You're listening to Amma Mia podcast. Mamma Mia acknowledges the traditional owners of land and waters that this podcast is recorded on. We pay our respects to elders past, present and emerging, and feel privileged to continue the sharing of birth stories and knowledge that has been a fundamental part of Indigenous culture.

You're listening to Amma Mia podcast. Mamma Mia acknowledges the traditional owners of land and waters that this podcast is recorded on. We pay our respects to elders past, present and emerging, and feel privileged to continue the sharing of birth stories and knowledge that has been a fundamental part of Indigenous culture.

Hi.

Hi.

I'm Cassania Lucid and this is Diary of a birth. I'm fascinated by identical twins. One embryo splits to create a perfect copy, two babies genetically the same, but with their own identities and personalities. Occurring in roughly one in two hundred and fifty berths in Australia. They're relatively rare, but let's be real. Any parent of multiples will tell you how challenging it is. The nappies, the feeding, and let's not forget the actual pregnancy. After undergoing IVF with their first baby, Today's mum was left with one viable embryo, and when it came time to add to their family two years later, she and her partner had one last shot. Fortunately for them, the embryo took they weren't expecting was a high risk pregnancy with identical twins so let's meet today's mum.

I'm Cassania Lucid and this is Diary of a birth. I'm fascinated by identical twins. One embryo splits to create a perfect copy, two babies genetically the same, but with their own identities and personalities. Occurring in roughly one in two hundred and fifty berths in Australia. They're relatively rare, but let's be real. Any parent of multiples will tell you how challenging it is. The nappies, the feeding, and let's not forget the actual pregnancy. After undergoing IVF with their first baby, Today's mum was left with one viable embryo, and when it came time to add to their family two years later, she and her partner had one last shot. Fortunately for them, the embryo took they weren't expecting was a high risk pregnancy with identical twins so let's meet today's mum.

Hello, my name is Laura and this is the diary of my birth with Alex and Riley.

Hello, my name is Laura and this is the diary of my birth with Alex and Riley.

So, Laura, can you tell us a little bit about your life before you fell pregnant with your twins?

So, Laura, can you tell us a little bit about your life before you fell pregnant with your twins?

Life was pretty busy and I guess interesting. My husband and I were both working, working full time. There was lots of travel, lots of holidays, lots of fun times, lots of going out and eating out. Yeah, we were also renovating our house, planning and starting to renovate, meeting with the architects, the builders, and yeah, life was busy, just traveling. I work in Melbourne, but traveled to Sydney quite a bit and we were able to get to Greece of what where my husband's family is from. And yeah, it was good. We had time. We had a lot of time for four kids.

Life was pretty busy and I guess interesting. My husband and I were both working, working full time. There was lots of travel, lots of holidays, lots of fun times, lots of going out and eating out. Yeah, we were also renovating our house, planning and starting to renovate, meeting with the architects, the builders, and yeah, life was busy, just traveling. I work in Melbourne, but traveled to Sydney quite a bit and we were able to get to Greece of what where my husband's family is from. And yeah, it was good. We had time. We had a lot of time for four kids.

You had a baby before you fell pregnant with the twins. Now I know that you went through IVF with both of your babies. Can you tell us a little bit about that process of falling pregnant with your first.

You had a baby before you fell pregnant with the twins. Now I know that you went through IVF with both of your babies. Can you tell us a little bit about that process of falling pregnant with your first.

My husband and I I guess we decided, you know, we wanted a family, we wanted kids. We tried for a little bit, and I naturally didn't get anywhere. I was son to get really impatient. I was still fairly young at the time, but you know, I wanted things done kind of now. We decided to embark on IVF. Actually, before IVF, we did a few cycles of a varying induction, which didn't work after two rounds, and went straight to IVF. So, you know, did the hormones, did the injections, the egg collection, which was a huge process. And this was in the middle of COVID winter lockdowns, so not a fun time. Yeah, it was really really tough. To be honest, The injections not nice and I'm not very good at them. My husband actually couldn't be in the same room when I was doing them. Injection after injection after injection into a collection of which I don't know if this is a good number or bad number, but I was fortunately, I guess to get nine eggs collected in the end, and.

My husband and I I guess we decided, you know, we wanted a family, we wanted kids. We tried for a little bit, and I naturally didn't get anywhere. I was son to get really impatient. I was still fairly young at the time, but you know, I wanted things done kind of now. We decided to embark on IVF. Actually, before IVF, we did a few cycles of a varying induction, which didn't work after two rounds, and went straight to IVF. So, you know, did the hormones, did the injections, the egg collection, which was a huge process. And this was in the middle of COVID winter lockdowns, so not a fun time. Yeah, it was really really tough. To be honest, The injections not nice and I'm not very good at them. My husband actually couldn't be in the same room when I was doing them. Injection after injection after injection into a collection of which I don't know if this is a good number or bad number, but I was fortunately, I guess to get nine eggs collected in the end, and.

All those nine eggs you got how many embryos.

All those nine eggs you got how many embryos.

Out of the nine every day kind of dropped off, dropped off, dropped off down to two embrus that were I guess day five blastsicists that were ready and appropriate to be implanted.

Out of the nine every day kind of dropped off, dropped off, dropped off down to two embrus that were I guess day five blastsicists that were ready and appropriate to be implanted.

Yeah, and you got really fortunate with your first and you feel pregnant with him straight away?

Yeah, and you got really fortunate with your first and you feel pregnant with him straight away?

Yes, yes, very fortunate the first round. What and we got beautiful Lucas.

Yes, yes, very fortunate the first round. What and we got beautiful Lucas.

So Lucas comes along and you know you're ready to try again and you've got your one embryo left. So what was going through your mind when you were ready to implant that embryo?

So Lucas comes along and you know you're ready to try again and you've got your one embryo left. So what was going through your mind when you were ready to implant that embryo?

Gosh, it was full on. So look, yeah, as you say, we had one embry left, it had been frozen for two years. There was a lot of hope and a lot kind of writing on that final one emberor I really didn't want to go through IVF again, the whole hormones and egg collection. I also got a very hyperstimulation and ended up in the emergency warard for a night. And yeah, it was one embror and one final one and all our hopes and dreams we kind of resting on this one embrew that had been frozen for two years, and we're just hoping that one worked.

Gosh, it was full on. So look, yeah, as you say, we had one embry left, it had been frozen for two years. There was a lot of hope and a lot kind of writing on that final one emberor I really didn't want to go through IVF again, the whole hormones and egg collection. I also got a very hyperstimulation and ended up in the emergency warard for a night. And yeah, it was one embror and one final one and all our hopes and dreams we kind of resting on this one embrew that had been frozen for two years, and we're just hoping that one worked.

You had your transfer, you went home. Now, for those who haven't been through IVF, when you get an egg transfer, you're not guaranteed to be pregnant. There's about a ten day window that you have to wait, and then they do a blood test and they can tell you if you're pregnant or not, and it is the most excruciating. Wait, yeah, how did you feel going into that blood test, because I know that you waited, which a lot of women don't wait.

You had your transfer, you went home. Now, for those who haven't been through IVF, when you get an egg transfer, you're not guaranteed to be pregnant. There's about a ten day window that you have to wait, and then they do a blood test and they can tell you if you're pregnant or not, and it is the most excruciating. Wait, yeah, how did you feel going into that blood test, because I know that you waited, which a lot of women don't wait.

It's a waiting game, right, It's like at the end of your pregnancy, when you're waiting for baby to come. It's a waiting game. Between that implantation and the blood test, it's a waiting game. And then from that blood test to the phone call, it's it's huge. What probably helped was I went on holidays, So after the implantation, I went on holidays, just up to write for a few days with my husband and son. I also got acupuncture, which has shown to support and help that implantation. And I just waited, and I tried to be really patient. I got the blood test and then just waited from the phone call from the fertility clinic.

It's a waiting game, right, It's like at the end of your pregnancy, when you're waiting for baby to come. It's a waiting game. Between that implantation and the blood test, it's a waiting game. And then from that blood test to the phone call, it's it's huge. What probably helped was I went on holidays, So after the implantation, I went on holidays, just up to write for a few days with my husband and son. I also got acupuncture, which has shown to support and help that implantation. And I just waited, and I tried to be really patient. I got the blood test and then just waited from the phone call from the fertility clinic.

What was that phone call?

What was that phone call?

Like tears of happiness and joy. I still remember it. And I remember getting the phone call first with Lucas exactly where we were, exactly the time, and exactly feeling of just you know, hope and want and longing and this real, like I don't know, it's somewhat desperate feeling that you just so want this baby and so want this child, and relief, complete relief just washed over me because they call you and you know the call is coming, and you know you know they're going to either tell you the best news or the worst news. And both times they were very quick and just said straight away, congratulations, you're pregnant.

Like tears of happiness and joy. I still remember it. And I remember getting the phone call first with Lucas exactly where we were, exactly the time, and exactly feeling of just you know, hope and want and longing and this real, like I don't know, it's somewhat desperate feeling that you just so want this baby and so want this child, and relief, complete relief just washed over me because they call you and you know the call is coming, and you know you know they're going to either tell you the best news or the worst news. And both times they were very quick and just said straight away, congratulations, you're pregnant.

Did you go for a dating scan?

Did you go for a dating scan?

If you went through, We did go for a dating scan. I think about week seven. I remember calling up my obstetrician at the time and said, oh, look, I'm pregnant. I'd love to come in and see my ob and they're like, oh, no, no, you're earlier to ORR. You know week seven, you know, come back in a few more weeks, come back at week ten. And I said, oh no, no, I really want to go, like I just want to make sure that it's a viable pregnancy and it's healthy and safe. And they're like, okay, sure, never always come in. And so I in at that week seven for that first dating scan.

If you went through, We did go for a dating scan. I think about week seven. I remember calling up my obstetrician at the time and said, oh, look, I'm pregnant. I'd love to come in and see my ob and they're like, oh, no, no, you're earlier to ORR. You know week seven, you know, come back in a few more weeks, come back at week ten. And I said, oh no, no, I really want to go, like I just want to make sure that it's a viable pregnancy and it's healthy and safe. And they're like, okay, sure, never always come in. And so I in at that week seven for that first dating scan.

And your partner was with you, yes, Yehannie was with you. Yes, So a spoiler alert, you have twins, so we know that we had twins here, But what I really want to stress is you have identical twins, right, yes, so they only implanted one embryo, so this wasn't a case of you know, IVF putting multiple embryos in and that's why you have twins, like you had identical twins. So at some point during your early weeks, this embryo split into your identical twins. I want you to kind of paint me a picture of being in that ultrasound room with your husband to find out that you are actually having twins.

And your partner was with you, yes, Yehannie was with you. Yes, So a spoiler alert, you have twins, so we know that we had twins here, But what I really want to stress is you have identical twins, right, yes, so they only implanted one embryo, so this wasn't a case of you know, IVF putting multiple embryos in and that's why you have twins, like you had identical twins. So at some point during your early weeks, this embryo split into your identical twins. I want you to kind of paint me a picture of being in that ultrasound room with your husband to find out that you are actually having twins.

So we get in the room. It wasn't a long wait and very quickly I was up on the table and the obstetrician you know, put the gel on, put that ultrasound one thing on, and very very quickly and very clearly we can see what we can hear and see your heartbeat, healthy, bible, normal pregnancy relief here tears, a cry, tears of joy, happiness done, obviously positive pregnancy and blood test. You know it's good and baby at week seven, very strong heartbeat, wonderful and I was just crying and crying and crying, but positive, good tears and then the obstetrician at the time. I just remember this so clearly. He got the sonography, I don't know the wand the thing, and he very quickly moved it from one side of my uterus to the other and up popped another embryo on the screen, the black and white sonography screen, very clearly another embryo moving, and automatically said there's two. He didn't say anything, he was silent, he was still. He is normally a very talkative ob and he didn't say a word. At the same time, I've got my husband in one corner of the room, engaged, but probably like also not that engaged. I have a student midwife in the other corner. Again, I don't think she was paying much attention at the time. And then all of a sudden, everyone was like watching and looking at the screen and looking at me and looking at my tummy, and my robe looked at me, looked at my tummy, looked at the screen, looked at me, looked and I just kept saying, there's two, there's two, like I could read and interpret the ultrasound that, you know, the black and white screen, and I knew what I was seeing. And again he doesn't say anything for a long time, and I was like, oh my god, just talk to say something for such a normally talkative guy. He looked at me, looked at the scan and said, congratulations, you're having twins. And more cries, more shock, more tears, more laughter. It just was a huge, huge, huge shock. Any profanities, Yes, I'm sure, yes, I think so. I think I swore yes, I remember the shock. I don't remember what I said, but I remember the shock. And then just like both like laughter but tears.

So we get in the room. It wasn't a long wait and very quickly I was up on the table and the obstetrician you know, put the gel on, put that ultrasound one thing on, and very very quickly and very clearly we can see what we can hear and see your heartbeat, healthy, bible, normal pregnancy relief here tears, a cry, tears of joy, happiness done, obviously positive pregnancy and blood test. You know it's good and baby at week seven, very strong heartbeat, wonderful and I was just crying and crying and crying, but positive, good tears and then the obstetrician at the time. I just remember this so clearly. He got the sonography, I don't know the wand the thing, and he very quickly moved it from one side of my uterus to the other and up popped another embryo on the screen, the black and white sonography screen, very clearly another embryo moving, and automatically said there's two. He didn't say anything, he was silent, he was still. He is normally a very talkative ob and he didn't say a word. At the same time, I've got my husband in one corner of the room, engaged, but probably like also not that engaged. I have a student midwife in the other corner. Again, I don't think she was paying much attention at the time. And then all of a sudden, everyone was like watching and looking at the screen and looking at me and looking at my tummy, and my robe looked at me, looked at my tummy, looked at the screen, looked at me, looked and I just kept saying, there's two, there's two, like I could read and interpret the ultrasound that, you know, the black and white screen, and I knew what I was seeing. And again he doesn't say anything for a long time, and I was like, oh my god, just talk to say something for such a normally talkative guy. He looked at me, looked at the scan and said, congratulations, you're having twins. And more cries, more shock, more tears, more laughter. It just was a huge, huge, huge shock. Any profanities, Yes, I'm sure, yes, I think so. I think I swore yes, I remember the shock. I don't remember what I said, but I remember the shock. And then just like both like laughter but tears.

So you and your husband get in the car. You've just found out this very shocking news. What's that conversation sound?

So you and your husband get in the car. You've just found out this very shocking news. What's that conversation sound?

Like? God, that was really tough. I'll be honest with you, Like this was just obviously not expected at all. Like, we don't have twins in the family. It's not a genetic link. They were completely random, identical twins. We get out, I'm meant to get back to work, Jani's meant to get back to his work, and we just like are still processing the news and still processing the information. And I must say it took weeks and months to process it and come to terms with that. You know, just a lot of questions I think, like are they healthy. Is it going to be a viable pregnancy? Can I carry twins? How are we going to feel? How will I emotionally cope? How will I physically cope? You know? Can I actually carry twins to term? Well? Will that look? Like? What does this mean for my career? What does this mean for Lucas our son? You know, we're giving him two siblings. We're renovating our house. Does it fit another room? Do we have to get a new car? You know? Three car seats? What does this mean for our family? And this wasn't on the cars, This wasn't planned. We wanted like this normal kind of two parents, two kids, and very quickly we're outnumbered three like that, And.

Like? God, that was really tough. I'll be honest with you, Like this was just obviously not expected at all. Like, we don't have twins in the family. It's not a genetic link. They were completely random, identical twins. We get out, I'm meant to get back to work, Jani's meant to get back to his work, and we just like are still processing the news and still processing the information. And I must say it took weeks and months to process it and come to terms with that. You know, just a lot of questions I think, like are they healthy. Is it going to be a viable pregnancy? Can I carry twins? How are we going to feel? How will I emotionally cope? How will I physically cope? You know? Can I actually carry twins to term? Well? Will that look? Like? What does this mean for my career? What does this mean for Lucas our son? You know, we're giving him two siblings. We're renovating our house. Does it fit another room? Do we have to get a new car? You know? Three car seats? What does this mean for our family? And this wasn't on the cars, This wasn't planned. We wanted like this normal kind of two parents, two kids, and very quickly we're outnumbered three like that, And.

To add complexity to this twin pregnancy, which is already a challenge, you know, we know that sort of risks increase with multiples. With a twin pregnancy. You actually had a very rare type of twins and they're called MCDA twins. Now I won't try and pronounce the actual name of it, but basically you told me that that means that they had a single placenter with two amniotic sacs, which means that they were sharing nutrients from one placenter, correct, can you tell us what the doctors told you about what that actually means.

To add complexity to this twin pregnancy, which is already a challenge, you know, we know that sort of risks increase with multiples. With a twin pregnancy. You actually had a very rare type of twins and they're called MCDA twins. Now I won't try and pronounce the actual name of it, but basically you told me that that means that they had a single placenter with two amniotic sacs, which means that they were sharing nutrients from one placenter, correct, can you tell us what the doctors told you about what that actually means.

So in that first stating scan, ob very clearly could see the type of twins that they were and very quickly said, look, this is a high risk twin pregnancy. They're sharing a placenter. Drew diagrams and kind of drew what it looked like. But effectively positive news is that they're in two separate amniotic sacs and there was the membrane between them. However, sharing a placenta, as you say, like, they're sharing nutrients from that one plus center with two umbilical cords, and so there's a potential risk. I mean a lot of risks for twins, but one of the most concerning ones they worry about is twin to twin transfusion syndrome, which is where one twin gets more nutrients than the other and it's really a problem for both twins. Because of that, I had to be monitored and scanned every fortnight from I think week fifteen, just to make sure that the babies are growing kind of normally and healthy and equally and they're kind of getting equal amount of nutrients, of which they were very fortunate and I never had They call it t TTS twin to twin transfusion syndrome.

So in that first stating scan, ob very clearly could see the type of twins that they were and very quickly said, look, this is a high risk twin pregnancy. They're sharing a placenter. Drew diagrams and kind of drew what it looked like. But effectively positive news is that they're in two separate amniotic sacs and there was the membrane between them. However, sharing a placenta, as you say, like, they're sharing nutrients from that one plus center with two umbilical cords, and so there's a potential risk. I mean a lot of risks for twins, but one of the most concerning ones they worry about is twin to twin transfusion syndrome, which is where one twin gets more nutrients than the other and it's really a problem for both twins. Because of that, I had to be monitored and scanned every fortnight from I think week fifteen, just to make sure that the babies are growing kind of normally and healthy and equally and they're kind of getting equal amount of nutrients, of which they were very fortunate and I never had They call it t TTS twin to twin transfusion syndrome.

Basically that could mean that one twin's growing much faster the other ones not getting any nutrients, and you can really risk the life of the baby yourself. It's pretty serious. Yes, So obviously that's a big concern for you throughout pregnancy. And I also understand that you were very unwell through your pregnancy as well. So what was it like, sort of juggling a toddler, a high demand position at work, being pregnant with twins.

Basically that could mean that one twin's growing much faster the other ones not getting any nutrients, and you can really risk the life of the baby yourself. It's pretty serious. Yes, So obviously that's a big concern for you throughout pregnancy. And I also understand that you were very unwell through your pregnancy as well. So what was it like, sort of juggling a toddler, a high demand position at work, being pregnant with twins.

It was rough. It was really rough, And I compare in contrast, I think a lot to my first pregnancy that I was told was very boring, a very normal pregnancy, not many issues, and this song was just very, very challenging. I was nauseous, severely nauseous for mass every day. I was fortunate I didn't throw up at all. But it was just like, think of the worst hangover you've ever had, mixed with travel sickness and motion sickness. It was rubbish. It was really rubbish. And looking after my toddler, who's two at the time, and here, you know, Terrible twos was challenging, and then work and then travel to Sydney, and yeah, it was a lot.

It was rough. It was really rough, And I compare in contrast, I think a lot to my first pregnancy that I was told was very boring, a very normal pregnancy, not many issues, and this song was just very, very challenging. I was nauseous, severely nauseous for mass every day. I was fortunate I didn't throw up at all. But it was just like, think of the worst hangover you've ever had, mixed with travel sickness and motion sickness. It was rubbish. It was really rubbish. And looking after my toddler, who's two at the time, and here, you know, Terrible twos was challenging, and then work and then travel to Sydney, and yeah, it was a lot.

Did you have anything any particular foods or drinks that really got you through when you were feeling nauseous?

Did you have anything any particular foods or drinks that really got you through when you were feeling nauseous?

Yes, Oh my god, ginger and just ginger beer and fresh ginger.

Yes, Oh my god, ginger and just ginger beer and fresh ginger.

Okay, so let's move along. You're feel naughtously, feeling horrible, But family's obviously very excited.

Okay, so let's move along. You're feel naughtously, feeling horrible, But family's obviously very excited.

Yes, yes, And in fact it was interesting because no one knew were pregnant. We hadn't told anyone until we know, had that dating scan, and so it was like double the news, like oh we're pregnant and we're having twins, kind of two in one, yeah, I think. Yeah, both sides of the family very very happy. A bit of a shock obviously, because as I said, like, twins don't run in the family either side, and again it's not a genetic thing at all. Yeah, a lot of excitement from the family.

Yes, yes, And in fact it was interesting because no one knew were pregnant. We hadn't told anyone until we know, had that dating scan, and so it was like double the news, like oh we're pregnant and we're having twins, kind of two in one, yeah, I think. Yeah, both sides of the family very very happy. A bit of a shock obviously, because as I said, like, twins don't run in the family either side, and again it's not a genetic thing at all. Yeah, a lot of excitement from the family.

Yeah.

Yeah.

I remember actually one early on in the pregnancy justice, we found the news and as I told my sister, as remember crying, crying with her, Yeah, because I was still processing the news and still processing what it meant and again it wasn't planned, and she just held me and I just cried. It was a beautiful moment, but it was still hard to kind of come to terms with it. Yeah, yeah, it still is a little bit. I know the voice that over a year, but it's wild to think we've had.

I remember actually one early on in the pregnancy justice, we found the news and as I told my sister, as remember crying, crying with her, Yeah, because I was still processing the news and still processing what it meant and again it wasn't planned, and she just held me and I just cried. It was a beautiful moment, but it was still hard to kind of come to terms with it. Yeah, yeah, it still is a little bit. I know the voice that over a year, but it's wild to think we've had.

Twins coming up.

Twins coming up.

I was already a few centimeters dilated and Raley's feet were coming.

I was already a few centimeters dilated and Raley's feet were coming.

Out well, I mean, one is still so little. Like I feel like once you get through that first year it is, that'll sort of start to get a little bit easier. But true first birthdays should be the celebration of mum and dad, particularly mum, but mum and dad.

Out well, I mean, one is still so little. Like I feel like once you get through that first year it is, that'll sort of start to get a little bit easier. But true first birthdays should be the celebration of mum and dad, particularly mum, but mum and dad.

Oh, I agree for sure.

Oh, I agree for sure.

Obviously with twins again high rise pregnancy of twins often gestation is often a little bit shorter. But your doctor didn't want you to go past a certain time. Can you talk to us about that.

Obviously with twins again high rise pregnancy of twins often gestation is often a little bit shorter. But your doctor didn't want you to go past a certain time. Can you talk to us about that.

With the twins, kind of coming to term is around thirty seven weeks. For the type of twins I had, it was about thirty seven weeks, and we had a planned cesarean. Well, no, we had planned for a vaginal delivery, and my ov was very happy for that. Given the kind of the first physiological vaginal delivery with my first son. We're working towards that and aiming towards that. It was great, all on board. However, at week thirty two, my first son, Riley, twin one, he flipped, so from being head down he was now fit down and breach. And as soon as that happened, that through, you know, a vaginal birth plan alt the window because there's not much you could do with like I know, with one spinning babies and you can kind of get them to try and flip again. You can't do that with twins. And so every week and every scan I was just hoping like Riley had flipped again and flipped back to head down, but he hadn't, and he didn't, So then we had to think about, okay, well, plan B cesarian and we had booked a cesarian for kind of mid March, so that was booked in and all good and all fine. And from that moment I did a lot of research. I spoke to a lot of girlfriends, particularly friends with twins and who had gone through a cesarean, spoke to a lot of friends with both negative and positive experiences of air cesarean. I did a lot of research, a lot of information. I spoke to a lot of people to kind of really get me ready and prepare me for that moment. But that planned Cesarean date didn't happen because the boys came early. The boys came at thirty four and four, because I went into spontaneous labor. Well, as you'd jumped back a step, Riley, we think it's Frailey, chicky bugger. He kicked and broke my.

With the twins, kind of coming to term is around thirty seven weeks. For the type of twins I had, it was about thirty seven weeks, and we had a planned cesarean. Well, no, we had planned for a vaginal delivery, and my ov was very happy for that. Given the kind of the first physiological vaginal delivery with my first son. We're working towards that and aiming towards that. It was great, all on board. However, at week thirty two, my first son, Riley, twin one, he flipped, so from being head down he was now fit down and breach. And as soon as that happened, that through, you know, a vaginal birth plan alt the window because there's not much you could do with like I know, with one spinning babies and you can kind of get them to try and flip again. You can't do that with twins. And so every week and every scan I was just hoping like Riley had flipped again and flipped back to head down, but he hadn't, and he didn't, So then we had to think about, okay, well, plan B cesarian and we had booked a cesarian for kind of mid March, so that was booked in and all good and all fine. And from that moment I did a lot of research. I spoke to a lot of girlfriends, particularly friends with twins and who had gone through a cesarean, spoke to a lot of friends with both negative and positive experiences of air cesarean. I did a lot of research, a lot of information. I spoke to a lot of people to kind of really get me ready and prepare me for that moment. But that planned Cesarean date didn't happen because the boys came early. The boys came at thirty four and four, because I went into spontaneous labor. Well, as you'd jumped back a step, Riley, we think it's Frailey, chicky bugger. He kicked and broke my.

Waters lot a little so and sound a little chicky monkey had day.

Waters lot a little so and sound a little chicky monkey had day.

No because he was fit down and he was breach. Like my ob says to me, he probably kicked kick too hard and broke your waters. And one afternoon, I remember i'd you know, been that day like shopping and washing and cooking and cleaning and all the things as you do as a mum and managing a family. I had like a five minute break, and I remember lying on my bed with my husband and my son and we put on like Bluey or something for my son to watch it. Oh perfect, I can literally just lie down, get off my feet and watched this with him for like half an hour and lye in bed. Within literally like two minutes of putting on that show, my water's broke and water went everywhere all over the bed My husband actually was talking to another friend who's a twin dad at the time on the phone, and Yanni had thought I had actually like wet my pants all like worse because I was holding my bump like I was holding my backside. I was on the bed and I like literally said, oh, and how my backside. He's like, oh my god, have you like wet yourself or what's happened? He was on the phone and he's like, oh, mate, I'm gonna have to like drop off because I think Lauren's just her waters are broken. Got off the phone call. I was lying bed still with my son. All of a sudden, we were like up and off the bed, but there was water everywhere and it kept gushing and gushing and gushing. Went to the toilet, waters coming. I've got a like a maternity pad, put that in my underwear, and very quickly I just said, okay, it's on like waters are broken. We need to get to hospital.

No because he was fit down and he was breach. Like my ob says to me, he probably kicked kick too hard and broke your waters. And one afternoon, I remember i'd you know, been that day like shopping and washing and cooking and cleaning and all the things as you do as a mum and managing a family. I had like a five minute break, and I remember lying on my bed with my husband and my son and we put on like Bluey or something for my son to watch it. Oh perfect, I can literally just lie down, get off my feet and watched this with him for like half an hour and lye in bed. Within literally like two minutes of putting on that show, my water's broke and water went everywhere all over the bed My husband actually was talking to another friend who's a twin dad at the time on the phone, and Yanni had thought I had actually like wet my pants all like worse because I was holding my bump like I was holding my backside. I was on the bed and I like literally said, oh, and how my backside. He's like, oh my god, have you like wet yourself or what's happened? He was on the phone and he's like, oh, mate, I'm gonna have to like drop off because I think Lauren's just her waters are broken. Got off the phone call. I was lying bed still with my son. All of a sudden, we were like up and off the bed, but there was water everywhere and it kept gushing and gushing and gushing. Went to the toilet, waters coming. I've got a like a maternity pad, put that in my underwear, and very quickly I just said, okay, it's on like waters are broken. We need to get to hospital.

And this is a Sunday too, Sunday afternoon. Yeah, so you basically had to call the whole new team in Yes.

And this is a Sunday too, Sunday afternoon. Yeah, so you basically had to call the whole new team in Yes.

Yes, so my obi wasn't on call that weekend, and I got a whole new team because it ended up becoming an emergency s asaian and a whole new team greeted us in hospital and you pay all the penalty rates because it's a Sunday afternoon. So that was fun, all new people. But look, we knew the hospital, we knew the plan. My Obi. I was very lucky because I spoke to him on the phone actually in hospital about what was about to happen, and the saesarean and you know, as discussed, you know we're going to be doing s Y and zaid, So did have continuity of care from him, and I knew what I was going into and it was still to plan. It was just a little bit early.

Yes, so my obi wasn't on call that weekend, and I got a whole new team because it ended up becoming an emergency s asaian and a whole new team greeted us in hospital and you pay all the penalty rates because it's a Sunday afternoon. So that was fun, all new people. But look, we knew the hospital, we knew the plan. My Obi. I was very lucky because I spoke to him on the phone actually in hospital about what was about to happen, and the saesarean and you know, as discussed, you know we're going to be doing s Y and zaid, So did have continuity of care from him, and I knew what I was going into and it was still to plan. It was just a little bit early.

Yeah, you get in there, get spinal tap, you're in the theater and they take out the first baby. Yes, what was that experience like? Did they have to go straight to special care?

Yeah, you get in there, get spinal tap, you're in the theater and they take out the first baby. Yes, what was that experience like? Did they have to go straight to special care?

They did shock again, a lot of shock because it happened I think so quickly from when my waters broke to then going into labor to then arriving.

They did shock again, a lot of shock because it happened I think so quickly from when my waters broke to then going into labor to then arriving.

How long was it between when your waters broken when the babies came?

How long was it between when your waters broken when the babies came?

About three hours?

About three hours?

It's very quick.

It's very quick.

Yeah, it's pretty fast. We got off pretty quick. And then what they were hoping to do, was hoping to keep me in for another day or two, even though my water said broke. They were hoping I wouldn't start contracting and kind of go into labor. But I did, and I went pretty quickly, and the contractions wrapped up bloody fast and hard, and boy, I didn't have my Tenis machine or pain relief or anything planned, and gosh, it just brought me back very quickly to that first labor of my son, very quickly, ye three hours. And unfortunately, because I then contracted when to labor, there was no choice but to get the babies out because basically their hope would have been to put steroids in to help with GN development, to try and grow the lungs a little bit faster. So their hope was to try and keep those babies in for maybe a day or so extra. Yeah, but because you started contracting, you had to go straight to theater. I had to go straight to theater.

Yeah, it's pretty fast. We got off pretty quick. And then what they were hoping to do, was hoping to keep me in for another day or two, even though my water said broke. They were hoping I wouldn't start contracting and kind of go into labor. But I did, and I went pretty quickly, and the contractions wrapped up bloody fast and hard, and boy, I didn't have my Tenis machine or pain relief or anything planned, and gosh, it just brought me back very quickly to that first labor of my son, very quickly, ye three hours. And unfortunately, because I then contracted when to labor, there was no choice but to get the babies out because basically their hope would have been to put steroids in to help with GN development, to try and grow the lungs a little bit faster. So their hope was to try and keep those babies in for maybe a day or so extra. Yeah, but because you started contracting, you had to go straight to theater. I had to go straight to theater.

Yeah.

Yeah.

They would have liked another day or two, which would have been good because my ov would have been back, but it didn't happen, and luckily I was in hospital, and luckily we got there quickly because in theater, I was already a few centimeters dilated and Raley's feet were coming out.

They would have liked another day or two, which would have been good because my ov would have been back, but it didn't happen, and luckily I was in hospital, and luckily we got there quickly because in theater, I was already a few centimeters dilated and Raley's feet were coming out.

And can you imagine if you had tried to deliver vaginally you would have that would have been really really dangerous.

And can you imagine if you had tried to deliver vaginally you would have that would have been really really dangerous.

Yeah, there's a thing. It's called twin blocking centro and it's a really really dangerous and risky procedure where they try and deliver. Well, I don't think they do it or even attempt it where twin one. So twin one is the twin close to your cervix meant to come out vaginally first. That's an issue that they can't feed first breach because the head can get locked with the other twins head anyway. So they don't even attempt that at all, and that was never an option and hence the cesarean Yeah, that wouldn't have been an option and it's very dire outcomes.

Yeah, there's a thing. It's called twin blocking centro and it's a really really dangerous and risky procedure where they try and deliver. Well, I don't think they do it or even attempt it where twin one. So twin one is the twin close to your cervix meant to come out vaginally first. That's an issue that they can't feed first breach because the head can get locked with the other twins head anyway. So they don't even attempt that at all, and that was never an option and hence the cesarean Yeah, that wouldn't have been an option and it's very dire outcomes.

Yeah, okay, so the boys come out and they go straight to special care. How big were they They were little?

Yeah, okay, so the boys come out and they go straight to special care. How big were they They were little?

So thirty four and four premature. There are about two kilos each.

So thirty four and four premature. There are about two kilos each.

That's pretty good.

That's pretty good.

Yeah, look for their gestation age, it's not bad. I think one was just over two killers. One was just under two killers, but like literally fifty grams apart, pretty equal weight.

Yeah, look for their gestation age, it's not bad. I think one was just over two killers. One was just under two killers, but like literally fifty grams apart, pretty equal weight.

No, that's not. I mean I've heard people with full term babies were at two and a half killers, so it's not that's not. I know, five hundred gram is a lot in the space of a baby, but I mean you did an amazing job to keep them in that long, and you know they got a little bit extra support their special care.

No, that's not. I mean I've heard people with full term babies were at two and a half killers, so it's not that's not. I know, five hundred gram is a lot in the space of a baby, but I mean you did an amazing job to keep them in that long, and you know they got a little bit extra support their special care.

Yeah, well you think about it, but it's like a four kilo baby, yeah, exactly, and the placenta and.

Yeah, well you think about it, but it's like a four kilo baby, yeah, exactly, and the placenta and.

Yeah, so how long were the boys in special care?

Yeah, so how long were the boys in special care?

They were in for nineteen nights? Wow, so five nights we were in there with them, and then we had to go home, which look is hard obviously living your babies at the hospital while you go home, but also okay too, because it meant that I could recover and I could actually, you know, recover and heal from emecessaria, which was major surgery, and I could rest at home and be in my own bed and see our son and be home and really recover.

They were in for nineteen nights? Wow, so five nights we were in there with them, and then we had to go home, which look is hard obviously living your babies at the hospital while you go home, but also okay too, because it meant that I could recover and I could actually, you know, recover and heal from emecessaria, which was major surgery, and I could rest at home and be in my own bed and see our son and be home and really recover.

It was your son, like, where are these babies, Mum, what's going on?

It was your son, like, where are these babies, Mum, what's going on?

I don't think he could put two and two together at the time. I think of all the positives, right, and I think we came home without them we could spend one or one time with him, and he got a lot of attention and quality time with us. He didn't know any different, and we got used to basically caring for three kids, but with a lot of help and support while they're in special care.

I don't think he could put two and two together at the time. I think of all the positives, right, and I think we came home without them we could spend one or one time with him, and he got a lot of attention and quality time with us. He didn't know any different, and we got used to basically caring for three kids, but with a lot of help and support while they're in special care.

And how is life now with your three babies? The boys are now just over one?

And how is life now with your three babies? The boys are now just over one?

It is wild? Yeah, chaos and crazy. It is nuts. I swear three kids, it's beautiful. You just leave them and they play together. They hold each other's hands, they hug, they cuddle. They also you know, rip the hair and pull the shirt and whack each other and literally crawling over one another for like a toy, and they take in stell toys. Again, there's beauty and there's chaos. It we get both worlds.

It is wild? Yeah, chaos and crazy. It is nuts. I swear three kids, it's beautiful. You just leave them and they play together. They hold each other's hands, they hug, they cuddle. They also you know, rip the hair and pull the shirt and whack each other and literally crawling over one another for like a toy, and they take in stell toys. Again, there's beauty and there's chaos. It we get both worlds.

Okay, I can't let you go before I ask you the typical twin questions, which I know that I'm sure you get asked all the time. Did you mix them up by any point when you first brought them home?

Okay, I can't let you go before I ask you the typical twin questions, which I know that I'm sure you get asked all the time. Did you mix them up by any point when you first brought them home?

Oh? Constantly, constantly? Who's who? I still do it?

Oh? Constantly, constantly? Who's who? I still do it?

You can obviously tell the difference now, I'm sure your partner can. Is there anyone that is like still struggling like you're in laws or your parents.

You can obviously tell the difference now, I'm sure your partner can. Is there anyone that is like still struggling like you're in laws or your parents.

Oh look, most people when they come over, they're just still a bit of a check, like, oh, this month's Friday.

Oh look, most people when they come over, they're just still a bit of a check, like, oh, this month's Friday.

Right.

Right.

Half the time they're right, half the time they're wrong. But look fifty so well that's it.

Half the time they're right, half the time they're wrong. But look fifty so well that's it.

That's your probability though, isn't it.

That's your probability though, isn't it.

Yeah, yeah, yeah. We do tend to dress like Alex in a particular color, generally like blues, and Riley in kind of greens or red orange.

Yeah, yeah, yeah. We do tend to dress like Alex in a particular color, generally like blues, and Riley in kind of greens or red orange.

They've got a color Palada, which I love that they do.

They've got a color Palada, which I love that they do.

They do.

They do.

Well, Laura, Thank you so much for sharing your story. Fascinating to hear about this kind of twin.

Well, Laura, Thank you so much for sharing your story. Fascinating to hear about this kind of twin.

Thank you. Yes, it's a crazy ride and I think it's nuts every day, and we are blessed every day. Really, it is a gift to have twins, and they're beautiful and healthy and well. And Lucas is very lucky boy. He gets two brothers. Yeah, two for the price of one.

Thank you. Yes, it's a crazy ride and I think it's nuts every day, and we are blessed every day. Really, it is a gift to have twins, and they're beautiful and healthy and well. And Lucas is very lucky boy. He gets two brothers. Yeah, two for the price of one.

Thank you so much for joining us today, Laura, thank you so much for having me on the show. Now, given today's birth was a very technical one, we wanted to bring in our resident expert obstitution and gynecologist, doctor Bromin Devine to give us some insights. So what can doctor Devine tell us about MCDA twins?

Thank you so much for joining us today, Laura, thank you so much for having me on the show. Now, given today's birth was a very technical one, we wanted to bring in our resident expert obstitution and gynecologist, doctor Bromin Devine to give us some insights. So what can doctor Devine tell us about MCDA twins?

So MCDA twins are always identical twins. They are the identical twins that occur when the split of an embryo occurs relatively early in embryo development, so somewhere between about day two and day six of post fertilization life, round about day three to day five, the embryo starts to form its placenter part and its baby part, which is known as the inncel mass. And MCDA twins form when the inncell mass splits into two, so that you end up with two separate babies that are genetically identical, but they share a placenta and they share a big membrane called the choreon, So they're in one choreonic sack, but they're in two separate amniotic sacs because there are two membranes, the choreon and the amnion. The amnions the inner membrane, and so these twins have two separate inner membranes. They're in their own little inner membrane sack. They share a placenter, and because they share a placenter, you can get connections of blood vessels between the two and that's quite common, but with a particular type of blood vessel connection, you can get a situation where one twin gives all its blood or a lot of its blood across to the other twin. What that means is that one poor little twin ends up giving all its blood and the other twin receives all the blood. So the twin that's the giver the donor can end up very small and skinny with hardly any amniotic fluid around it, and the recipient twin, which is often the sicker twin, ends up with way too much blood, way too much amniotic fluid. Its poor old kidneys get over profuse and it makes a lot of urine, and its poor old heart gets really overloaded with fluid and they can go into heart failure. So twin twin transfusion occurs about a third of the time in monochoreonic twin pregnancies, certainly twin pregnancies, and of those third, about half of them are associated with really severe outcomes. So it's one of the reasons why we need to deliver MCDA twins earlier, but also twins can come earlier as well, that people can go into labor earlier with twins, they can up to their membranes early and things like that. So twin twin transfusion can be quite mild and we can just keep an eye on it, or it can be very severe and there are things we can do to help it. But when we see people come to us with MCDA twins, we usually warn them quite early. You'll be having a lot of ultrasounds every two weeks. We're going to be keeping an eye on these bubs and keeping an eye on the fluid difference between them. And there are certain very subtile things that we can see very early on that give us an indication that twin twin transfusion might be developing.

So MCDA twins are always identical twins. They are the identical twins that occur when the split of an embryo occurs relatively early in embryo development, so somewhere between about day two and day six of post fertilization life, round about day three to day five, the embryo starts to form its placenter part and its baby part, which is known as the inncel mass. And MCDA twins form when the inncell mass splits into two, so that you end up with two separate babies that are genetically identical, but they share a placenta and they share a big membrane called the choreon, So they're in one choreonic sack, but they're in two separate amniotic sacs because there are two membranes, the choreon and the amnion. The amnions the inner membrane, and so these twins have two separate inner membranes. They're in their own little inner membrane sack. They share a placenter, and because they share a placenter, you can get connections of blood vessels between the two and that's quite common, but with a particular type of blood vessel connection, you can get a situation where one twin gives all its blood or a lot of its blood across to the other twin. What that means is that one poor little twin ends up giving all its blood and the other twin receives all the blood. So the twin that's the giver the donor can end up very small and skinny with hardly any amniotic fluid around it, and the recipient twin, which is often the sicker twin, ends up with way too much blood, way too much amniotic fluid. Its poor old kidneys get over profuse and it makes a lot of urine, and its poor old heart gets really overloaded with fluid and they can go into heart failure. So twin twin transfusion occurs about a third of the time in monochoreonic twin pregnancies, certainly twin pregnancies, and of those third, about half of them are associated with really severe outcomes. So it's one of the reasons why we need to deliver MCDA twins earlier, but also twins can come earlier as well, that people can go into labor earlier with twins, they can up to their membranes early and things like that. So twin twin transfusion can be quite mild and we can just keep an eye on it, or it can be very severe and there are things we can do to help it. But when we see people come to us with MCDA twins, we usually warn them quite early. You'll be having a lot of ultrasounds every two weeks. We're going to be keeping an eye on these bubs and keeping an eye on the fluid difference between them. And there are certain very subtile things that we can see very early on that give us an indication that twin twin transfusion might be developing.

And is there something to identical twins being more common in IVF.

And is there something to identical twins being more common in IVF.

Interestingly, we have definitely moved away from putting back multiple embryo. Sometimes people will come along and say, look, I just want to get this all over and done with. Can you just put two embryos back from the get go, And we're really reluctant to do that because twin pregnancies are definitely more complicated. Even if there's two separate sacks, two separate percenters. So in general that means non identical twins. But even in that situation, you're more likely to go into labor prematurely. You're more likely to have one bubby grow at a faster rate than the other one. Not so the twins are always going to be more complicated. Birth can be more complicated. You're more likely to have an intervention like a caesar or an instrumental birth. So we don't want to increase people's complications. So the movement away from putting back two embryos is very well established now in Australia, and we almost exclusively put back a single embryo where we do IVF, but because we want to know that the embryo we put back is a nice, hearty embryo. We grow embryos on now till they're five days old. Certain circumstances will put them back earlier, but generally we'll put them back when the embryos five days post fertilization, and embryos at that stage, as I mentioned earlier, are starting to form. The percent of heart and the inncel mass and the innercell mass in IVF is a little bit more likely to split, and that might be to do with the fact that we're culturing embryos on. It might be to do with the culture media, it might be to do with other things that happened. But the chance of having monochoreonic twins is increased slightly with IVF, So even if we put back a single embryo, there is a slightly increased chance with IVF that you're going to end up with a twin pregnancy if you did have a single embryo put back and you didn't conceive a spontaneous pregnancy at the same time, which can happen as well. If you did put a single embryo back and people come along with twins as long as they didn't conceive a natural pregnancy at the same time, those are going to be identical twins because a single embryo is not going to make non identical Twinssolutely, IVF does increase your risk of having monochoryonic twins.

Interestingly, we have definitely moved away from putting back multiple embryo. Sometimes people will come along and say, look, I just want to get this all over and done with. Can you just put two embryos back from the get go, And we're really reluctant to do that because twin pregnancies are definitely more complicated. Even if there's two separate sacks, two separate percenters. So in general that means non identical twins. But even in that situation, you're more likely to go into labor prematurely. You're more likely to have one bubby grow at a faster rate than the other one. Not so the twins are always going to be more complicated. Birth can be more complicated. You're more likely to have an intervention like a caesar or an instrumental birth. So we don't want to increase people's complications. So the movement away from putting back two embryos is very well established now in Australia, and we almost exclusively put back a single embryo where we do IVF, but because we want to know that the embryo we put back is a nice, hearty embryo. We grow embryos on now till they're five days old. Certain circumstances will put them back earlier, but generally we'll put them back when the embryos five days post fertilization, and embryos at that stage, as I mentioned earlier, are starting to form. The percent of heart and the inncel mass and the innercell mass in IVF is a little bit more likely to split, and that might be to do with the fact that we're culturing embryos on. It might be to do with the culture media, it might be to do with other things that happened. But the chance of having monochoreonic twins is increased slightly with IVF, So even if we put back a single embryo, there is a slightly increased chance with IVF that you're going to end up with a twin pregnancy if you did have a single embryo put back and you didn't conceive a spontaneous pregnancy at the same time, which can happen as well. If you did put a single embryo back and people come along with twins as long as they didn't conceive a natural pregnancy at the same time, those are going to be identical twins because a single embryo is not going to make non identical Twinssolutely, IVF does increase your risk of having monochoryonic twins.

Diary of a Birth was hosted by me Cassenia Lukitch with expert input from Dr Bromwin Divine. If you have a birth story, we'd love to hear from you. Details are in the show notes. This episode was produced by Tina Matalov and myself, Cassanie Lukitch with audio production by Leoportos

Diary of a Birth was hosted by me Cassenia Lukitch with expert input from Dr Bromwin Divine. If you have a birth story, we'd love to hear from you. Details are in the show notes. This episode was produced by Tina Matalov and myself, Cassanie Lukitch with audio production by Leoportos