Twin Pregnancy Third Trimester Update – Giving Birth During Covid 19, Birth Plan Changes, and Preterm Labor (Weeks 29-25)

As I am writing this I am 35 weeks and one day pregnant and I thought it was a good time to write this post as I don’t have much time left! 37 weeks is considered full term for a twin pregnancy, and over 50% of twins are born at 36 weeks or before so we are definitely coming to the end here!

Overall, the third trimester has had a lot of ups and downs both physically and emotionally. Currently, we are in the middle of the coronavirus crisis as is the rest of the world. Although Tokyo is not in a complete lockdown like many countries, we are experiencing much stricter rules in hospitals here which is affecting my birth plan. As of writing this, birthing mothers in Japan are being denied a support person during labor, delivery, and recovery at many hospitals, including mine. Throughout my pregnancy, I had been preparing for an unmedicated vaginal delivery of my twins and my birth plan greatly relied on the support of my husband and doula. Finding out that I would not be allowed anyone in labor, delivery, or recovery with me was a huge shock as you can probably imagine.

Since this policy change, I have had to face the cruel reality that I will be denied my right to a support person and be giving birth alone. Because of this, I have decided to change my birth plan. The two most important things to me regarding the birth of my twins is to simply get in and out of the hospital with all three of us healthy and to be able to breastfeed exclusively since we are in a global pandemic. Currently, I am scheduled for a planned c-section on May 1st (I will be 37+2 then) with the doctor who delivered my first son and has been with me throughout this pregnancy. If I go into labor naturally prior to this date, I will decide at that time if I will continue to go for a vaginal delivery or opt for a c-section, also with the same incredible doctor. It’s very frustrating to have been put in this situation, particularly since my twins and I have been healthy throughout this pregnancy and they are in an optimal position for vaginal birth. I have had to let go of my ideal birth given the circumstances and am trying to make the decision that is the least stressful for everyone involved. I feel lucky to have such a caring OB who I have known now for multiple years. I know that I will be in good hands.

Physical Symptoms

I can’t complain too much about my physical state as I know many twin moms have had it much worse, but I haven’t felt my best during this trimester. I have had hip and pelvic pain on and off but had a flare up around 30 weeks. I was also experiencing some rib pain on one side and ended up going to the chiropractor for an adjustment. Luckily, it all seemed to resolve itself over time and I haven’t had much pain since then. I think it is also due to the fact that we have been in voluntary quarantine for quite a number of weeks now and my activity has slowed, giving my body a chance to rest. Prior to this I was still fairly active, taking my son to preschool and attending meetings, but things have slowed down for good reason now.

Near 35 weeks I started to get some mild swelling in my ankles and feet, but so far it is nothing concerning.

tiredness + Sleep

From about 33 weeks I have been much more tired than I was previously. I have been taking a ~30 minute nap nearly every day when my son takes his (and sometimes more if my husband is home!) and it is surprisingly not impacting my nighttime sleep. Since the second trimester, I have been quite wakeful at night and sometimes suffered from insomnia. Although the insomnia phase has passed now, I still wake up roughly every two hours during the night to pee (practice for having a baby!) and sometimes find it hard to go back to sleep. I have found that taking a magnesium supplement before bed has helped my restless legs though! When I wake up between midnight and 2AM, I tend to have to get up and stretch a bit or eat a snack before I can fall back asleep. I primarily sleep on my left side, as is recommended, with multiple pillows for support.

Food Cravings

I can’t say I have had that many cravings during this pregnancy, but for some reason a couple have developed in the third trimester! The main one is carrots! Specifically raw carrots! I eat a raw carrot basically every day (not usually more though ha!). When I looked up the craving I noticed it could be a sign of iron deficiency. I mentioned it to my doctor but she wasn’t worried. I also am finding myself drawn to eating white chocolate quite a lot as well!

In general though I am definitely eating more than I normally would. Hopefully that means we will have some nice big babies!

Preterm labor

Preterm labor is a concern in any multiple pregnancy. Preterm for twins is usually considered to be going into labor before 36 weeks. I am working really hard to try to stay relaxed and make it to 36 weeks because that is also the age cut-off for babies to go to the NICU. Another change due to coronavirus at my hospital is that they are limiting visiting hours for parents of NICU babies. Mothers who are currently checked in to the hospital would have 24/7 access to their babies but once discharged, they could only visit for one hour per day. This is devastating news for anyone, but especially if you plan to breastfeed since physical contact is so important for milk production. I am hoping to avoid this situation at all costs so I have been putting myself on modified bed rest (basically not doing anything too physically stressful) for about a week and will continue until at least 36 weeks.

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Just a couple more weeks left before our babies arrive! The situation isn’t ideal but we couldn’t be more excited to meet them. How is your third trimester going?