Twin babies can be born with normal birth

Interview: Zuhal Eyüboğlu

Although single babies can be born normally, what's missing from twin babies? Today, twin baby births increase mostly due to in vitro fertilization applications, experts tell that twin babies can be born with normal births.

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Turkey second in the world and first in Europe cesarean delivery rate! So, what could be the main reason for this result? The lack of social awareness and birth culture is one of the biggest factors in this! In a time when there is a tendency to the naturalness of everything, the tendency to the naturalness of birth is not enough, unfortunately it is quite tragic in terms of maternal and infant health! Well, while pregnancy and childbirth is a natural phenomenon, can't twin baby births be naturally normal? Those who are curious about this issue are among the most experienced doctors in twin baby births. How would you like to learn about Hakan Çoker and Pregnant and Birth Psychologist Nergis Azanpa, who gave birth to her twin babies with normal birth?

“NORMAL BIRTH RATES CAN BE AT LEAST 60 PERCENT IN TWIN PREGNANCIES SUPPORTED ENOUGH.”

- Dr. Hakan Çoker / Founder and Instructor of Keskesiz Birth

• In Turkey, the normal birth of twins can be realized and how perceptions about the world?

In my assistantship period, most of the twin births were expected to start spontaneously and many were born. But two things happened over the years; Both cesarean surgeries and baby care have become easier, and families' expectations for risk have changed. This situation has increased the cesarean rates in twin pregnancies in the world and Turkey. Currently twin pregnancy is almost equal in Turkey as a culture dominated by cesarean section.

• In what cases can twin births occur normally? In what cases can not normal occur?

Obviously a medical issue that is too long to be answered here. This issue varies greatly with the health of the baby and mother, whether the pouches are single or double, single or double twins, the formation and placement of placenta, hospital conditions and the experience of the doctor. But we can say that twin births in separate sacs, in which both babies are healthy and both come with the head, are the most susceptible to birth.

• How much are the risk rates in twin baby births?

First, let's separate risky twin births. So, for example, one of the babies remained very small, there are placental problems, babies have problems, some diseases occurred in the mother, etc. Let's compare twin babies with suitable additional risk factors, who come in suitable positions, and single babies under the same condition. In the low risk singleton babies, the rate of having a problem in the womb or birth after 37 weeks is 1.5 per thousand, while in the twin babies this rate is in the range of 3.5-5.5 per thousand. This increased risk may be important for some families and minor for some families.

There are also some risks belonging to the mother, which is bleeding after birth. This risk can be met by appropriate measures and appropriate hospital selection.

• What are the normal birth rates in adequately supported twin births? Do you have enough data on this subject?

For pregnant women who are all right, selected and supported properly, birth rates will be at least 60 percent and above.

What are the ways parents and fathers should follow in order for twin babies to be born normally?

Twin parents should be good at feeding first. Good nutrition brings healthy babies. Then they will investigate the risk rates, etc., in twin births. And my suggestion is that they also participate in birth training. Then a healthy decision will come for the birth of their babies.

• How knowledgeable and experienced are doctors and midwives in our country about twin births?

It would not be wrong to say that as the “twin births” decrease, the experiences on this subject decrease gradually. In large hospitals today, the majority of twin deliveries are taken by scheduled cesarean delivery, unless it is due to give birth to an emergency.

“TWIN NORMAL BIRTH IS NOT A COURAGE JOB, IT IS A CHOICE”

• Do you think a couple who wants to make their twin birth normal is very brave? Or is it very close to the birth of a single baby?

I define it not as courage, but as a choice. Because the cesarean, which is the alternative you choose, also has risks. But in properly selected twin pregnancies, hospitals where appropriate and precautions are complete, twin births with experienced teams are not an adventure but a choice.

How are the stages of realization of twin baby births normal (Everyone is very curious about how this happens ...)

The baby who comes first in twin births is born with a head. The examination is made for the second baby, if necessary, the water bladder is opened and the head is placed under control if it comes with the head. If it does not come in the proper position, the doctor will maneuver the baby inside to get the correct position inside. Then the birth of the second baby is left to spontaneous again. Both placenta spontaneously leave after babies come out. Twin births sometimes make you sweat, but as a doctor, I can say that there are many delightful births.

• In recent years, in the world and in our country, a lot of attention is paid to the tincture between the mother baby and the father baby. Is it possible to contact skin to skin in twin babies?

It is of course possible if there is no preterm birth etc. and there is no breathing problem. Yes, this is currently the preferred health practice. Twin babies born at 36 weeks or more are almost as developed as babies born at term. So they do not have an obstacle for Skin to Skin Contact. If there is a problem, the necessary interventions will be done immediately.

• What are the advantages of normal birth of twin babies in terms of mother, baby and father?

The advantage for the mother is very clear; she does not have surgery and connects with the baby. In terms of the father, if he is born, he strengthens the bond with his baby and increases respect for the wife. In terms of the baby, he has all the advantages of birth.

Do twin normal births occur both in the private and in the state? What should be the conditions for it to happen?

The number of doctors allowing twin births in private hospitals is low. In public hospitals, it can be said that only very busy hospitals remained in an emergency. The number of both family and physicians, who planned to follow twin births and allow vaginal delivery, decreased significantly.

“Critical point: Families should also share responsibility with the doctor”

Dr. Hakan Çoker gives the following advice to expectant mothers and fathers who are expecting twins: Yes, there are increased risks in selected twin births, but they are not in size to suggest that we deliver both of them by cesarean delivery. In the additional risks factor, which increases by 3-4 per thousand, the duty falls on the families. If they want their babies to have vaginal birth, they should consciously perceive these risks, accept them and give confidence to their doctor. Otherwise, no doctor will persuade them for childbirth. They will also refuse to enter the births of families who do not give this trust. In one of the twin births, a father told me: “We know the risks at this birth. But this is our choice, we will never hold you responsible. ” This sentence shows the level of consciousness of the family and relaxes the doctor. Unless parents share responsibility, doctors will continue to recommend and prefer cesarean delivery at the slightest risk, whether twin births or single births.

“If we can grow two babies in our size, we are equipped to be able to give birth to these two babies”

- Nergis Azanpa / Pregnant and Birth Psychologist

• What did you feel as a mother who gave birth to her twins with normal birth? Birth is a very intimate thing, we know yes, but can you tell us a little bit?

During my pregnancy, I was a mother-to-be prepared to give birth to my babies normally. Thanks to the prepartum training, I had the knowledge of mental and physical techniques that would help me at birth. I was in constant contact with my birth team. I think that is why I had a comfortable birth process for me. It has been 4 years since birth. When I go back and go to that moment, I remember the moment of birth and the moment of taking my babies into my arms. There is an average of 10 hours between the two. These 10 hours were a timeframe that I remember right now, but mentally “in the safest place”. When the mind feels safe, the body leaves itself and relaxes. My birth started when my water came around 03:00 on the day we entered the 38th week. I was prepared at home until 7 am with the guidance of my doctor and midwife. In the first hours I spent at home, I took a warm shower to relax. I made the final checks of my hospital bag and then woke my wife and mother. I didn't wake up earlier because I didn't want their stress and excitement to infect me. So I wanted to have control. Just like I want it to be at birth. I spent the time from hospitalization until our son's head appeared. It was me who first touched our son's head, and that was an incredible experience for me. From that moment on, we entered the next room, the delivery room. My wife was with me at every moment. My wife also used the techniques he learned in education. I think the effect of the massages he made me reaches our babies. The support of my birth team was incredible. With the support of my doctor, birth psychologist and midwife, our son was born first. They gave it to my first chest without cutting the cord. Words are insufficient for the description of that first scene. We welcomed our son with his father. He lay on my chest for 38 minutes, calmed down, his first examination was again on my chest. He was not taken away from me for maintenance. We even asked him to call his brother. After 38 minutes, our daughter was born. His cord was cut earlier because it did not reach my chest. And here both my babies were on my chest. The fruits of all my preparation for 9 months were in my arms. We made skin contact on my chest for about 1 hour. Because, according to them, a familiar heart rhythm, skin smell and voice of parents were the most important things for them to feel safe. My birth was like a peaceful and festive welcome.

• Especially, while a significant number of expectant mothers in our country do not dare to give birth to a single baby with normal birth, how did you show this courage? What were the feelings that made you think about this?

Those who heard that I was born with a normal birth with my twin babies first asked, "Is such a thing possible?" they ask. And I answer, "If there is no situation preventing them from being born medically normal, why not?" Unfortunately, we are convinced that twins cannot be born normally in social perception. I believe that if we can raise two babies in our body, we are created with the hardware that can give birth to both babies. I think before courage, it's a matter of faith. I cannot ignore the positive contributions of the stories of women who gave birth to twin babies in the village where I listened to from my family in the formation of this belief. If they were able to deliver without seeing a hospital and a doctor, these stories helped me to think about why I could not give birth with my birth team.

When we look psychologically; All the cells of our body are ruled by our minds. I, first of all, from a medical point of view, I have convinced my doctor that I can give birth to my baby normally after my knowledge of “You can give birth normally” and of course myself first. Although I believe that I can give birth normally, I did whatever physically and psychologically needed to do. Here, a Birth Preparation Training focused on birth has given me a lot of way.

“WE PREPARED TO BE A MOTHER AND FATHER BEFORE PREPARING WITH MY WIFE”

• How did you prepare for birth?

I was prepared to be a mother before I was born. My wife was also prepared to become a father. I had the opportunity to look at our parenting roles, which were started while we were still in our mother's womb, in the Psychodrama training I received. When I realized that I really wanted to be a mother, not because I should be a mother with the pressure of society, so when I internalized being a mother sufficiently, we took my wife and went to prep birth training. The goal was to ask my wife to realize whether she was ready to be a father. For this purpose, we went to the preparatory birth training with no babies in the middle. Preparing for birth, giving birth is perceived only as the duty of the expectant mother. It may be that the woman is giving birth, but I hope all birth teams will notice the importance of having father candidates in the process of preparing for birth. I believe that spouses, birth supporters and hospital managers can change their way of birth when they change their view of birth. The woman who gives birth feels all the positive and negative emotions of the people around her, and this is reflected in her way of birth. From this point of view, I think whoever will support her with the woman should be prepared for birth with her.

When my babies decided to come after being ready for motherhood, we took my wife and went to a preparatory birth training for the second time. This time it was our departure to prepare for birth. This training is an excellent guide for pregnant women and prospective fathers to prepare for birth. An interactive education in which theoretical and practical knowledge about both physical and mental preparation is given to birth. I took the information that worked for me from this training and tried to apply them until birth, as much as I could. I used mental techniques that worked for me and helped me give birth to my twin babies normally. For example; When my doctor said that both babies are expected to come upside down for normal delivery, I started the "Imagination" studies. I imagined and communicated with the image of my babies looking upside down in my mind. Another mental study; “Safe Area Exercise”. Thanks to this exercise, I met my waves (contractions) in my safe space that I created mentally. I was actually using this technique in the time period that I mentioned as I remember two questions as flu. Don't come back; it helped me to communicate with the baby and not to close myself to the outside world. In this way, I felt like an average of 10 hours. In fact, I was so surprised when I learned about my children's birthday. Again, thanks to the non-drug relaxing techniques I learned in this training, I did not feel any pain at birth. I learned the positive results of hypnotizing the mind by using the words " wave" and " contraction" since the beginning, not " pain", "pain" .

In short, as I was preparing for the birth, I started by reconfiguring the negativities and positives in my mind. Because I knew all my cells were affected by the messages in my mind. Afterwards, I was prepared to deal with pain and physical positions with physical preparations. Since birth is not just a physiological act, I was prepared for my birth considering both psychological and physical factors.

• How did you decide to become a Pregnant and Maternity Psychologist?

The Pregnant and Childbirth Psychologist is the person who supports the pregnant, relatives of the pregnant woman and the birth team, starting before the pregnancy, during the pregnancy and, if necessary, at birth. This field is just one of the specialties that can be taken upon the psychology license. You can become a pregnant and birth psychologist by going through a well-equipped training where you write a thesis, practice births, and get theoretical and practical knowledge and supervision.

When I was in the process of getting ready to become a mother, my process of becoming a pregnant and birth psychologist started. Before I started the Pregnant and Obstetrician and Birth Preparation Trainer training, I attended the birth preparation training. When I saw that the training added to me and my wife, I decided to take this training. I was not yet pregnant when I registered, but I attended the first session when I was 5 weeks pregnant. I completed a 9-month training as pregnant. It was a great opportunity for me. It was a great boon for me to have access to all the resources I could reach for preparation for birth and to get a certificate of expertise.

• This important area of ​​psychology is still unknown in our country, why is a pregnant and birth psychologist necessary?

The need was felt to this profession in Turkey, since that was seen as a natural process of birth, abnormal society and the media to the effect began to be perceived as a diseased state. In fact, because of fear of birth, cesarean surgery was unfortunately presented to mothers as a form of birth or mothers started to demand this. I think that psychologists should work in this area in order to find the source of these fears and to correct false perceptions about the concept of birth and birth. I believe that birth is not a passive but an active action and we are born with the ability to give birth to us like all mammals (cats, dogs), this power is in us, and our mission is to change the negative perception in society by telling the active process of babies. With this in mind; I set out on this path with the idea that all women I know and know should know and discover. I hope all women discover the strength of their own bodies and babies.

Unfortunately, if the negative experiences we still hear about change, I believe that the negative judgments passed down to the next generations will change. I am happy if I contribute as much as a grain of sand on this road.

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Suggestions for families who are expecting twin babies and want to give birth normally

Pregnant and Maternity Psychologist Nergis Azanpa:

• First of all, I suggest that they meet with their doctor. Because some medical conditions can prevent the normal birth of twins. I think that the support of the doctor is very important if his doctors give the information and support that they can give birth to twins normally. Then they can start the mental and physical preparation process. I am not sure if I could focus so much on normal delivery if my doctor didn't give me confidence in this.

• They should try to stay away from people who speak negatively about twin birth. If these people are family members, mother, sister etc. can talk about this with them. They can listen to the birth stories of women with positive birth stories until birth. Otherwise, they can watch normal birth multiple pregnancy videos on the internet. They can watch our birth video on the internet. I have watched too many plural normal birth videos. He had helped me. These will mentally create imagination and positively affect the pregnancy.

• If possible, they should listen to their own birth stories from their mothers. Thus, if there is a negative story, they can create an opportunity to restructure them. Even if it is not told, there is that information in their cells, and that information may appear as fear and anxiety at the time of birth. If his own birth stories are positive, this will also strengthen the pregnant woman.

• They can follow their birth preparation trainings in their provinces or districts. It wasn't that common 4 years ago. Now, I can see that these trainings are held outside the big cities.

• The support of the spouse and the support of the birth team is very important. If possible, they should know the team they will give birth to beforehand. Communication language is an important factor affecting birth. Communicate with them, get your expectations from each other. Because this process is not a one-sided process.

• The most important issue is never to be against a cesarean. Even when I was going to give birth with the intention of giving birth, I accepted that the birth could go to cesarean delivery if the need arises. And we discussed this with my birth team. Mothers who are prepared for normal birth but then have to have a cesarean are experiencing great disappointment and may feel deceived or unsuccessful. They should be prepared for birth, knowing that caesarean section can save the life of the mother and her babies, if necessary. Preparing blindly for normal birth will harm.

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• IVF twins can also be born normally, right?

There is a situation that caught my attention during my interviews with twin pregnant women; Especially, twin mothers who get pregnant in an unnatural way like IVF believe that their babies cannot be born normally. My message to prospective mothers thinking this way is that you may not have been pregnant in the normal way, but that does not mean that you cannot give birth normally. Of course, as always, after getting confirmation from your doctor, expectant mothers who are pregnant with IVF can believe that they can give birth if there are conditions that support normal birth in all respects. To me, faith comes before courage. Everything is possible if we believe!