ONE TOO MANY? FAMILIES WITH MULTIPLE BIRTHS

摘要

Providing support for families Pwith multiple births (FMBs) presents a range of challenges to both the family and health practitioners. Recognition of these challenges is becoming increasingly imperative - the rate of multiple births in England and Wales has risen over the past 40 years, from 9.7 per 1000 maternities in 1977 to 15.73 per 1000 in 2016, (Office for National Statistics, 2017), because of a combination of fertility treatments, women having babies later in life (a predisposing factor for dizygotic lvinning) and advances in obstetrics and intensive neonatal care. As Nelms (2007) has suggested, FMBs are challenging to work with for a number of reasons. Multiple births often carry with them an elevated risk of medical complications (Glazebrook et al, 2004), including the babies being born preterm (Martin et al, 2012), with autism (Gardener et al, 2011), or with low birthweight (Glazebrook et al, 2004), alongside risks to the mother (Dudenhausen and Maier, 2010). As Bowers (1998) highlights, multiple births are much more likely than singleton births to result in complications. Consequently, NICE recommends a specific range of specialised antenatal care guidelines for mothers of twins, triplets and higher -order multiples (Visintin et al, 2011). Aside