Help for parents of twins and multiples

21 "I bet you get lots of help!"

Well, yes and no. Yes to begin with family did really rally around to help. I can't fault them for their efforts. Their continued effort to support us as and when they can is second to none. However, both my parents still have jobs, and busy ones at that. And both sets of grandparents live 3 hours away, in opposite directions. So whilst their intention and desire to help is 100%, the reality is that it's just not practical to move my mother in. 

And yes, whilst employing a nanny and having an extra pair of hands permanently 'on hand' would help, it's not without its downsides. For a start there's the money. These things cost. End of. We don't have that kind of money spare. Secondly as it is we are already tripping over each other and having to queue for the bathroom, or at least we will once all the kids are toilet trained. Then there is the small matter of inviting a complete stranger to come and live in your house, and play a part in raising your kids. I totally get why people go for this option, I don't have a problem with it at all as a general rule, but it's not for us. 

When I was pregnant with the twins people kept telling me that there would be lots of help out there. There were promises of training childcare workers eager for work experience - this turned out not to be the case anymore due to health and safety issues they're not allowed to carry out work placements within the home. There was talk about home help, funded by charities - turns out this is only in certain post code areas. Not in mine. Sadly. 

I was offered support by my local children's centre, the midwife said she would visit me once a week with her colleague to help out for an hour. This never materialised. Because I was too busy to pursue it, and they were too busy to remember me. 

Friends were full of promises to help out. Some friends were and are amazing. Some promises were too generous to be at all sustainable. It would have been wrong of me to expect them to keep to their word. Some friends have sadly fallen away, in part because they can never comprehend what my life involves now, and partly because I just haven't had the energy required to pursue and invest in friendships that don't come easy. 

Then there's twin clubs. These really do add value. They're very much a source of comfort. The other mums are encouraging and welcoming and understanding. But you have to get out of the house and actually get there - which when you're struggling isn't as easy as saying it. 

The place I didn't expect to get support from, but definitely did, was strangers I met through social media pages; twitter, Facebook and the like. These complete strangers reached out and encouraged me during some of the more challenging times. Some of these people I now call friends. 

Financially you get (or at least did get) child benefit per child. Apart from that there isn't any further provision made for the unexpected arrival of twins. My husband didn't get any extra paternity leave. He was expected to go back when they were just 2 weeks old. And as most twins are born premature (ours 6 weeks early) many parents are still back and forth to the hospital to sit by their tiny babies' side watching machines breathe for them, watching nurses care for them - and yet daddy is expected to go back to work. 

Then there's the complication of going back to work yourself. Me. Well. After my daughter was born I was surprised that I badly wanted to go back to work, I missed my career. I'd worked hard and done well and I didn't want to give it up. So I went back part time. After childcare costs were accounted for it was just about worth it financially. 

After the boys were born it didn't and doesn't make sense for me to go back. Going back would mean paying for 3 places in a childcare setting. Or getting a nanny, which as I've said we don't have room for. So we decided as a couple that I would be a stay at home mum for the foreseeable future. 

So in order for us to survive on one income my husband had to find a new job. And he got one. And I'm so immensely proud of how well he's doing in his career. The downside, he travels. Fairly frequently. Enough to warrant joining frequent flyer clubs. And sometimes he's away for up to a week at a time. He also works longer hours, usually getting home just before I take them up the stairs to bed. Just after I've negotiated their dinner. Wrestled them out of the bath and into their pyjamas. 

So far this has all sounded somewhat like a plea for sympathy. It isn't. My point is this. When you have 'twins' the intentions are honourable and sincere, people genuinely would love to help. But the reality is that the buck stops with me. It is my job. And it is down to me to get on with it. No matter how much I look longingly at the front door in hope that some fairy godmother will ring the doorbell, she won't. 

It's a shame there isn't a more comprehensive support scheme out there. It's a shame that there isn't some allocation of home help, or nurseries could somehow make placing twins more affordable. Perhaps if there was more practical and financial (allowing families to afford the help they need) then my previous post on post natal depression wouldn't have read that statistically parents of multiples are more likely to suffer. 

I hope that those amazing people that facilitate twins clubs continue to do so. I hope that organisations like TAMBA continue to exist. But most of all I hope against all the odds that one day the government might review the social welfare support of families struggling to keep nappies on bums and milk in the fridge when raising multiples.

In the meantime, I just hope you're as blessed as I have been with friends, family and neighbours. Those that have helped, have helped massively and kept my head above water. I know they wish they could do more, heck I wish they could do more. But they can't. And what they do do can be the difference between surviving and drowning. 

Is postnatal depression an appropriate response to childbirth?

I bet they keep you healthy
I bet they keep you healthy?
Postnatal Depression and Multiples

20. "I bet they keep you fit and healthy?"

Is postnatal depression an appropriate response to childbirth?

Well, yes and no. Physically I am probably stronger than I have ever been, I have developed muscles in places I didn’t even know we were meant to have muscles. But mentally, well there I haven’t faired so well.

After my first daughter was born, a friend kindly popped over to cook me a sausage sandwich and hold my tiny baby while I ate said sandwich. A mother herself, we were discussing adapting to this new life, when she said, “I think postnatal depression is an appropriate response to childbirth”. And I hate to say it, but I do agree with her.

I had a traumatic birth with my daughter, which left me very ill for a few weeks. I’m not talking just a bit sore down under ill, but blood poisoning, blood transfusions and the like. So you can imagine my recovery was somewhat slower than most. And therefore my bonding with my daughter was some what hindered. Now, don’t get me wrong here, we love each other to bits, but the early days weren’t fun. Far from. For a while I ignored the depression. I’ve had a history of it, so I’m used to those feelings.

But after a few months passed, things got easier, but my mood didn’t.  I admitted I probably had postnatal depression. I was avoiding answering the telephone or making calls. I wasn’t eating properly – food was a source of comfort not nutrition. I lost all self-esteem. I didn’t want to nor have the energy to socialise. Slowly I had stopped engaging in children’s activities. And this for me (and this really is my own personal opinion, I am not an expert) but this is where depression being an appropriate response turns into an inappropriate response.

It is normal to get down after a baby. Nothing is quite how you imagined, you’re not sleeping, you’ve hardly time to brush your teeth never mind your hair or chose an outfit or a matching pair of shoes. So of course in those early days being depressed is normal. I think you’d need to be concerned if you didn’t feel a sense of depression some of the time.

The nice guidelines say that;

"At a woman’s first contact with primary care, at her booking visit and postnatally
(usually at 4 to 6 weeks and 3 to 4 months), healthcare professionals (including midwives, obstetricians, health visitors and GPs) should ask two questions to identify possible depression.
– During the past month, have you often been bothered by feeling down, depressed or hopeless?
– During the past month, have you often been bothered by having little interest or pleasure in doing things?"

I mean, in honesty what woman, who has just given birth and not slept for more than two hours straight for the last month, would answer no to that first question?

When you do need to be careful is when that depression becomes disproportionate to your situation, and when that depression starts becoming a barrier to bonding with your child, or stops you from taking your child out into the big wide world as they grow. Then, in that situation, depression is not an appropriate response at all, and you need to seek support.

This all led me to wondering whether there is an increased risk of post natal depression when you’ve been blessed with twins.

I came across an article in The Guardian, which supports this theory;

Mothers of twins or triplets have almost twice the average risk of postnatal depression, a survey by the Twins and Multiple Births Association showed today.

It found that 17% of mothers who had a multiple birth experienced PND, compared with an average of 10% among all mothers. Another 18% of mothers of multiples were not sure if the feelings they had amounted to postnatal depression.”

The 18% who were unsure were probably way too tired and far too overstretched to know if they were coming or going never mind depressed. I am lucky in that my GP always asks how I am and my mood is whenever I take any of my snotty fevered kids in for a check up. I know what he’s asking, and I appreciate his observations. It is really important that health professionals, GPs and midwives look out for signs of post natal depression, as the likelihood is that the mother is too busy to notice herself.
And then lets not forget the daddy in all of this.

The actual report from TAMBA that The Guardian article was referring to (and of which I am a member of and highly recommend to any parent of multiples).

"Fathers of multiples may also suffer from postnatal depression, as a few respondents described:
“My husband suffered much more than me. He got very depressed”. Another father had to take four months off work to deal with his depression. Related to this, a particular issue arose around family breakdown with fathers unable to cope with the shock of multiples and subsequent PND for single parents of multiples."

So lets not forget that it isn’t just us mothers who can suffer. One of the big differences between my daughter’s arrival and the boys’ arrival is the involvement of ‘daddy’. When my daughter was tiny I would do the night feeds while daddy slept. However when the boys came along we would each feed one boy, and regularly have to nudge each other awake as one dropped off mid feed. We were both pushed beyond our limits, emotionally and physically.

Given that just the news that I was having my twins was enough to send my mental health into a spiral, I was pretty sure that I would need support with looking after my mental welfare once they arrived. And I was right. In some ways those early days were much more enjoyable than my first child, in part because I wasn’t nearly as ill this time, secondly because I didn’t wait to arrange treatment. Under the guidance of my doctors, my consultant, and my perinatal mental health workers I took treatment during my pregnancy and I continue to treat my postnatal depression now.

Therefore I didn’t wait to reach a low, as I have learnt the hard way that ironically it is harder to seek out help when you are at your lowest, as you lack the motivation. I anticipated the depression and treated it. And I am glad I did. Being a mother of any number of children is hard enough, being a mother of multiples is bloody hard, and leaves you with very little time or space to rationalise your thoughts, never mind notice that you might be depressed.

I’m not for one second saying that any mother of multiples will suffer from postnatal depression. However what I am saying is that it is understandable that it could be easy to fall foul of it, but that you are probably so busy dealing with the day-to-day trials and tribulations, the daily marathon you have to run just to reach the end of the day, that you might not notice it is happening. You might not notice that you’ve tipped from an appropriate amount of struggle, to an inappropriate and debilitating amount of struggle.

Therefore it is key that health workers, GPs, midwives, family and friends should educate themselves on the signs of postnatal depression, and look out for them even more when speaking with a mother, who quite frankly, has her hands full.

How important is it to know the difference

3 Small Individuals

19. But you’re their mum, surely you can tell them apart?

So the other day the thing I dreaded occurring happened; I yelled at one of my son’s “Rufus, Edwin, oh whichever one you are, stop pulling your sister’s hair”.

Ok, so I wasn’t actually terribly angry with myself, as speed was of the essence due to my poor daughter’s terrified face.  But I was a bit surprised that I hadn’t immediately known which of the boys was pulling her hair.

You see, to me, they look completely different. To the point that the other day whilst looking at photos of my lovely children, I found myself thinking ‘oh Rufus looks just like Edwin in that picture’. And then I was surprised that I had even thought that. Of course he looks like his brother. They are identical twins.

I haven’t, until very recently, read much about the theories of raising twins. I haven’t had time if I’m honest. The pregnancy was a disaster from beginning to end so I didn’t exactly have time to sit down with a book and consider my twin parenting perspective, and then they were born, and I didn’t have time sit down full stop.

So I based my parenting style on instinct, on the model of parenting I had been shown by my own Mam Bach, and through discussion with their other parent, my husband. Together he and I cobbled together a theory that we wanted to very much treat them as individuals. We didn’t want to refer to them as ‘the twins’, we certainly didn’t want to dress them the same, and we didn’t particularly want to treat them the same. Yes, we would of course love them equally, and be as generous with one as with the other, but not presume that if a certain song soothes one then it will soothe the other. We were prepared to separate them at night if one was having a sleepless night and the other in need of some peace and quiet. They had names, and we used them. We respectfully asked (with mixed success) our families to not refer to them as the twins. In our heads they just happened to be born on the same day.

Needless to say we still hear the ‘twin’ label a lot, from passers by who stop to ask the obvious ‘are they twins?’.  To the point that my daughter, following yet another passer by showing an interest in my sons, asked me if her surname was Milling. To which I replied yes, and I was proud that she knew this. However, then she asked “and is *my boys’ surname ‘Twin’ mummy?”  It was then that I realised that we had both succeeded and failed in our approach to having twins in our family. We had succeeded in so far as clearly ‘twin’ wasn’t how she primarily identified them. We had failed in so far as we obviously hadn’t managed to explain enough to our daughter what being a twin meant.

I’ve always felt it important that my sons both know I see them as separate and individual, and one of the things I found most frustrating in the early days was that I couldn’t mother them in the style that I wanted to.  Personally I am very child led to begin with, I feed on demand, allow them to sleep when they want, for as long or as little as they want, and if they need a cuddle they jolly well get one.  As the child grows so does their understanding that they aren’t the centre of the universe and that they will be ok if they have to wait a couple of minutes for their milk.  Try following those guidelines with two newborns and you soon fall foul. So there were many times when one wanted feeding and wanted feeding now, and I was unable to respond as I was still feeding the other child.  There were most certainly times when one just needed a cuddle and I couldn’t give them one as I was dealing with the other baby. I used to call them the double melt downs. But, as most parents do, I just did my best. I made sure that when I was dealing with one he knew that at that moment he was everything to his mummy. For those precious few minutes he was the centre of my universe, an extension of me, or whatever he needed to be in order to feel safe.

Now that our sons are nearly two (next week, they turn two, I can’t ruddy believe it) I am slowly gaining the odd glimpse of time within which I can turn my mind to something productive. One of the things I have been reading is (as I’ve mentioned before) Winnicott on the Child, the Family and the Outside World.  I have found this rather validating, as he also looks at these issues about a mother not being able to meet two infants’ immediate needs at once.  He says ‘as a matter of fact she will find her aim is not to treat each child alike, but to treat each child as if that one were the only one. That is to say, she will be trying to find the differences between each infant from the moment of birth.’

And here comes the bit that makes me feel bad on the odd occasion that I do get them muddled; he says ‘She, of all people, must know each from the other easily, even if she has to tell one at first by a little mark on the skin (Edwin had a tiny birth mark on his lip when he was born) or by some other trick (we left their hospital tags on at first). She will usually come to find that the two temperaments are different (when they were tiny we used to call Edwin ‘thumper’ and Rufus ‘tree hugger’ and those labels remain true even now) and that if she easily acts in relation to each as a total personality, each will develop personal characteristics.’

Winnicott goes on to talk about the huge importance of them being treated as two individuals, and this sentence really stayed with me ‘it is essential in every case that there should be no confusion among the children themselves, and for that there must be some person in their lives who is quite clear about them.’

Thankfully, despite my lack of any real research nor any vast amount of time spent reflecting on it, I seem to have stumbled upon what I consider to be a healthy approach to parenting twins.  It is quite validating to know that you aren’t getting it all wrong, even if you know you’re not getting it all right either.

I guess our job as parents of twins and a ‘singleton’ (gosh I hate that word) is to parent as though we have 3 distinct, quite separate, and rather adorable children.

*Elspeth refers to her brothers as ‘my boys’ which we think is rather lovely, a sense of ownership over them.