When you go in for your first ultrasound post-embryo transfer, you and your intended parents will simply be hoping for a healthy, strong heartbeat. It will probably come as a shock to both of you if the doctor picks up two — it means you’re carrying twins!
Even though reproductive endocrinologists often do all they can to ensure a healthy singleton pregnancy with little risks, sometimes nature has other plans. You may not have seen yourself carrying twins for someone else for nine months. But, now that you’re in this situation, what can you do?
We know getting news of a multiples pregnancy can be shocking. Remember, your American Surrogacy specialist will always be there to answer your questions and support you moving forward.
While identical twins are rare, they can happen. Here’s what you should do if you find yourself in this situation:
1. First, Talk with Your Intended Parents
An identical twin pregnancy can bring up a lot of complicated emotions, and that’s especially true in a gestational surrogacy. You and the intended parents may need some time to process this news and what it means for your journey, but it’s crucial that you’re all on the same page moving forward.
Make sure that you are open about your thoughts and emotions during this time. Fortunately, you’ll have a roadmap for the next nine months (see below about your contract), but there will always be opportunities to update that plan as you figure out what works best for you. Having an open conversation and building a solid team dynamic from the beginning will make the challenges ahead much easier.
Remember: You have as much of a say in this gestational surrogacy as the intended parents, so don’t be afraid to share your feelings about this unexpected situation.
2. Look to Your Contract
The first decision you’ll make together is whether or not to continue this pregnancy. Because identical twins share a placenta, it’s nearly impossible to safely reduce the pregnancy to one fetus. Instead, you will be faced with an “all-or-none” decision: to continue with the twin pregnancy or terminate in hopes of a healthy singleton pregnancy during your next transfer.
Your path forward will be laid out in your surrogacy contract. Making this important decision in the heat of emotions is incredibly difficult; that’s why we require all intended parents to discuss these complex situations ahead of time with a lawyer. Your contract will likely inform your next steps.
Your contract will also address the additional compensation you are entitled to during a multiples pregnancy: the additional payment for carrying twins, bedrest compensation, wages for missed work and additional compensation for invasive procedures (such as a Cesarean-section). If you ever have any questions about your surrogate compensation, talk with your surrogacy specialist or attorney.
3. Remember the Risks
There’s a reason why reproductive endocrinologists take steps to ensure singleton pregnancies in IVF and gestational surrogacies. Carrying more than one baby increases the health risks for both carrier and babies.
If you and your intended parents will move forward with an identical twin pregnancy, you’ll need to be comfortable with the additional risks this can create, including:
- Preterm labor and delivery
- Low birth weight
- Preeclampsia
- Gestational diabetes
- Cesarean-section
- Placental abruption
- Fetal death
You will need to be extremely careful and take certain precautions to keep yourself and the intended parents’ babies safe. This may mean you undergo a planned c-section before your due date or spend the last few weeks of your pregnancy on bedrest or limited in the activity you can do.
Your surrogacy contract will address the worst-case scenario (disability compensation and life insurance), but you must be comfortable with these risks before you agree to continuing a multiples pregnancy.
4. Create a Plan for Your Family
Because a multiples pregnancy comes with the risks mentioned above, you’ll need to work with your spouse and immediate family members to create a plan. This will come in handy, should you be placed on bedrest, have to take maternity leave early or have an extended recovery from a c-section.
Your family should have a plan for:
- Who will watch your children and pets while you are unable to
- Who will put together meals for your family while you’re incapacitated
- Who will bring you supplies when you’re at the hospital
- And more
Your surrogacy specialist can give you suggestions of things to plan for, based on her experience with other surrogates.
This is where having a great support system of family and friends can come in handy. Reach out to your support system; see if someone would be willing to prep some ready-made meals for your family, or take some of your laundry to the laundromat after delivery. You may be surprised at just how much help you’ll get!
5. Take it One Day at a Time
In many ways, a multiples gestational pregnancy is no different from a singleton gestational pregnancy. Yes, there are some added risks but, by taking things slow and keeping yourself safe, you can still have a successful, memorable surrogacy experience.
The last thing you’ll want to do is stress yourself out with all the “what-ifs.” You and your intended parents should instead focus on all the things you can control: your birth plan, your relationship during surrogacy and the beautiful experience you’re having together. A positive outlook can make all the difference during the uncertainty of a multiples pregnancy.
Remember, if you are ever in need of additional support or guidance, American Surrogacy will always be there for you.