Dealings
Parenting Multiple Preemies...Oh Baby, Oh Baby, (Oh Baby, etc.)

By: Mara Tesler Stein, Psy.D. and Deborah L. Davis, Ph.D.

Being pregnant with multiple babies is exciting for most parents. Whether your multiple gestation was spontaneous or a result of fertility technology, the anticipation of raising more than one baby can be overwhelming but joyful. You might find yourself saying that you feel doubly (or triply, etc.) blessed.

It is a common assumption that "twins come early," but not usually as early as they did for those of you with very early twins, triplets or more. At least initially, many relatives and friends may not understand that your babies came way too early. Instead of seeing this as a crisis, people might assume that this is fine and dandy for multiples, and not appreciate your panic and fear. They may translate the early birth of your multiples into "just a few weeks early" and then you have to take a deep breath and be much more specific. So, from the outset, others may diminish your preemie experience and you may feel totally misunderstood. And it can be difficult to have to explain over and over again that, yes, multiples often come early, but your babies came far earlier still, plus explaining all the ensuing medical complications and consequences. Not only do you feel separate from the experience of parents with singletons, but also from the common experience of parents of multiples whose babies are born closer to term.

When you have more than one baby in the hospital, the roller-coaster ride that every preemie parent experiences is at least doubled. There are times when it seems you can’t get any relief because often, if one baby is having a "good day", another may be having a harder time. You have the medical course of more than one child to keep track of, to worry about, and to ultimately take charge of. With more than one infant in the NICU, there is also a tendency to compare the babies. How much weight is being gained? How much supplemental oxygen? Any apneas or bradycardias? One child provides a sort of "baseline" for the other. In a situation where unpredictability is the rule, looking to one child as a predictor for the other is a common pitfall.

Dealing with Multiple Realities

Parenting multiples in the NICU is a gargantuan task. Your worries about feeding, infections, surgeries, setbacks, and other complications are multiplied. As you face multiple realities, you can expect to react and respond differently than a parent for whom a particular event is the only reality. Remember that these realities you’ve endured would be considered overwhelming for any family to deal with over a number of pregnancies and several years. You’ve experienced them simultaneously.

When your babies’ hospital courses vary, besides worrying about each individual baby, you may also worry about how their outcomes may differ. Of course you want all of your babies to be okay, but your fears can run deeper than this. If one in a set of multiples is disabled or developmentally delayed, not only do you mourn for the "abled" child that you’ve lost, but you also fear a loss of unity— that mystical bond between siblings who are twins or triplets, etc. If one has significantly more limitations that the other(s), you may worry that he or she will be the "odd one out".

If one or more of your babies die, not only do you grieve for your child(ren), but for the lost chance to raise twins, triplets, quads, quints or more. And if you have survivors, you want to be able to think of them as more than just "part of a broken set".

When you have more than one baby in the NICU, you may also struggle with trying to connect with each one separately. Getting to know your multiples would be a challenge even if they were not premature and in an NICU. Becoming acquainted and attending to their needs to be with you when they are in the NICU, and even once they come home, is a monumental juggling act. Each baby is precious yet you may feel like you don’t have enough emotional or physical energy to give to even one. And when they are in separate beds, you may also grieve for the fact that they cannot snuggle together anymore, and that besides missing your womb, they miss each other.