "constitutional" and due to heredity. Long before birth, babies begin to feel touch, hear sounds, and have periods of good or bad health. Therefore, the habit of many mothers to talk to their unborn children and stroke their belly has a real basis.

A look into the future

In addition to the already existing differences in the behavior of ultrasound, it makes it possible to observe the rudiments of future properties of temperament. The future individual traits of each child can be judged by the characteristic movements of the fetus, preferred postures and favorite activities. However, this should be treated with caution. We can observe only the individuality of the child and the first signs of temperament. Although twins are by and large similar to each other, each of them moves in their own special way and has their own biological rhythms. Some adhere to a clear regimen, while others have states of rest and activity that alternate irregularly. Some move more, some less; one needs more stimulation to cause activity, while the movements of the other are sharper and faster; someone reacts more strongly to their co-twin, etc. These traits continue to appear in the behavior of children after birth. In addition, they are more visible in twins, because there is always the opportunity to compare one child with another.

In addition, ultrasound reveals some of the characteristics of future relationships between twins. Some twins tend to be more intimate, touch more often, or get closer to each other. Others avoid contact, which may indicate irritation or displeasure with communication. These features continue to appear after birth. This, of course, does not mean that twins in the womb can establish complex social relationships. They feel stimulation from their twin, but interpretation of these sensations and endowing them with meaning in the fetus may not occur.

Newborns, even born on time and without complications, do not show any "social" feelings towards the co-twin. For them, it practically does not matter whether they are in the same bed or in different places. Parents are often surprised and disappointed by the episodic or even lack of interaction between newborn twins. Many adults, in an attempt to recreate the closeness of children in the womb and instill a sense of comfort in them, put them in the same bed; this often only results in babies crying continuously because of the tightness. Most twins prefer to lie in different corners of the bed and show dissatisfaction with any stimulation from their twin. Only a few children seek spatial closeness. Moreover, even they first need not a co-twin as such, but the warmth emanating from his body. Perhaps the same happens in the later stages of intrauterine existence.

The desire for interaction and the experience of loss

We are faced with the question: when and at what stage of pregnancy can a fetus yearn for a co-twin in the event of his sudden intrauterine death? So far, we have only testimonies from children and adults reporting their feelings of loss, which they can only explain as a desire to be reunited with their deceased twin. However, in such cases, we cannot determine whether this feeling is due to real memories of intrauterine life or feelings of loneliness that arose after birth.

Dreams of a "double", an ideal partner who can understand us without words, very often visit both children and adults. Mythology and literature are full of references to such doubles, which reflects the universality of the named phenomenon. In addition, it is not difficult to imagine how the shock experienced by parents during intrauterine death of the fetus can be reflected in the surviving twin. Here we need to clarify when and under what circumstances the loss occurred. Much has been written about the so-called “vanishing twin” phenomenon, when an ultrasound scan in the first trimester of pregnancy reveals a healthy fetus and another empty fetal membrane. It is unlikely that such a discovery can be a serious shock for parents. Besides, it's hard to imagine that a leftover fetus could yearn for something it never felt. The "vanishing twin" no longer exists at those stages of pregnancy when interaction between twins could begin.

The mother perceives the later loss of a child in a completely different way - spontaneous or as a result of medical intervention. After the mother has already got used to the idea that she will have twins, such a loss inflicts a deep spiritual wound on her.

Only after the interaction between twins has become an integral feature of their intrauterine existence, can we talk about the sense of loss that the surviving twin can experience. It is the stronger, the older the twins: as the fetuses grow, contacts between them become inevitable. In any case, we must not forget that most twins in the womb are separated by a membrane; therefore, the fetus may “yearn” not for a specific personality, but for more or less strong stimulation from the other twin and for some “animal” feeling of comfort that occurs in all young mammals in the presence of brothers. Although stimulation from the other twin is a very important factor in intrauterine life, we have only some, not very definite, reasons to say that all this leaves a permanent mark on the subconscious of the surviving twin (we will discuss this below). This challenging area requires further research. However, it is clear that for many important questions development of the child, you can find the answer by looking closely and carefully into his intrauterine life.

Experiment in vivo

In addition to all of the above, twins in the womb can tell us some other facts.

The presence of interaction between twins convincingly shows us that the skin sensitivity of the fetus is already well developed. This is indicated by the fact that the fetus obviously responds to light blows and strong jolts from the co-twin.
Ultrasound monitoring of twins is a kind of experiment in vivo, because it allows you to conduct research without interfering with the usual habitat intrauterine fetus. It is impossible to determine the level of development of skin sensitivity of a child during a singleton pregnancy in this way.

The onset of interaction between twins does not coincide with the onset of fetal motor activity at 7–7.5 weeks of gestation, but is usually delayed by several weeks. Until about the 10th week of pregnancy, the twins do not stimulate each other. Between the 10th and 12th weeks, stimulation occurs in monochorionic twins. An earlier start of contact is facilitated by the fact that the twins share a placenta and are separated by a thin membrane. At week 13, the dichorionic twins catch up with them. After the 15th week, interaction between twins becomes an integral feature of all multiple pregnancies.

The interaction between twins means that their intrauterine life proceeds in a completely different way than in one fetus. In addition, the study of the interaction of twins allows us to make another interesting discovery. The fetus does not always respond to stimulation; he has periods of insensitivity. The body moves passively in the amniotic fluid after the push of the co-twin, but the fetus itself does not react to this in any way. This discovery allows us to link the still insufficiently understood cycles of rest and activity of the fetus to the stages of sleep of the child after birth.

Thus, the study of the origins of the behavior of twins allows us first of all to know how differences between twins arise during pregnancy, which will be observed after birth. Each person is individual and is not someone else's copy. Studying twins from the first days of their intrauterine life allows us to understand why we are all unique and unlike creatures.

New data of prenatal psychology

Specialists in prenatal psychology, an interesting new field that studies the human psyche before birth, have collected many stories from children and adults about their memories and experiences in the womb. Psychiatrists, such as Graham Farrant and Stanislav Grof, have a lot of evidence in favor of the existence of a person's memory of events related to the moment of conception and implantation of the zygote in the uterine wall.

Neurologists say that the ability to remember is provided by the myelin sheath of nerve fibers, which is formed only by the time the child begins to learn to speak. However, Canadian psychiatrist Thomas Verney writes that in the sixth month of pregnancy, the level of development of the fetus allows him to perceive, process and recode information.

According to psychologist Arnold Buschheimer, memory is not only the responsibility of the brain, and long-term learning also occurs at the cellular level. Thinking about what a single-celled animal like the amoeba is really capable of, we agree that human germ cells can also have their own memory. Cellular memory has nothing to do with consciousness; it is stored in certain areas of the body and can be accessed throughout life through hypnosis, deep massage, bioenergetic techniques, brain surgery, visualization techniques, rebirthing, holotropic breathing and other approaches.

Despite the understandable skepticism of those who have never witnessed such memories or have not experienced them themselves, there is a lot of evidence in favor of their existence. The correctness of memories of specific events in the intrauterine life of the fetus is often confirmed by family members or doctors' records, and the patient himself experiences a feeling of intuitive but firm confidence that this was so.

Experiences of twins in the womb

The general interest in twins is caused not only by the fact that they are born at the same time, but also by the fact that their conception and intrauterine development takes place in a common space. Therefore, twins can independently report on intrauterine events that have taken place.

Usually, the existence of twins in the womb is experienced as a constant struggle for space. Toward the end of pregnancy, the space of the uterus becomes very cramped even for one child. The serene existence of the baby in the mother's tummy is experienced as cosmic unity, oceanic bliss, and the pressure of the uterus provides the child with the necessary tactile stimulation. According to psychiatrist Stanislav Grof, the presence of a twin disrupts the ideal course of intrauterine life and can give rise to the experience of a “bad womb”, where you are oppressed from all sides. A situation where two or more children compete for the same resources can turn into a life-and-death struggle.

Often the behavior and relationships of twins are associated with their type: for example, it is believed that same-sex twins compete more with each other. However, changes in the fetal environment, fetal position, uterine tension or laxity, and the experience of birth may play as important a role as, if not more important than, the sex of twins.

Jane Greer, a psychotherapist and specialist in twins, often counsels twins who experience conflict between twin attachment and the bond of marriage. One of her clients during hypnotherapy recalled that she was constantly shoved in the uterus, and was pushed out at birth. And suddenly her twin sister called her and said that at the moment she was also undergoing psychotherapy, but in another city. She remembered that she had to fight for a place in the uterus, and in childbirth, force her sister to push out in order to be born after her. Both sisters confirmed that the same situation is repeated in their current life. The sister who was pushed out in labor often suffered from mistreatment by others, and the other sister somehow attracted people who had to be urged on and urged on.

Such intrauterine experiences leave imprints behind them - changes in the nervous tissues that retain memories of the experience. Cells are able to form such imprints long before the development of the cerebral cortex responsible for memory in the usual sense of the word. This is how the foundations of further human behavior are laid, which concerns not only the relationship between twins, but also their interactions with family members and the choice of a life partner.

The Italian psychiatrists Burnaby and Levy describe the case of dizygotic twin brothers, one of whom underwent intrauterine treatment for hydrocephalus (excess fluid in the brain). By the time of birth, the treatment was complete, no effects were observed, and the twins were never talked about. However, by age 7, the healthy twin assumed the role of "doctor" and leader, overprotecting his brother unnecessarily. The second brother clearly rejected the subordinate role assigned to him. After several conversations with psychiatrists, the dominant twin explained that the brother needed to be protected because "he had a headache." These words reflect the presence of memories that have an intrauterine origin.

Psychotherapist Graham Ferrant independently treated monozygotic twin sisters. During therapy, the patient comes into contact with his physical and emotional experiences, as if returning to the earliest periods of his life, when these experiences first arose. Both sisters suffered from gender role confusion, which negatively affected their marriage and independent life. They began to experience similar problems independently of each other, and their experiences in therapy were almost the same. The most striking thing was the coincidence of memories of the moment of their conception. Both recalled how two spermatozoa simultaneously implanted into one egg. Both experienced how the first sperm pushes the opponent out of the egg, merges with it, and then it splits into two parts. The short-term presence of the second, Y-sperm, which determines the male sex of the child, was enough to cause the sisters to mix gender roles. After the end of the course of therapy, one of the sisters returned to her husband, and the second entered into a relationship with another man.

One participant in therapy describes her experience of losing a twin before birth (her mother subsequently had two more sets of twins):

“I expected this to be another therapeutic exercise that I take a nap on. But in the middle, when we needed to feel like balls of cages slowly moving through the pipe, I suddenly felt that I was really there. The stroking touch of the walls of the pipe, the smooth movement in the direction of something ... a feeling of complete security. Security, integrity. But my calmness was very short-lived. Once in the uterus, I split and became two. Some time later (perhaps in a few weeks - this process was out of time), my "other" was gone forever. The image that comes to me as I think about it is of a woman riding off into the darkness with her back to me, and all I see is the rear wheel of a yellow bicycle, like a golden yellow star being swallowed up by the darkness. Since then, my whole being - body and everything else - has plunged into sadness, into a deep, all-encompassing despair that permeates my entire universe. It was everything, it was my life. It was so material. It made me weak."

She goes on to describe the experiences of her own birth and the birth of her child, and the dislike she had all her life for the golden yellow color. However, during pregnancy and after childbirth, she began to decorate clothes, a cradle, postcards, toys with gold stars. She puts it this way: “I believe that soul came back to me in the body of my daughter. When we are seen together, 90% of the time we are told that we should have been born twins.”

Conception, implantation in the uterus and birth for twins are more difficult than for singleborn children. After the first twin is attached to the wall of the uterus, it becomes denser, which makes it difficult for the second to implant into it. Hanspeter Rach, a twin and clinical psychologist from Switzerland, relived his existence in the womb as part of primary therapy. He says that as a second dizygotic twin, he experienced uterine implantation as "one of the most traumatic experiences of my life." His feeling that he could not bear it, that he would have to die, was accompanied by a strong physical sensation - he wanted to scratch a hole in the wall with his nails.

The moment of implantation is not only an important psychological dimension of twinning. Rach suggests that many second twins die due to physiological difficulties with implantation. Geneticist Charles Bukledzh notes that the largest proportion of mortality of embryos, conceived both in vitro and naturally, occurs in the intrauterine period.

Rah says that after implantation, he existed as if in a soft, gentle, warm ocean. However, this world began to change: he felt that his “kingdom” was becoming “limited, even cramped ... the feeling that something outside of him, in the distance, was colliding with him ... sometimes by accident, sometimes in response, like a shadow, like two air balls that easily hit each other. At first he took it for a game and thought how great it would be to get to that shadow, but he could only flounder in the liquid. He describes his state at this stage as "intermediate, having neither beginning nor end." He then describes "something like a wall ... many times I touched it, climbed up and down, but could not find the passage." In an effort to get to the "shadow", he knew that they could never touch: there was always a shell between them that prevented contact.

The disturbances of Raha's original oceanic bliss became more frequent, intense, even violent, and interrupted his sleep. The space was getting smaller, and the pushes and stabs in the back made him feel "insecure and vulnerable." Unable to avoid this, he felt doomed to fight, became more and more embittered and irritated.

He writes: “The presence of my brother scared me more and more. We started fighting more, especially when one of us tried to turn around. They pushed me against the wall, and I fought furiously and resisted as best I could ... My close friend became my enemy and threat. To survive, I also had to attack and push him away.

Since Rach was unable to resolve the situation, he could only suppress his feelings. He hid the pain and irritation under the mask of numbness and indifference.

“Life before birth was pretty creepy for me. Both of us were like fragile snowdrops, but we already had a long history of fighting. Our fight was a matter of life or death. It was like one of us had to die."

As a result, Rach felt compelled throughout his life to compete with his brother in every field. As Rach relived and let go of the memory of the struggle with his brother in the womb, he felt freed from the obsessive desire to surpass him.

Rah as a psychotherapist believes that our conception determines how we are born. In his case, memories of the struggle for survival, for penetration into the egg at conception, were further intensified by experiences during implantation in the uterine wall and at birth. Such memory imprints lead to the formation of certain behaviors in later life that reproduce the initial experience.

Existing in the same womb with a friend or rival often causes conflicting feelings. One twin said: “I remember that sometimes I had the opportunity to move to get more space in the uterus. But I hid my joy about it. I didn't want Claire to know about this, because if I have more space, then she has less space.

Experiencing early loss of a twin

The death of a co-twin in childbirth or shortly thereafter greatly affects the surviving child, who may take on a heavy burden of guilt. With fetal death or stillbirth, the surviving twin feels even more intimately involved in what is happening and often feels directly responsible for the loss of a co-twin. The earlier the loss occurred, the deeper the imprint left by it.

Christopher Millar, an Australian physician and family therapist, believes that many famous writers and artists act like surviving twins in their work. Examples include Edgar Allan Poe's Oval Portrait, Dostoyevsky's novels, Lewis Carroll's Alice Through the Looking-Glass, Oscar Wilde's The Picture of Dorian Gray, Leonardo da Vinci's Mona Lisa, Paul McCartney's song "Yesterday", Shakespeare's "Twelfth Night" and "Dark Lady" from his sonnets.

Millar concludes that "the urge to create in such people originates from the experience of losing part of their "I". By their creativity, they provide themselves with immortality, a guarantee that some part of them will live after death. Every act of creation is an attempt to recreate their first creation – a copy of themselves.”

Millar believes that in each of these examples, the deceased twin was monozygous, but female. This situation occurs with a genetic disorder called Turner syndrome, which can lead to miscarriage. Millar believes that confusion about the self, caused by the death of a monozygotic twin in utero, can lead to autoimmune diseases. He also believes that the disturbed gender identity of homosexuals and transsexuals may be the result of the death of the second member of an identical, heterosexual couple. That is, the loss of the second "I" of the opposite sex leads to confusion of gender roles. Another of Millar's ideas is that the loss of a monozygotic twin can cause schizophrenia, "the blurring of the self," in which the distinction between what is "me" and what is not "me" is blurred.

Physician George Engel, describing his close relationship with a monozygotic twin, speaks of "the blurring of the boundaries of "I", in which you never know exactly who is who" and admits that in his dreams he constantly confuses himself and his brother.

"Not remembering kinship"

People who have no idea that they had a twin sometimes discover this fact in the process of psychotherapy.

Some singleborn children and their mothers constantly experience an unconscious feeling of incompleteness, some kind of irreparable loss. One woman puts it this way: “Ever since I was a child, I have felt very lonely. I couldn't handle it and didn't understand why I felt this way. Even as an adult, I continued to feel this longing. And just when I was preparing for the birth of my first child, my mother told me that I had a twin who died at birth.

Love for mirrors and reflections, facial asymmetry, left-handedness, stuttering, and malformations are more common among twins, and may lead single-born adults to believe that they once shared the womb with another person.

Graham Ferrant believes that missing twin syndrome can lead to impaired mental functioning. He describes one patient who, unaware of her "twin past", bought all the articles of clothing in double quantities, and another who bought a double house, the other half of which was empty. Mothers of surviving twins describe oddities in their children's behavior, such as talking to an imaginary companion, having dreams about a twin, or setting a dinner table for a non-existent twin.

Mary-Ellen O'Hara, a psychotherapist in San Diego, has no children but has had three miscarriages. All her life she has experienced a feeling of "longing for someone", and often dreamed that she was standing in the fog against a long wall, "as if made of plastic", which separates her from another person. She recalls that she tried to get over her, trying to hug and save the other. As a child, she often asked her mother if she had a brother; although she already had three brothers, she was looking for another, lost forever. Six months before Mary Ellen's conception and six months after her birth, her mother suffered miscarriages. Between 4 and 5 months of Mary Ellen's pregnancy, the mother had bleeding and labor pains. Mother never discussed these events with Mary Ellen, who, to her surprise, was able to accurately describe them later. The mother recalls that Mary-Ellen began telling her her recurring dream from the age of 4, and also that as a child, her daughter liked to play with a sheet of plastic, resting her forehead on it and shouting something. She also gazed fascinated through glass, especially frosted glass, or any shiny translucent material.

During therapy, Mary-Ellen experienced "strange sensations", as if the left and right sides of her body felt differently - one side was cold, the other was warm. In one of the sessions, she experienced the formation of her fetal bladder: “I see how such a balloon, I feel how it comes out of the middle of my body and surrounds me with every breath, like a parachute or a sail. Finally, I turned into them, like a larva in a cocoon. Both in her recurring dream and in her therapy experiences, she felt "a strong urge to connect with another person." She knew that he was a male, and she was seized with deep sadness when she felt his death. Experiencing his departure meant not only that she would henceforth be on her own, but also "the loss of the most important and deepest connection with the male part of me." Later, she realized how difficult it was for her throughout her life to accept her "male" qualities - self-confidence and career aspirations.

Mary-Ellen's contact with her intrauterine experiences allowed her to accept her sense of loss and realize that it was impossible to "find" her twin. The dreams eventually stopped. She admitted that for her "it was a turning point - not to devote yourself to finding, but to fully live your own life and enter into healthy, stable relationships with men without the fear of being abandoned."

Joan Woodward notes that parents who lose their twin as children begin to worry about their own children when they reach the same age. She describes a 40-year-old man who suddenly fell ill when his daughter had reached the age at which his monozygotic twin died in an accident.

The data of perinatal psychology can be put at the service of mother and children. For example, there are mothers who, having already agreed on an abortion, decide at the last moment to continue the pregnancy. They are interested in whether this fact has any effect on their unborn child or children. By the way, in some cases, the turning point is the news that the pregnancy is multiple. The mothers decide two babies are something special and cancel the appointment.

As David Chamberlain says, “A confession from the heart is an exciting story for your child. Honest disclosure of your inner life is an alchemical flask in which negative feelings are melted into positive ones.” Such mothers are encouraged to explain their feelings to the unborn children and ask them for patience while the mother adjusts to the continuation of the pregnancy. Similarly, any negative situation should be explained to toddlers, emphasizing that they are not the cause of an accident, divorce, job loss, death of a relative, or any other event that causes anxiety to the mother. Any situation can be corrected; The first step to this is open recognition.

How to create optimal conditions for intrauterine development of twins

Ideally, any child, including twins, should be wanted and planned. There are mothers of twins who, even before conception, dreamed that the egg would split, or asked God for double fertilization. Some mothers who have lost twins or one child from a couple subsequently had twins again. During sexual intercourse, both parents should have an equally strong idea of ​​what kind of child or children they want to have. Conceive your babies consciously using meditation and visualization techniques.

From the very beginning, visualize your children clearly. If conception happened unintentionally, start communicating with them as soon as you have a multiple pregnancy. Be open to any dreams, images, premonitions, and other manifestations of intuition.

Take care of optimal nutrition, physical activity, create a good atmosphere in the family. It is very important to have frank communication between partners both before conception, and during pregnancy and after childbirth.

Get to know your family history, especially related to twins. Try not to coincide with the anniversaries of miscarriages and stillbirths in your family.

Maintain the image of a soft, relaxed womb that can stretch out enough for each child to sit comfortably and turn around in it. Place your hands on your stomach often and reassure your little ones that you have enough space, oxygen, food, love and attention for them. Find out how they are located in your stomach. At each visit to the doctor, ask him to mark the location of each child on your stomach. When you feel that one of the children is pushing, tell the second that nothing threatens him, breathe calmly and imagine that with each exhalation your uterus relaxes more and more.

Start cultivating an idea of ​​the individuality of each of the twins. The widespread availability of ultrasound allows parents to know their sex, type of placentation and, possibly, zygosity long before the birth of their children. Use this information to love each child as a unique individual.

Be optimistic that you will be able to carry twins to term - no matter how many you have. Be proud of the strength and wisdom of your body, able to bear so many babies. We create our own body; a person's life is the life of his body. One can learn to voluntarily control the flow of blood to certain organs, pulse rate, blood pressure and other physiological functions. Reflect and verbalize your ideas daily about the optimal conditions for the mental, physical, emotional and spiritual development twins. Imagine that you are able to fully meet all the needs of your children in terms of space, food and love. Concentrate on the most valuable traits of your character and the character of your partner that you would like to pass on to children.

Express your anxieties, fears and worries. Anxiety and fear can become self-fulfilling prophecies and lead to unnecessary embarrassment. Each woman approaches pregnancy and childbirth with her baggage of opinions, fears and prejudices, and it is with their revision that her personal growth occurs. Allow yourself to experience the fear and express it. Feelings should be expressed and explored, not suppressed. Future mothers of twins recommended for bed rest can improve their health simply by asking their body what it is trying to express through symptoms of distress (usually just what the mind seeks to suppress). Doctors often try to treat symptoms without understanding their causes, and thus ignore the psychological aspects of the disease.

Keep a journal. The habit of writing down your thoughts and feelings will help you fall in love with the twins both together and separately. In addition, in a few years it will be interesting for them to read the description of their intrauterine existence.

If you have complications in childbirth and need medical attention, briefly describe what is happening to your unborn or newborn children. They are able to understand you; it turned out that a few years later, children can literally repeat the conversations in the ward that were conducted at the time of their birth.

11. Thank the little ones: they are your teachers and mentors. After all, they chose you as parents, no matter how consciously you chose them.

"Me or WE: HOW TO GROW TWINS", S. Malykh and A. Siburina

In contact with

No one needs to be explained that twins are children born from the same mother and as a result of the same birth. Twins develop during one pregnancy and are almost always born at the same time.

Twins are monozygotic and dizygotic (in our concept, identical and multi-egg). The first are obtained from one zygote when one egg is fertilized by one sperm. The development of identical twins is almost the same: they are of the same sex, often have identical portrait resemblances, as well as similarities in characters and habits. A quarter of these twins are mirrored (one may be left-handed, the other right-handed). One may have a mole on the left side and another on the right. Even the heart can be on different sides.

Identical - one egg, multi-egg - two eggs fertilized by two spermatozoa (and not necessarily during one intercourse). They are not identical in appearance, but simply look like brothers or sisters.

Features of the development of twins

Twins are often born prematurely. It's just that two or more fetuses have a greater total weight and stretch the uterus more than the largest baby. The twins themselves have the right to weigh differently and differ in size.

The smallest requires more attention and care, as it is weaker, which is why there is a risk of death, if not at the peak of pregnancy, then in the first year of life. Over time, the little one catches up with the large twin, but up to a year old, the differences are still clearly visible. By about seven years old, the twins become the same in size, only the one who was larger has a more developed fine motor skills and coordination of movements. Differences begin to appear even in the womb, namely at the 8th month of pregnancy.

Twins have features in the development of both physical and neuropsychic. They may lag behind their peers: later start walking, talking. Parents experience difficulties at first, and this is not surprising. The main thing is to distribute responsibilities correctly and wisely, caring for twins.

Development of twins in the womb

What can be said about the development of twins in the womb in the early stages of pregnancy? For a period of 1-2 months, each embryo will weigh up to 5 grams, and the sprout - 2.5-3 cm. Paternal genes lay down organs that begin their development.

In the next third month, the twins triple in size. By the end of the month, they become more and more human-like: the heart, limbs, genitals are formed, the intestines are lengthened and twisted. The first manifestations of sucking and swallowing reflexes begin.

The development of twins in the womb for a period of 3-4 months transfers them from embryos to the stage of fetuses. With a good angle, the doctor can already determine the sex of the babies. The body length of one reaches 17 cm, and the weight is 200 g. If the mother is not giving birth for the first time, then she can feel the movements of the twins, who can already coordinate movements, find their own mouth and suck their fingers.

By five months, each twin looks like real baby, only tiny (25cm/300g). From this point on, the most developing organ is the brain. Now your conversations with the tummy will be heard - the children begin to respond to sounds.

Six months - the body is covered with hairs, eyebrows and eyelashes are formed, the nose is finally formed. Fat accumulates under wrinkled skin and it will soon smooth out. Twin dimensions: 600-700 g, 30 cm.

6-7 months and everything is still the same. Greater height (35-40 cm / 1000-1500 g). More hair and more fat. The skeleton is constructed, but the bones are still soft and flexible. Survival increases from 6.5 months and there is no need to worry about prematurity.

The intrauterine development of twins is coming to an end. At the eighth month of pregnancy (36 weeks), mostly twins are born. Such a child weighs 2500 g and has a body length of 45 cm. Modern medicine will do everything to save the twins and give them a ticket to our world.

The ninth month, which is also the final one, means that the time has come. It's doubly tight inside, there's no room, so they can't move. Babies are already quite full-term, although they can differ significantly from loners, whose parameters are on average 3.7 kg / 55 cm.

Development of twins by month

Hooray! The birth was successful, so it's time to talk about the development of twins up to a year. You can read how boys and girls develop by months here and here.

You are at home, busy getting to know the kids, taking care of them, feeding them. And they, in turn, begin persistent development. Feelings develop, so that soon the twins will recognize you. They feel each other, and your voice and smell will soon become familiar.

At the age of two months, twins are able to recognize relatives, each other, and in general those who often contact them. They will often cry in a duet, because one is not interested. Twins develop like normal children, just two, three or more of them. By 2 months they may be trying to hold their head up. Babies should develop synchronously, and if not, then consult a doctor, do not be shy. Record any violations found in your notebook. You can start doing gymnastics with massage.

At 4 months, twins need an eye and an eye. Already now or soon they (or someone alone) will learn to roll over from their back to their tummy. And in general, kids become faster, so you should never leave them unattended! If you need to go out for a second, it would be good to put them on the floor or in the crib, otherwise you can fall from another surface (sofa, table).

At about six months of age, twins can be planted. You can sit them on your lap, carry them in your arms, which they really like. The horizon is expanding, many new things are visible. Yes, and they can have fun alone. Now they have a mode that gives parents more personal time.

Further more interesting. Like all children, twins begin to crawl before they can walk. They learn this at about 8 months. To crawl means to move. And to move for a cub means to do something unpleasant for the parents. Very soon, the twins will be standing, and by the age of one they will take their first steps. Here you will not envy the parents of the twins, because when the children run, they will definitely go in different directions.