Women who are pregnant with twins will find that their pregnancy and the first six years are about triple the challenge faced by women who have single births.

Some physical risks during pregnancy include pre-eclampsia, placenta abruption, fetal and growth restriction. Emotional challenges are financial and physically related.

Pre-eclampsia is a pregnancy-induced high blood pressure disorder which develops in about 10 to 20 per cent of women carrying twins, twice the rate in women pregnant with one baby. The condition also tends to develop earlier and be more severe in women carrying twins or more babies.

Placental abruption is when the placenta detaches from the uterine wall before delivery, and is also more common when you're carrying more than one baby. But the condition is mostly linked to malnutrition and smoking, and is rare in well-nourished expectant mothers. Placental abruption can lead to preterm labour and delivery, and is responsible for about one in five twin deaths late in the pregnancy, or in the babies' first month outside the womb.

Growth restriction

Fetal growth restriction occurs when one or both twins isn't growing at the proper rate. It may cause the babies to be born prematurely or at a low birth weight. Up to almost half of pregnancies with more than one baby have this problem compared with slightly more than 10 per cent of single pregnancies.

Another risk is twin-twin transfusion syndrome, when one twin takes the other's blood supply. It is another rare but serious complication in identical twins. One baby somehow gets too much blood and the other too little. Until recently, severe cases meant the death of both babies, but these days survival rates are much higher, thanks to early detection.

If you are pregnant with twins, work with your doctors who will keep close tabs on your physical condition and the babies' development.

Local mom Susan Parchment told Outlook that her delivery was complication-free, but the financial burden of providing for her twin daughters was her greatest source of stress.

"Providing for them was the worst part. I needed twice the amount of everything all the time - food, clothes, love. Buying pampers was so expensive." " There were also times," she said, "when I could not get time for myself. Once I wanted to use the bathroom and could not. My husband was not at home 24 hours when they were younger."

As the twins grew older, she said she was also challenged to develop ways of solving their disagreements without injuring the self-esteem of the other. Usually the twins were also demanding affection at the same time too.

"I try to understand their personalities and to think of strategies beforehand that will best suit their personality," she said.

Experts note that the heavy demands of caring for multiples make parents especially susceptible to stress, but there are measures that can help to reduce the strain.

Both parents will experience stress, and they can do much to help each other. In addition to being physically exhausted, women may be emotionally drained from feelings of anger, frustration, sadness, guilt, depression or self-pity. Fathers of multiples also feel neglected, jealous of the attention showered on the babies, and pressured by the extra financial demands.

Physical exercise can aid in reducing emotional stress. Try walking, jogging, stretching, yoga, swimming, bicycling and aerobics. Meditation also can reduce stress and increase your energy level.

Support

Accept the support of friends, family, play groups, sitters or community services. Often, just talking with other parents of twins, either informally or in a support group, provides emotional release.

Reduce interruptions by unplugging the phone or using an answering machine during mealtimes and naps. Minimise hazards by finishing one task before starting another.

Deal with financial pressures by making twins share cribs during early infancy, buying quality used equipment and clothing, and swapping outgrown items with other families.

Make up a daily list of all the household chores, from shopping to vacuuming, to feeding the babies that each parent can share. Remember to say thanks to each other every day. Appreciation is a proven method of reducing stress.

Sources: www.parentivillage. com and www.babycenter.com