Pregnant with Twins or More

• Increase your rest - Resting on your side is a helpful way to keep your uterus relaxed. Also elevating your bed so that your hips are slightly higher than your head will keep the pressure of the baby off your cervix.
• Fluid intake - During your pregnancy, it is important to drink 6 to 8 glasses of fluid per day or as other wise directed.
• Bedrest - Your doctor/midwife may ask you to take rest periods during the day, or stay in bed all day except for getting up to go to the bathroom and sitting up for meals.
• Decrease strenuous activity - You may be asked to not do any heavy physical activity such as jogging, running, tennis or frequent trips up and down stairs. Also, you may be told to limit heavy lifting, cleaning, and long trips.
• Consider a temporary change in work activities - Work activities may need to be changed or stopped. Your doctor/midwife will tell you about decreasing your activity and what they feel would be best for you. They can provide you with a doctor ordered limitation list for work.
• Sexual activity - Your midwife/doctor may ask that you stop or limit your sexual activities.
• Be alert for the signs and symptoms of preterm labor.
• Be aware of your uterine activity using one or more available methods:
  • Use of Self-palpation - You can check for contractions after the 20th week of pregnancy by emptying your bladder and drinking a glass of water. Lie down on your left side. Use pillows to help support yourself so you can find a comfortable position. Do not lie flat on your back. Place your fingers on your stomach on either side of your belly button. Wait for your uterus to contract or tighten. During a contraction, your uterus will feel hard like your forehead. Use a watch to see how long the contraction lasts. After the contraction, your uterus will relax and you can press into it with your fingertips. If you have 4 or more contractions in an hour, call your provider right away. Contractions occur normally throughout pregnancy. They are usually painless and they can occur at any time. If you are having difficulty feeling contractions, you may not be having contractions or you may not be aware they are occurring.
  • Use of a small recording device similar to the one used in the hospital labor and delivery unit - An electronic monitor may be used in certain situations to detect the contractions that may be associated with preterm labor. You will wear a belt around your stomach for an hour, most likely twice a day. The belt has a sensing device, which is attached to a small recorder. If you have a contraction while you are wearing the belt, the sensing device records the information about your contraction. Once each day you will be asked to send any information that has been recorded across your telephone line to a monitoring center.

Always remember to follow your doctor/midwife's instructions about your prenatal care and activities.

What to do if you think you are experiencing preterm labor:

• Call our office
• Go to the bathroom and empty your bladder
• Check to make sure you have not missed a dose of any medication you might be taking
• Maintain adequate fluid intake as instructed by our doctors and nurses
• Rest, lying down on your left side
• Monitor your uterine activity

EMERGENCY SITUATIONS

Sometimes a problem can occur that needs attention right away. If you experience any of the following signs and symptoms, CALL YOUR PROVIDER IMMEDIATELY.