Connie Agnew - Twins!: Pregnancy, Birth and the First Year of Life

twins!

2 ND EDITION

Pregancy, Birth, and the
First Year of Life

Connie L. Agnew, M.D., Alan H. Klein, M.D.,
and Jill Alison Ganon

ILLUSTRATIONS BY VICTOR ROBERT

This book is dedicated to:

My parents; my husband, William Brien; and my children,
William Jr., Brent, Kelly, and Ashley
CONNIE L. AGNEW

The memories of my parents, Lois and Don Klein;
my daughters, Laura Klein-Danilov and Rachael Klein;
and my wife, Rabbi Toba August
ALAN H. KLEIN

My husband, David Arnay; my son, Miles;
and my wish for a bright future for children everywhere
JILL ALISON GANON

our fascination with twins

As we prepare this revised edition of TWINS!, twins, triplets, and higher-order multiples now account for approximately 3 percent of all pregnanciesa percentage point higher than it was when this book was first published in 1997. Societys interest in multiple birth remains keen, yet we grow increasingly familiar with twins in our childrens class-rooms, on their sports teams, and for some of us, in our immediate or extended families. Scientists continue to study twins, obstetricians and pediatricians all over the country grow more familiar with the particular medical and health concerns that may apply to some twins, and the marketplace is increasingly engaged with supplying products for twins. We are happy to have had the opportunity to update and expand this book to support the needs of loving parents as they prepare to welcome their twins into the world.

As the Roman myth comes to us, Romulus and Remus were born to Mars, the God of War, and Rhea Silvia, one of the Vestal Virgins. After the birth of her two healthy boys, Rhea Silvias wicked uncle Amulius had them placed in a basket and thrown into the Tiber River, so as to remove any potential threat to his throne. The twins were rescued and nursed by a she-wolf on the slope of the Palatine Hill and later discovered by the shepherd Faustulus and reared by his wife. When the brothers grew to manhood, they deposed Amulius and placed their grandfather Numitor on the throne. Then they decided to build the great city that we know today as Rome.

Romulus and Remus, Castor and Polluxstories of twins and their unique positions in society appear in Greek and Roman mythology as well as in the literature of the Old Testament. Even before there was any written documentation about the miracle of twinning, there were drawings of twins and twin births. We have ancient evidence of an incredible range of cultural responses to the phenomenon of twinning, as well as equally seasoned documentation of exceptional behavior attributed to twins.

Every culture has its own unique relationship with this phenomenon. It is the structure of each society, from its day-to-day function to its most profound view of life and death, that ultimately informs attitudes toward twinning. Economic conditions undoubtedly influence custom. Anthropologists tell us that in a well-supported economy, twins pose no threat to the survival of the family. But if povertywith its devastating lack of adequate nutrition and shelteris more prevalent, twins may represent an unbearable burden to the struggling family.

As well discuss later on, there is a racial component to the incidence of twinning. Twinning is most common among the black population. Outside Lagos, Nigeria, there is a temple dedicated to twin deities. Members of the Ibex tribe of Africa erect a statue to honor a twin who died at birth. The statue is carved and raised to watch over its twin. The surviving twin cares for the statue and lives in close proximity to it, reminded forever of the absent brother or sister. The Mojave Indians of North America believe a twin represents the return of some beloved and highly esteemed family member who is honoring them with a reincarnation here on earth. For the Indians of British Columbia, Canada, the birth of a twin into the tribe heralds plentiful hunting and fishing in the year to come. Interestingly, in Asia, where the incidence of twinning is lowest, twins have not traditionally been welcomed. In modern China, there are strict rules governing a familys limit to have only one child. Certainly the birth of twins is not viewed positively by the state.

The significance of birth carries implications in every culture. In some societies, twins have been viewed as an aberration, a punishment for some known or unknown wrongdoing on the part of the mother, father, or both. There are examples in primitive cultures of the community, bewildered by the question of twin paternityThis unfaithful woman has lain with another man!making outcasts of the mothers of twins. While it is unlikely to be the source of this belief, there is a very rare phenomenon in twinning that can be the result of two different fathers. This extraordinary event can occur if a woman ovulates two eggs that are fertilized within a short period of time by sperm from two men. These are not your everyday twins.

We seem to have an abiding fascination with the miracle of twin birth. Apparently there is no end of curiosity regarding the laws of nature as they apply to multiple births. Media coverage of high-order multiple pregnancies is relentless. Every year, thousands of twins congregate for a Twins Day Festival in Twinsburg, Ohio, where they revel in one anothers company and pick and choose from among the many researchers who vie for their attention. Scientists have long been interested in exploiting the uniqueness of twins in an attempt to differentiate between the influence of genetic and environmental factors as they apply to our health and emotional well-being. There is fascinating data confirming our suspicion that we have a lot to learn about twins. From medical journals to television talk shows, there are demonstrations of uncanny similarities in the lives and habits of twins raised apart since earliest childhood. Social anthropologists, psychologists, and educators view twins as a sort of miraculous living laboratoryan invaluable tool for the examination of the effects of environment, parenting, and shared genetic material. Researchers have used twins to study the impact of certain pollutants when one identical twin has been exposed and the other has not. The perception that twins share some special ability to communicate has been noted since primitive times. Identical twins, more rare by far than fraternal twins, hold an even firmer grip on our collective intellect and imagination, holding a mirror up to the face of society and asking us to explore the very idea of identity, and to what degree (if any) our genetic information figures into the development of the individual psyche.

But for a parent, discovering that you are pregnant with twins is like being an explorer at the mouth of a beautiful, unexplored river. There is the shock of discovery, quickly followed by speculation about the unknown. Will the river be wild at times? Is your craft sturdy enough to navigate this uncharted territory? How about your crew and supplies? Can you afford to take the voyage? If the rich, miraculous experience of parents who have already begun their expeditions is any measure, you cant afford not to. So, safe travels to you and your unborn twins. Youre starting out on a truly epic journey.