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A Tale of Twins

The story of my boys begins long before they were born. As a toddler, I experienced peritoneal infection following a ruptured appendix. The scarring of my fallopian tubes and my resulting infertility was not discovered until I had an ectopic pregnancy in 1997. My obstetrician immediately referred me to an IVF clinic. Being told we might never have children was an absolutely frightening experience.

Thanks to God and technology our daughter Abby Grace was born February 12, 1999. Ironically, her birth date is the anniversary of my appendectomy in 1972.

We experienced three failed IVF attempts over the next 2yrs. Those who have been there will be able to relate to the grief and fear that goes with such a loss. The emotional roller coaster you’re on when you go through an IVF cycle is hard to describe, regardless of whether or not a pregnancy results.

In July 2001, we discovered that science and God had come through for us again. Cramps and bleeding began at 7 weeks. I was alone at work, and panic set in immediately. I remember lying in the ER begging God, “Please don’t take my baby!”. Waiting for an exam from my OB I was thinking “maybe it’s a twin pregnancy and I’m only going to lose one.” It’s scary the thoughts that come to mind in those situations. I was somewhat relieved to hear that my cervix was still closed. An ultrasound showed two babies with normal growth parameters and great heartbeats! My tears of fear were for the moment replaced with those of relief and thanks.

My uneasiness and fear lasted throughout the pregnancy, as the bleeding came and went. I was hospitalized once just before Christmas, and again mid-January. On the morning of January 18, 2002, one of the baby’s placentas abrupted. I felt a fear and panic that I had never known before and could not describe easily with words. Thankfully I was already in hospital. I had an emergency c-section. I can remember waiting to go into the OR and thinking, “It’s so early. (31weeks and 5days)”, but at the same time I was relieved that it was coming to an end. I couldn’t stand the anxiety anymore. Alec and Ian were born at 0730 and 0733, weighing 4lb4oz and 3lb9oz respectively. Despite their small size, they did amazingly well. Neither needed any resuscitation. They were so beautiful! It tore at my heart that I couldn’t cuddle them right away.

The boys spent 5 weeks in ICN, during which time they grew well and experienced only minor setbacks. It was rewarding to know that my breastmilk was doing such a great job for them, but man did I get tired of sitting with that pump!!! My husband, Shaun, created a little nursery humour by labeling all the jars of milk with names like “Carter’s Creamers”, and “From the twin peaks to the twins’ beaks”!

Breastfeeding got off to a slow start as it often does with preemies, but they were troopers by the time they came home.

Now, approaching their second birthday, they are happy, healthy, delightful children. Our days with Ian, Alec and their big sister Abby are hectic yet filled with smiles and laughter. I thank God for them every day, and reflect often on the technology that helped Him out. I’ve enjoyed connecting with other moms of multiples in our area, and am looking forward to continued involvement with MBC [Multiple Births Canada].

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Speech by Joel Haslam at Multiple Births Canada’s Conference 2003

Recently, I was thinking about my very first “multiples moment”. Do you remember yours? Well, I don’t know about you but mine wasn’t exactly “Hallmark” greeting card material.

My wife, Pam was expecting (what we believed to be) our second child. Thanks to the miracle of fertility drugs, we had already been blessed with a beautiful baby girl–her name is Sydney by the way–who was about 2 1/2 when Pam got pregnant a second time. We were overjoyed. You see, we were one of those couples who were, supposedly, unable to successfully conceive. Suddenly, the wonders of science and, of course, the Grace of God had given us a child. Now, another gift was on the way. But right from the get go, our second prenatal experience was different. At just 7 weeks or so, I noticed that my wife was really hungry…really really hungry…all the time. I couldn’t make sandwiches fast enough. I was slinging food like a short-order cook. Of course, I never said anything because being pregnant, she was also really emotional…really, really emotional…all the time. So believe me I was really careful – really really careful…all the time.

With a raised eyebrow, I patiently awaited our first ultrasound at the doctor’s office which was just days away. Do you remember your first ultrasounds? We went in feeling quite confident about the experience because this was, afterall, baby number 2!! Old hat. We didn’t want to know the sex – we were just praying that the baby to be was healthy and presumably happy…. But almost instantly the doctor doing the ultrasound goes, “Hmmm”… And I go, “What?” And she says, “I don’t know if you saw those as quickly as I did? Hmmmm” “What?”, I say… “Two heart beats”, she says. Suddenly the room was silent. You could hear a pin drop. With tears in her eyes, my wife gives me “the look”. I’ll never forget it. I return her gaze…welling up equally…take her hand and say the only thing there was to say,”OH MY GOD!! OUR BABY HAS TWO HEARTS!!!”

It was my first multiples moment and I missed it.

Now, my wife and the doctor lock eyes and roll them simultaneously. “Joel,” Pam says to me, “twins, we’re having twins.” Now it’s my turn to lock eyes with the doctor. With a congratulatory smile, she nods. I immediately feel really blessed–really stupid–but really blessed-even chosen. Whatever did we do to deserve this? It was a question we would ponder on the long car ride home. Later, it was a question I would utter out loud–in a much less celebratory tone–just weeks after the twins were born.

Wow, those early days were exhausting…the bottles, the diapers, the numbing fatique. We burned out two coffee pots, which seemed to be dripping Tim Horton’s best at our place 24 hours a day. And then, there’s all the STUFF–the double playpens (and in some of your cases triple and quadruple), strollers, cribs, and highchairs. At times, it felt like we weren’t going to make it. Really. Those folks on those realityTV shows got nothin’ on us. We’re the original survivors. So what if you can eat bugs or swim with sharks. Just try a weekend on twin or triplet island when little Johnny and Susie are teething. We’ll see what you’re made of. And, of course, there are the memories. I won’t bore you with my mine. But this weekend you’ll keep company with yours as you meet others who understand and can relate to your multiple moments. You’ll remind each other that the extra work loads that come with multiples result later in lives filled with two, three, and four times the joy. And if you’re like me, you’ll wonder just where the time’s gone. My son Tait is 7 and a half, his sister Madison is just 5 minutes younger…Their older sister, Sydney is 10.

I may have missed my first multiple moment in the doctor’s office all those years ago but I’ve savoured everyone since. And you know what? Back then, I wasn’t far off saying my baby had two hearts. They bring so much love to my life that most days I just can’t believe their hearts are regular size. I’m just glad there will always be a special place in them for me. I’m lucky. So are you. Have a wonderful Conference.

By Joel Haslam

Joel Haslam, Host/Producer Regional Contact, CJOH TV (CTV Ottawa), speech given at Multiple Births Canada’s Conference, May 2003.

0 comments on “Premature Delivery of Twins”

Premature Delivery of Twins

I found out I was having twins when I was about 23 weeks along. I thought I was having twins right from the get go though. At 25 weeks, I went into early labour. I was stopped and ordered on to strict bed rest. Premature delivery is not so convenient when you have a 3 year old and 18 month old at home.

All was well until Jan 29 2002. My due date was April 9. I awoke at about 6:00 am with a little pain and a rock hard belly. I sat in the tub for most of the morning. The pain got a little better as the day went by. My best friend was a little concerned and dragged me to the hospital. The Dr. on call came to look me over and said I was 1 cm dialated. I did not see anything wrong with this [as] I had been 1 cm for three weeks.

The contractions were consistant, about every 2 minutes or so but did not hurt too bad. He let me be for a bit [and] to get rehydrated to see if that would help. I felt better but was now 2-3 cm dialated. I was now starting to worry. It was now after midnight and I was tired and hungery. They would not feed me though. He had given me some steroids to help their little lungs develop and called an ambulance to bring me to the hospital. He came into my room with the ultrasound machine to take a look at the positions of my girls and of course they were lying sideways.

By this time it was about 4:00 am and the peramedics were finally there to take me away. That is when I became scared. I did not want to go in the ambulance by myself. I did ok though. I was transported to a high risk hospital and another Dr to come in and ask if I knew what a c-section was. Of course I know what a c-section is I told him and he handed me a piece of paper and told me to sign it. I did as he asked and away he went. They hooked me up to the fetal monitor for a few seconds and then they wisked me away. I had to have an epidural. My other children were natural delivery’s no i.v’s or other kind of meds.

At 30 weeks gestation, Jenna Mae or baby A, as they called her, was born at 5:47 am weighing 3lbs 3oz’s and 16 1/2 in long, followed by her little sister, Emma Leigh, at 5:49 am weighing 2lbs 15ozs 16 in long. Jenna cried for a few moments but Emma did not move or make a sound. So off to recovery I went and it was the NICU for the girls. Nobody would tell me if my sweet baby girls were ok. They kept telling me they were being stablized.

At about 1:30 in the afternoon and still no sleep for me, a nurse came in with the NICU Dr to let me know that they were fine. Jenna had been able to breath on her own for about 10 minutes before being vented. Emma was vented right away but resonded well and pinked up as soon after. They told me it was ok to go and see them. So off we went. I was wheeled into the NICU by my best friend and we washed up. A nurse came out to get us so we could see them. I do not think I had ever seen such little babies in my life. I reached out to touch my beautiful girl and the nurse grabbed my hand. You can only lightly place your hand on them she said. I must have gave her quite the look because she quickly explained that if you rub them even lightly you can rub their skin right off. So of course I was now afraid to touch them.

Emma got well right away. She was off the ventilator after 5 days. Jenna took a turn for the worst at 1 week [old]. She got an infection called NEC [Necrotizing Enterocolitis: A gangrene-like condition of the intestinal tract which can afflict premature babies] and had a blood infection. Emma came home weighing 4lbs 9ozs at 5 weeks old. Jenna came home weighing 6lbs 5ozs at 4 months old.

They are now 20 months old and Emma weighs 24lbs and Jenna 21lbs. They are trying hard to walk and talk. They are very determined little girls and I feel that once they catch up, they will not be stopped.

Erika

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Delayed Speech or Autism?

Hi my name is Laurie. My husband is a twin and I am a twin. He has a twin sister and I had a twin sister who died 5 days after birth. Neither my husband nor I are monozygotic twins. We have dizygotic twin boys who are very different. One is more talkative and the other is very laid back.

A pediatrician recently said that there was a possibility that the laid back twin may be autistic. We are in a speech play group to help him with his words. It has been a wonderful experience and we feel that he doesn’t have autism but rather speech delay, as his brother has always been the one to ask for things and lead the way. Austin (the talker & and first born) will ask for a cookie and Colton (the laid back one) will automatically get one as well. Because he doesn’t have to ask for it, he doesn’t get to practice his verbal skills.

Colton is doing much better now we realize how to assist him with his verbal skills and he will continue to improve. My husband (David) and I have decided not to send Colton to be assessed. We feel that if there are problems, that a few months more of waiting and encouraging him will not hurt him. The Speech Pathologist feels that we are doing everything we need to be doing and in her professional opinion, if he is Autistic, it is a very mild case.

I would love to chat with other mothers in the same position. The boys turned two years old in April of 2002. I can’t stress enough how important a schedule is with newborn twins. Please e-mail me at ajpcdw@msn.com.

Laurie, Fort Frances, Ontario

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Early Delivery

I am very interested in sharing my story of my early delivery, premature, low birth weight babies. I am happy to say I am the mother of wonderfully healthy and beautiful four-year old twins who have been amazing to watch develop. I had a fantastic, problem free pregnancy and was loving every minute of it.

At a routine ultrasound at 30 weeks, I was told my twins were not developing equally and would have to be delivered immediately – I was not given any feedback as to what the problem might be. I was induced within three days (of my ultrasound) and delivered a 4lb. 3oz. boy and a 3lb. 8oz. girl. Very big for 10 weeks early.

As it turned out, they were both developing very well, were close in weight and did not need to be delivered so early. It was a very truly, frustrating and scary time for us.

Of course we ran the gamut of incubation, tube feeding, long hospital stays, no sucking reflex, breast pumping every two hours, one baby home while one remained in the Neonatal Intensive Care Unit, living in a new city with no family or friends close by, guilt for letting them be taken from me needlessly, and lots more.

But we were so lucky there were no major health problems and I did learn a life-long lesson about being an advocate for my children. This is just a small part of our story and I would love to be able to help others by sharing it.

Thanks,

Michelle, St. Thomas, Ontario

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Postpartum Depression and Mothers of Multiples

This article offers general information regarding Postpartum Depression for general educational purposes only. Consult your healthcare professional if you or someone you know is in need of health care support.

Postpartum Depression (PPD), in some areas, is also known as Post Natal Depression (PND). This article uses the term Postpartum Depression.

The medical dictionary defines Postpartum Depression as: A form of severe depression after delivery that requires treatment. It is sometimes said that postpartum depression (PPD) occurs within 4 weeks of delivery but it can happen a few days or even months after childbirth. A woman with PPD may have feelings similar to the ‘baby blues’ — sadness, despair, anxiety, irritability — but she feels them much more strongly than she would with the baby blues. PPD often keeps her from doing the things she needs to do every day. When a woman’s ability to function is affected, this is a sure sign that she needs treatment. While PPD is a serious condition, it can be effectively treated with antidepressant medications and counseling.

Some statistics about PPD

  • one in ten new mothers suffers from PPD (a new mother being one with a newborn infant, not necessarily a first time mother)
  • PPD is Five Times more common in mothers of multiples than mothers of singleton newborns. LaTobe Twin Study calls this twinshock*.1
  • based on these two statistics, we can estimate that there is a greater chance that PPD will affect new mothers of multiples.
  • 76% of all mothers of newborn twins felt constantly exhausted as compared to only 8% of mothers of singletons.2,1

It isn’t uncommon to confuse the Baby Blues and PPD. Baby Blues is a hormonal and physical condition that often occurs within the first week or so of childbirth and lasts just a few days or weeks. Medical professionals estimate that as many as 85% of mothers of multiples experience Baby Blues to some degree.

Baby Blues feelings can include

  • feeling tired and exhausted
  • bouts of crying for inexplicable reasons
  • insomnia
  • feeling easily irritated

PPD can begin as Baby Blues and last weeks or up to two years after birth. PPD occurs more frequently than many other pregnancy related conditions such as pre-eclampsia, gestational diabetes and preterm labour, and yet new parents know less about PPD than they do about these pregnancy conditions. PPD is often viewed as a stigma or as a result of the new mother’s inability to cope, thus making it more difficult to seek professional help.

Depression is a mental illness which, in the extreme, can render an individual’s normal day to day coping mechanisms completely ineffective. The simplest tasks can take on enormous proportions and make everyday, common tasks seem impossible.

Signs of PPD can include

  • crying for no apparent reason
  • chronic fatigue or hypersomnia
  • loss of appetite
  • feeling overwhelmed and hopeless
  • doubt or guilt
  • compulsive over the babies’ care
  • ignoring the babies’ care
  • feeling worthless, unable to cope
  • anxiety attacks
  • inability to concentrate, indecisiveness
  • in the extreme, thoughts of suicide

If a mother of multiples is experiencing such symptoms, don’t dismiss them as being part of the extra workload due to having multiples. The more of these symptoms the mother is feeling, the more likely it is that she is suffering PPD. Consult a doctor immediately.

Causes of PPD

While a specific cause has not been determined, hormones in the woman’s body can trigger symptoms. During pregnancy, two female hormones estrogen and progesterone are greatly increased. After birth, the levels of these hormones drop dramatically. Such changes could lead to depression.3 . A new mother should not feel guilty if she experiences PPD. Whether or not she does and to what degree, is beyond anyone’s control.

  • lack of social support from one’s partner and families can be a key contributor. Before the babies arrive, it is important to have good support systems in place.
  • if a mother has had PPD after a previous pregnancy, she is more likely to have it in subsequent ones. Arrange appropriate support systems before the babies’ arrival.
  • Cesarean section is a major contributing factor to depression. Some Cesareans result because something has developed with the babies that requires their immediate birth. It can be difficult to be excited about the babies when the mother is in pain.
  • there may be a greater risk if the birth does not go as planned.
  • if the babies are premature, they could be away from the mother in the Neonatal Intensive Care Unit, adding to anxiety and depression.
  • feeling guilty about not being able to cope, take care of everyone (including other children), having a preference between the babies.
  • the inability to begin breastfeeding or to continue breastfeeding may cause concern in the mother.

Once diagnosed, some ideas for coping with PPD

  • some PPD mothers having difficulty bonding and relating to their babies. Being proactive and treating the PPD is helping your babies.
  • always say ‘Yes’ when help is offered.
  • if you need help, ASK for it. Most of our family and friends are willing to help and respond favorably when asked to.
  • tell your partner how you feel, keep the lines of communication open.
  • if you need to, seek professional intervention by visiting your doctor regularly. You may, for a time need counselling and/or medication. Not all people like to take medications but they can help you get back on track and make it easier to work on behavioural strategies. Counselling could be alone or as a couple.
  • keep your stress levels as low as possible, stay flexible.
  • breastfeeding can elevate a mother’s spirits.
  • keep your daily activities and expectations to a reasonable level, e.g. vacuum one room of the house and not the whole house.
  • don’t isolate yourself. It is important to maintain contact with others.
  • plan one night a week, or every other week, when a baby sitter will come in and spend time as a couple.

Hints for Partners

  • learn all of the signs and symptoms of PPD. In some cases, you may need to take the initiative, step in and make an appointment with your partner’s doctor. Attend the appointment with your partner.
  • organize household help. Participate in baby care, ask friends or relatives to pitch in, or hire extra help for the first months;
  • organize care for older siblings.
  • be patient and understanding. Don’t take your partner’s words or actions personally. PPD is no one’s fault and to answer back may only escalate the situation.
  • listen (you don’t always have to have answers), sympathize, empathize.

Remember

  • Awareness of the signs and symptoms is the best defense against PPD.
  • BOTH parents need to know the signs and symptoms of PPD and, if necessary, the partner needs to take the initiative and make an appointment with the doctor on behalf of his/her partner.
  • PPD is an illness and it can be treated.
  • PPD affects everyone in the whole family.
  • By looking after yourself, you are also looking after your family.
  • Although rare, fathers can experience PPD too.

Lynda P. Haddon, Multiple Birth Educator, www.jumelle.ca

David Hay, Professor of Psychology, Curtin University, Australia for his help and feedback on this article.

*The term ‘twinshock’ was originally coined by Pat Malmstrom, founder and President of Twin Services Inc. in California, U.S.A.]

Bibliography

  1. David Hay, LaTrobe Twin Study, Australia
  2. From work by and conversations with Alex McPhail, Ottawa
  3. Article, ”A common illness, not uncommonly overlooked,” by Lisa Priest, The Globe and Mail, Tuesday, 14 th December, 2004
  4. Emotional Health During Pregnancy & Early Parenthood: An Information Booklet for Parents of Multiple Birth Children, beyondblue: the national depression initiative www.beyondblue.org.au

Other Resources

For Partners

 

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Dad / Partner’s Role

During pregnancy and childbirth, it is not unusual for the other partner to feel somewhat left out and unimportant. In reality, nothing could be farther from the truth!

Dad’s role as supporter, labour coach, listener, evaluator of when Mom may be in (preterm?) labour, baby handler/changer, cook, cleaner and, did we mention listener? – is not to be underestimated. Children thrive under the guidance and nurturing of both of their parents. However, when children are born two or more at a time, it is imperative that Dad become proactive in the care of the babies. Multiple birth babies can cause a lot of stress in the family and being aware of this ahead of time can be important. Taking the initiative in child care, communication and sharing of thoughts and tasks is essential for the well-being of all concerned.

Note: The following has been prepared in order to assist the partner in being supportive of the pregnant woman. It is acknowledged that not all relationships are composed of a mother and father. For ease of writing, the “partner” throughout this article has been referred to as “dad”.

Night Feedings

5-first-year-challenges-with-multiples-360x240
It may take several days before you find a routine which works well for the whole family. One family of twins worked out a system whereby when a baby awoke, Dad would get the baby, change him and bring him to Mom to feed in their bed. He would ‘sleep’ until they were finished, take the baby back to his crib, wake the second baby, feed her and bring her to Mom to feed and then return her to her crib when feeding was finished.

A variation of this style of feeding would be to wake both babies and feed them simultaneously, thus shortening the awake time.

Some families agree that since Dad probably works in the daytime, he needs to sleep the night through. Two possible scenarios could help you if this is your decision:

  1. If bottlefeeding, Dad could do the last night feeding, say at 11:00p.m. and the first morning feeding, say 6:00a.m. Both parents can there get some extended sleep time.
  2. If breastfeeding, Mom could get up to do the night feedings and try to catch up on some of her sleep during the next day when the babies are also sleeping.

Some families have hired a night time nanny instead of a daytime nanny. This could be especially helpful for parents of higher order multiples.

Another breastfeeding twin family used this idea, which worked for them. Mom would continue pumping her breasts after each feed during the week, collect and freeze the milk. Friday and Saturday nights, each parent would take a child to a different part of the house and Mom would breastfeed while Dad bottlefed the baby the expressed breastmilk. This guaranteed each parent longer periods of sleep time at least two nights a week.

You will need to communicate often with each other and establish a routine which works not only for you but for your babies too. It may take some time to work out, but don’t give up. Ask other parents of multiples how they worked out the night feedings and be creative with what will work for all of you.

Some Things Dads Need to be Aware of

Father with twinsIt is important that each parent remember that in times of stress and sleep deprivation, things may be said to one another that are unintentionally hurtful. If Dad is the main source of family income, he has the opportunity to leave the home, engage in adult conversation, have uninterrupted bathroom and coffee breaks and he receives positive feedback for achievements. Mom, at home, doesn’t have these small, but important, luxuries. Further, Dad leaves his work and comes home to a new routine. As the stay-at-home Mom, she is on duty 24 hours a day, 7 days a week. It is not unusual for Mom to be waiting at the door for Dad and to thrust a baby into his arms. Getting away to shop for groceries or run errands can provide a much needed change of scenery for Mom.

Sick, cranky or colicky children can cause tears, anger or venting by Mom when Dad returns home at the end of his workday. If you find yourself in such a situation, please remember not to take it personally. An acknowledgement of the situation: “It sounds as if you have had a long and tiring day” or “My how did you manage to do all of that?” is an important validation of what Mom has been dealing with all day. Nothing is going to change, the children aren’t going to “be returned”, but sometimes a validation of our exasperated feelings and a realization that we are together and not facing the situation alone, can make a huge, positive world of difference to all. Listening and acknowledging another’s business in any situation can never be the wrong thing to do.

Remember that each of you are learning how to take care of children from Day One. Women are not born knowing how to look after children and babies don’t arrive knowing how to suckle. Child rearing is an on-going learning situation and Dads are learning too. He needs to learn to diaper, bathe and dress babies. While of course you are assisting your partner in taking care of your children, you are also developing a close rapport with your babies. This is an extremely important and beneficial side effect for all of you.

Little Things Mean a Lot

  • If your partner has had a cesarean section, you may need to do all of the shopping and carrying for the first few weeks;
  • This may be the time to hire someone to cut the grass or shovel the snow. Make your life as simple as possible over those first few weeks;
  • If there is another child(ren), take her grocery shopping with you. This changes the dynamics at home and provides quality time with your other child(ren);
  • You might take one baby grocery shopping. Strap him on into a baby Snuggli and away you go. This is helpful for everyone and allows for important one-on-one time with each child plus encourages each child to become independent and separate from the others;
  • Bring home supper once in a while;
  • Hold/pick up a baby whenever necessary. Don’t wait to be asked to do so;
  • Give Mom a chance to bathe or take a shower, uninterrupted and at her leisure;
  • Learn how to work the washer and dryer and throw in a load of laundry;
  • After the babies are in bed, take some time to be together. You can talk, cuddle, share a glass of wine, offer a back rub to each other or simply sit together. It is important to remember how you got to this place and to take time and space for each other as well;
  • Listen to each other! This cannot be emphasized enough;
  • Provide time for your partner to go out somewhere with friends, alone or to a multiple birth support Chapter meeting;
  • Bring home flowers once in a while;
  • Keep a sense of humour;
  • Join a fathers of multiples support group;
  • Enjoy your children. They will make you feel very special and proud.

Additional Resources

The Art of Parenting Twins by Patricia Maxwell Malstrom and Janet Poland
Twins, Triplets and More: Their Nature, Development and Care, by Elizabeth Bryan, published by the Multiple Birth Foundation, London, England
Twin Care: Prenatal to Six Months, Multiple Births Canada
Finding our Way: Life with Triplets, Quadruplets and Quintuplets, published by Triplets, Quads, Quints Association: http://www.tqq.com
The Joy of Twins and Other Multiple Births by Pamela Patrick Novotny

Written and Developed by Lynda P. Haddon and Sandra Tompkins, 1998