Helping Families Navigate Multiple Pregnancy and Beyond

two pairs of newborn feet

In order to meet the unique demands and concerns of mothers and families expecting twins, triplets or higher-order multiples, the Brigham and Women’s Hospital Division of Maternal-Fetal Medicine (MFM) launched the Comprehensive Care Center for Multiples in December. It is the first center of its kind in Massachusetts and one of only a few in the United States.

Center Director Carolina Bibbo, MD, an MFM specialist, joined the MFM division in 2015. She subsequently heard from many patients about the lack of services and resources geared toward multiple parents. With the Center for Multiples, she and her team are addressing that need.

“I wanted to create a center where everything we do is focused on multiple pregnancies, which are very different than singleton pregnancies,” Dr. Bibbo said. “My team and I have been taking care of families expecting multiples here for over five years, so we have a lot of experience managing everything from small hiccups to major issues. It’s what we do every day.”

Prenatal Care and NICU Services

As part of the Division of Maternal-Fetal Medicine, the Center for Multiples is well-equipped to manage any medical complications that might occur as the result of a high-risk pregnancy. Patients have the option to receive all their prenatal care from an MFM specialist with a clinical focus on multiple pregnancies.

“We’re happy to be as involved as the patient and her local OB/GYN want us to be,” Dr. Bibbo explained. “If the patient decides to have all prenatal care here, we would welcome her. If there are concerns about complications during the pregnancy and the patient would like to have a one-time consult at our center, that’s fine too. We can make recommendations for the pregnancy and delivery planning and stay connected in case other complications arise.”

In addition to Dr. Bibbo, the Center for Multiples team includes physician assistant Kara Donati, nurse/breastfeeding specialist Lucy Graves, NICU nurse/lactation consultant coordinator Sue Bryant, childbirth and lactation educator Sarah McNamara and social worker Marysabel Gomez. Each patient sees a nutritionist for a consult early in her pregnancy, and genetic counselors and newborn specialists are available to provide assessment and counseling services before, during and after pregnancy. All of these professionals have extensive experience serving multiple mothers and families.

The team collaborates to offer a full range of clinical services, including prenatal care and diagnosis, assessment and treatment of complications, obstetrical ultrasounds, delivery and newborn care. Also available are a number of prenatal education classes designed especially for multiple parents. Topics addressed in the classes include having a healthy pregnancy, preparing for labor and birth, breastfeeding, preparing for a possible NICU stay and caring for multiple newborns at home.

Expertise in Multiple Deliveries

During the last trimester, Dr. Bibbo wants to make sure families are ready for all that lies ahead. She noted that parents tend to focus on potential complications during the pregnancy but not the myriad challenges that come after the birth, such as child care, meal preparation and getting help around the house. For this reason, the Center for Multiples team encourages parents to think through their post-delivery plans earlier rather than later.

Patients can choose to have their delivery at the Brigham, where the care team includes an obstetric anesthesiologist and a nursing staff highly experienced in multiple births. The Brigham’s state-of-the-art Newborn Intensive Care Unit, the largest and most advanced in Massachusetts, is available for premature and seriously ill newborns requiring intensive care.

In the days and months following the delivery, Dr. Bibbo’s team continues to keep in touch with the mother and family. “We reach out soon after the birth to see how the family is doing and what help they may need,” Dr. Bibbo said. “We recognize it can be isolating to be at home with newborns and overwhelming at times, so we strive to extend our continuous support after delivery until 12 weeks postpartum.”

Ultimately, Dr. Bibbo stressed, the Center for Multiples is designed to provide a safety net for mothers and families under their care.

“It can be nerve-wracking and stressful to have multiples,” she said. “We opened this center so that these families can have access to experts in every area of their care and get answers to all their questions so that they are informed, feel safe and have the best possible experience and outcome.”