Expecting twins, or triplets? Here's some wise advice from BC Women's Obstetrician, Dr. Dena Bloomenthal

September 1, 2016
If you are expecting more than one baby, beware of consulting "Dr. Google!" The internet can provide you with an overwhelming amount of information, as well as some unrealistic expectations for pregnancy, birthing and early parenting. This advice comes from busy BC Women's obstetrician Dr. Dena Bloomenthal, who has delivered more than 300 sets of twins.

She encourages women who are pregnant with multiples to be kind to themselves and accept that not everything will go according to their ideal birth plan.

"I try to manage (couples') expectations and encourage forgiveness and self-care throughout the pregnancy," she says. "The truth is that not all moms of twins have a vaginal birth and are able to exclusively breastfeed."

Bloomenthal is dedicated to helping the couples under her care to understand and cope with the challenges of a twin pregnancy and caring for two newborns.
She is a also a firm believer in the power of the support that can be found by connecting with other parents in the same situation.

Here is Dr. Dena Bloomenthal with two of her beautiful little patients

We asked her to share the common-sense advice that she gives to pregnant women and their partners when they find out there is more than one baby on the way.

Prepare for the challenges of a twin pregnancy.

As your babies grow, your size will impact every activity that you do. It will be more difficult to move around, work, drive etc. Towards the end of your pregnancy, your partner will need to help you with the simple things that you take for granted, such as getting out of bed, dressing and driving. As you grow bigger, it will also impact your ability to sleep or rest comfortably.

With a singleton, you can work to 38 weeks, but with twins, plan on finishing earlier.

Your ideal birthing plan may not be possible, but it's important to kind to yourself.

It's less likely that you will have a "normal" vaginal delivery when you are pregnant with twins. For example, epidurals are common in twin pregnancies because there are two babies to deliver and it's important for women to have good pain control.  For some women, an elective (pre-booked) cesarean section will be the recommended approach.

When you have twins, feeding breast milk alone is not the norm.

Although many of the internet sources stress feeding babies with breast milk alone, not all women can breastfeed two babies exclusively.

"Trying to feed twins and pump breast milk can make women exhausted and depressed," Bloomenthal notes. "The last thing that a woman should be feeling at this point in her life is a failure. Don't base your happiness on exclusively breastfeeding. If you need to top up your babies, don't feel bad about it - just do your best."

Get help! Develop your support network.

Sort out your support network before the babies come home. When there are twins on the way, Bloomenthal recommends that partners plan on taking as much time off work as possible. Also, if grandparents, or other relatives/friends offer to come and help, take them up on it and develop a schedule so that there's always someone there to help you.

"It's so wonderful to have help holding, caring, bathing and feeding babies when you have two," she says.

If you can bring in professional help, such as a part-time nanny for a few days or nights a week, consider this option: "Just because you are home on maternity leave, it doesn't mean that you should be able to manage on your own!"

Connect with other parents of multiples.

Networking with others in the same situation gives parents the opportunity to feel connected and supported by a wider network, even when they are home all day with the babies.

Other parents with experience can provide a wealth of information - everything from advice on positions for breastfeeding two babies at once, to insights on the best baby equipment and reassurance that poor sleep patterns don't last forever.


When you are expecting multiples, your maternity care provider is the best person to provide advice and recommendations on the best resources to guide you through pregnancy, birthing and early parenting.

BC Women's Hospital + Health Centre website has breastfeeding information for parents of multiples.

Multiple Births Canada is a national support organization providing a variety of information for parents of multiples. 

This article was written by Anne McLaughlin with information provided by BC Women's obstetrician, Dr. Dena Bloomenthal


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Supporting Mature Moms

BC Women's has the expertise needed to help moms over 40 experience a safe and healthy pregnancy

Beth McInnis is heartbreakingly familiar with a moment no one wants to experience “There is that terrible moment in an ultrasound where the entire room knows the baby no longer has a heartbeat.”

Beth and her husband, Neville Lok, decided to start a family in their late 30s. They felt lucky when Beth conceived quickly but, at nine weeks, she miscarried. That crushing experience would be repeated again, and again, as the couple kept trying for a child.

At BC Women’s Recurrent Pregnancy Loss Clinic, under the care of Dr. Dena Bloomenthal, Beth learned the miscarriages were unavoidable, caused by abnormal chromosomes. “Everyone was so caring,” says Beth. “The nurses would come up and hug me.”

Determined, Beth conceived again, through IVF, only to experience another devastating miscarriage.

“I was crying every night,” she says. “I knew I needed to talk to somebody.”
The clinic connected her with a grief counsellor, who helped her find coping strategies, and accept that her own genetics were no longer an option.

Then Beth, by this time aged 45, discovered a U.S.-based program that pairs families who have stored frozen embryos with families who want to “adopt” them.

“By their mid-40s, the chance of healthy, spontaneous pregnancies is significantly reduced,” says Bloomenthal. “Often, they use donor eggs or embryos.”

In Beth and Neville’s case, they were matched with a family in Washington State, and had the donated embryo implanted.

The pregnancy was officially confirmed at BC Women’s, where Beth was monitored regularly for diabetes, preeclampsia and other complications.

“The risks are heightened as you get older,” says Beth. “Dr. Bloomenthal and her colleagues at BC Women’s really kept an eye on my health and how our baby was doing.”

At 11 weeks, Beth experienced bleeding and was diagnosed with a subchorionic hematoma. Dr. Bloomenthal prescribed bedrest to reduce the risk of pregnancy loss, and the danger passed. Then, in May 2014, the couple welcomed their son, Tristan.

“The team is phenomenal,” says Beth. “They provided support, care, and a community where we no longer felt alone and lost in our struggles.”

Recently, Beth and Neville welcomed their daughter, and second embryo adopted child, who was also  born at BC Women’s.

Written by Melissa Edwards
Photography by Claudette Carracedo

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The content provided in Women’s Health eNews is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition

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