Research and Studies


double-mei-tai

Most of us are interested in Naturally Parenting Twins because we find that there is inherent wisdom in the “natural” way of doing things (however we define that), even as we are thankful for those times that medical intervention is available when warranted. Frequently, our providers, not recognizing how much time and thought we have put into our birth and parenting decisions, may say to us that there is one best way for things to happen. And indeed, in some narrow and specific instance, there may be! But most of the time, there are different options open to us that are safe, and there may be research to support what we intuitively know is right for our families.

Remember, RESEARCH + INTUITION = SPECIFIC DECISION

One of the tricky things about research conclusions is that they are sometimes contradictory. Part of the reason for this is that we’re all unique individuals, and our pregnancies, babies, and bodies are unique as well. We also recognize that it empowers women to have peer-reviewed research to back up their choices. With that in mind, here are some of our favorite links to research that supports our requests for natural options in multiples pregnancy, birth, and parenting! Again, these are the studies that support AVOIDING intervention. This list is a work in progress!

Nutrition and Prenatal Care in Twin and other Multiple Pregnancies

http://www.midwiferytoday.com/articles/veganpregnancydiet.asp
Dr. Barbara Luke’s guidelines for nutrition are here: http://www.twinsmagazine.com/fostering.pdf
More on nutrition in her book (though she advocates a more medicalized approach to pregnancy and birth): http://www.drbarbaraluke.com/Books/Expecting.aspx
Elizabeth Noble’s more natural-friendly book about twin pregnancy, birth, and parenting, _Having Twins and More_: http://elizabethnoble.com/file/Books.html

Bedrest in Twin and other Multiple Pregnancies
http://www.ncbi.nlm.nih.gov/pubmed/11279677
Bedrest during pregnancy may WORSEN risk of premature labor

Birth Weight Discordance and Vaginal Birth (Larger twin B)
http://www.ncbi.nlm.nih.gov/pubmed/12847538

Gestation Length
http://www.ncbi.nlm.nih.gov/pubmed/22959832
http://www.ncbi.nlm.nih.gov/pubmed/16483372

Cesarean
http://ican-online.org

Mono-Di issues
http://www.ncbi.nlm.nih.gov/pubmed/20579959
http://www.ncbi.nlm.nih.gov/pubmed/23200164 (This one has lots of potentially scary details about complications of TTTS, but the takeaway is that TTTS affects 8-10% of Mono-Di pregnancies).
http://www.ncbi.nlm.nih.gov/pubmed/23025564
http://www.ncbi.nlm.nih.gov/pubmed/19900048
http://www.ncbi.nlm.nih.gov/pubmed/23447913 (Vaginal safe for mono-di)
http://www.ncbi.nlm.nih.gov/pubmed/22812918 (“The neonatal outcome was not affected by the mode of delivery, and therefore vaginal delivery seems safe in MC twins.” Does support birth by 37 weeks.)
http://www.ncbi.nlm.nih.gov/pubmed/22554921 

Vaginal Breech B (This is a pretty easy one to find studies for, so I’m only posting a few.)
http://www.ncbi.nlm.nih.gov/pubmed/16214286
http://www.ncbi.nlm.nih.gov/pubmed/11717658
http://www.ncbi.nlm.nih.gov/pubmed/10895024

Vaginal Breech A
http://www.ncbi.nlm.nih.gov/pubmed/17230290
http://www.ncbi.nlm.nih.gov/pubmed/22465994
http://www.ncbi.nlm.nih.gov/pubmed/17003746
http://www.ncbi.nlm.nih.gov/pubmed/10636499

VBAC
http://www.ncbi.nlm.nih.gov/pubmed/16157110
http://www.ncbi.nlm.nih.gov/pubmed/15501161
http://www.ncbi.nlm.nih.gov/pubmed/12679821
http://www.ncbi.nlm.nih.gov/pubmed/11444785
http://www.ncbi.nlm.nih.gov/pubmed/19658041
http://www.ncbi.nlm.nih.gov/pubmed/12679820
http://www.ncbi.nlm.nih.gov/pubmed/10635485
http://www.ncbi.nlm.nih.gov/pubmed/9292641

Triplets
http://www.ncbi.nlm.nih.gov/pubmed/9790375
http://www.ncbi.nlm.nih.gov/pubmed/15144337
http://www.ncbi.nlm.nih.gov/pubmed/9822488
http://www.ncbi.nlm.nih.gov/pubmed/9776599
http://www.ncbi.nlm.nih.gov/pubmed/7612511

Homebirth
We have a homebirth with multiples support group on Facebook: Contact us for more details.
Mary Cronk (UK Midwife) Guidelines for Twin Birth: http://www.chcroft.com/share/mary_cronk_twins_guidelines.pdf
Ina May: DVD Delivery of Twins:http://www.inamay.com/natural-delivery-vertex-twins-dvd
“High Risk” homebirth about weighing risks, not “designer births”: http://www.midwiferyjournal.com/article/S0266-6138(11)00181-1/abstract

Food and Drink in Labor
http://evidencebasedbirth.com/q-a-food-and-drink-during-labor-9/
http://www.ncbi.nlm.nih.gov/pubmed/10507677

Gestational Diabetes
http://evidencebasedbirth.com/category/gestational-diabetes-2/ (All articles from EBB pertaining to gestational diabetes)
http://www.ncbi.nlm.nih.gov/pubmed/20722122

Ultrasound, Fetal Weight, Birthweight Discordance
http://www.ncbi.nlm.nih.gov/pubmed/22762512 (Singleton, 38% false positive)
http://www.ncbi.nlm.nih.gov/pubmed/16964298 (Singleton, 1 in 4 off by 10% or more)
http://www.ncbi.nlm.nih.gov/pubmed/21311174 (Birthweight discordance, twins, 65% detection, 15% false positive)
http://www.ncbi.nlm.nih.gov/pubmed/18827117 (“The accuracy of the ultrasonographic estimated fetal weight seems to be lower for twin gestations than for singleton gestations, especially for second twins.”)
http://www.ncbi.nlm.nih.gov/pubmed/10492103 (Essentially, the “Femur 4″ method of birthweight prediction is easier with twins, but still “problematic” at determination of BW discordance.)
http://www.ncbi.nlm.nih.gov/pubmed/7900521 (“Prediction of individualfetal weight seems to be more accurate than prediction of inter-twin discordance.”)

Importance of Support from Educators, Doulas, Providers, and Friends
http://www.midwiferyjournal.com/article/S0266-6138(04)00037-3/abstract

If Cesarean Becomes Necessary
This is a document that used to be available from ICAN (although I can’t find it online any more) that I believe can be invaluable for times when cesarean is medically necessary: http://www.chcroft.com/share/icanfamilycenteredcesarean.pdf

Breastfeeding
http://www.midwiferyjournal.com/article/S0266-6138(07)00091-5/abstract
Late preterm birth and bf challenges: http://www.internationalbreastfeedingjournal.com/content/7/1/16
Epidurals and bf challenges: http://www.internationalbreastfeedingjournal.com/content/1/1/24

Cosleeping Safety
http://cosleeping.nd.edu/safe-co-sleeping-guidelines/
http://kellymom.com/parenting/nighttime/familybed/
http://www.askdrsears.com/topics/sleep-problems/scientific-benefits-co-sleeping
http://www.midwiferyjournal.com/article/S0266-6138(06)00075-1/abstract

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Helpful sites:

Solace for Mothers: http://solaceformothers.org
Solace for Mothers is an organization designed for the sole purpose of providing and creating support for women who have experienced childbirth as traumatic.

ICAN’s Facebook group: https://www.facebook.com/groups/ICANOnline/
Includes support for CBAC mothers who were planning for a VBAC but ended up with a repeat cesarean.

AP Multiples discussion group: http://groups.yahoo.com/group/apmultiples/
This list is a great place for information and networking about attachment parenting with twins, triplets, and quads!

Sidelines National Support Network: http://www.sidelines.org
If you end up with pregnancy complications and/or bedrest, this organization helps provide support and assistance to mothers experiencing higher risk pregnancies.

Fetal Health Foundation: http://www.fetalhope.org
If your pregnancy is in any way high risk or complicated, Fetal Health Foundation can help with information and research support, and are specifically informed about TTTS and other issues specific to mono-di pregnancies. They even have a Facebook support group for discussion of mono-di pregnancy issues, as well as a group specifically for families whose multiples have been diagnosed with TTTS.