Finally we have proof! Doctors often misinform parents about zygosity

Throughout my pregnancy, my OB and the ultrasound technician told us our boys were absolutely, positively, no-doubt-about-it fraternal. Yes, my doctor said, identicals can have separate placentas and sacs, but mine implanted too far apart to be identical.
Their placentas were on polar opposite sides of the uterus.
Identical twins implant more closely, he said.
He was wrong.
And he has company.
In a new study from University College London, researchers found that doctors wrongly told parents their identical twins were fraternal in 27.5 percent of the cases. Like my guys, those twins had their own sacs and placentas.
The study also found that 2 percent of parents were wrongly told their fraternal twins were identical because doctors did not realize their separate placentas had fused into one. Overall, 15 percent of twin parents were misinformed about zygosity.
I have long suspected the statistics involving identical twins are skewed.
This proves it.
So many parents find out long after birth that their twins are identical through DNA testing. That information is never reported to any statistic-gathering source. If this study hold true in the US, then statistics showing the odds of having identical twins is about 3 in 1,000 are way off.
It has become a game on online twin forums: Guess whether the twins are identical while the parents await results of DNA testing. In most every case where parents of di/di had trouble telling their twins apart, the results showed they were, indeed, monozygotic, or identical.
I have come across just as many parents of look-alike twins in real life and virtually who decline testing despite their gut feelings. Either they can't afford the $100 to $200 fee or they see slight differences between their twins and accept those as evidence their twins are fraternal.
We could have done that do that with our guys.
Matthew has a slighter build and a thinner face. Jonathan is much more muscular and has a rounded face -- a little more body fat in his cheeks. But that scenario is true of most identicals. One usually has a slightly different facial shape than the other.
In some of those cases, parents brushed off their identical suspicions because their hospitals "tested" the placentas and the results showed they were dizygotic, or fraternal.
Our own doctor fell for that until I pressed him for more information and he checked with the hospital.
It turns out hospitals check only whether placentas are fused. The hospital techs either definitively declare the zygosity according to the results or the pass the results on to doctors or midwives who were told in medical school that two placentas equals fraternal.
The doctors or midwives then pass that misinformation on to parents.
Remember this: hospitals DO NOT do DNA testing.
In the defense of OBs, midwives and ultrasound technician, zygosity is irrelevant in caring for pregnant women. What matters is only whether there is one placenta or two, and one sac or two. So they really don't need to know for medical purposes.
That doesn't, however, excuse the giving of misinformation.
In our case, a fellow soccer mom who was a neonatologist educated me.
She told me that identical twins implant separately when the split occurs immediately after conception -- within the first few days. Matthew and Jonathan probably became two far up in the fallopian tube, she said, allowing them to fall and implant independently, just like fraternal twins.
At the very least, our OB should have told us he didn't know.
He should have known that he didn't know.
All doctors, midwives and ultrasound technicians should know that they can't be certain with same-gender twins until after the babies are born. Though the information is medically irrelevant during pregnancy, there is no excuse for being misinformed about something so relevant to the field in general or for passing that information on to parents.
None.

Fraternal verses identical: the attention factor

It's rare, but it happens.
Most often, parents of fraternal twins find the fact that Matthew and Jonathan are identical interesting, but it ends there. Raising identical twins has its unique challenges, but parents of any category of twins have so much in common that further discussion of their zygosity needn't come up.
But every now and then, I'll get that immediate snub from a fraternal-twin parent, that kind of look that I'd expect to see on a middle school playground from the girl who is envious of the other girl for reasons that are all in her own head.
I know what that look means because I am a curious person. I've explored it before. I've pushed past the snub and pursued conversations. It means that this parent is a little envious because she believes my twins get more attention than hers.
The hard part is that she is probably right.
The harder part is that it shouldn't matter.
The people we meet don't mean to upset anybody and it certainly doesn't mean that fraternal twins are any less valued.
It's just that identical twins are more obvious.
They attract attention.
But, as we were often taught during sensitivity training in my former career as a journalist, intention is pretty much meaningless. Perception is what counts. Reporter Dionne Searcey of The Wall Street Journal does a wonderful job of capturing that perception and the dynamic behind it at the annual Twins Days festival in Twinsburg, Ohio, last weekend.
Click this link for her story: At a Convention Full of Them, It's Apparent Not All Twins are Created Equal.

Are they natural?

I logged onto my favorite online forum for parents of twins the other day and I couldn't believe what I saw.
On the first page of recent posts, there were three new threads.
One was a lengthy thread of vents from women who were tired of being asking whether their twins were "natural." Another was a poll created by a fellow member asking others whether their twins were conceived naturally or through fertility treatments. The third asked the same question, but not in poll form.
I usually avoid those threads all together.
People have a million reasons for asking that question (They are undergoing fertility treatments, they are concerned about a family history of twins, they are struggling for something to say while their eyes are fixed on our adorable babies, they are just plain curious). But rarely is the reason malicious.
I'm not bothered.
So I don't bother with the threads.
But this situation piqued my interest.
I opened the two threads in which board members posed the question to each other. I expected rants. I expected anger. I expected virtual riots between those who spontaneously conceived and those who underwent fertility treatments.
There were none.
Those who conceived with the help of drugs or IVF told of their struggles, their tears, and their gratitude to have not just one baby, but two. Those who conceived spontaneously told of their shock, their family histories, their glee.
Not even the teeniest bit of irritability.
So I opened the vent thread.
Many of these same women, these women who so cordially and eagerly answered the same question for each other, expressed outrage that anyone--family, friends or strangers--would even dare ask.
All babies are "natural," they argued, even those conceived through fertility.
So, I wonder.
Why is it okay for strangers (because, really, no matter how long you've known someone through an online forum, that person is still a stranger) who might also happen to have twins (How do you even know that other person is who he or she claims to be?) to ask how our twins were conceived on an online forum, when the same question is concerned taboo, rude or unbelievably inconsiderate if asked in person?
My conclusion is that some women just love to get angry and they love to tell others how angry they got. They seek out confrontation where there is none and then they feed off of it for the rest of the day, sometimes the rest of the week.
And this might just be the way some twin moms deal with the stress.
It's a non-issue for these particular women in an online setting. They can answer honestly because they have no desire to destroy the relationship. They need the other moms on the forum. They have an investment in the online "friendships," where they can hide behind usernames, never revealing their real-life selves.
Beside, confrontation is more fun when it's face-to-face.
For the record, not all identicals are spontaneous (depending on our definition of spontaneous). Many sets of higher-order multiples include sets of identical twins. The identical twinning is an indirect result of the treatments (Treatment aid fertilization and implantation, and the eggs just happened to split), but still, chances are that those identical twins would not be here without the help of modern medicine.
So if you ask "the question" of a triplet mom or a quad dad or even parents of octuplets and you get a puzzled look in return, try to be understanding. It's a long story and perhaps they are just wondering whether they have the energy to answer.

Identical twins; fraternal eaters

Our oldest son is vegetarian.
He is 9 and hasn't eaten meat in five years.
Our 7-year-old daughter makes up for her brother's lack of meat consumption. She routinely eats the meat, fruit and vegetables and she leaves the carbs behind. She'll even leave French fries untouched.
I have always figured their eating habits were genetically influenced. After all, our oldest two children are only 17 months apart and they were raised in the same eating environment. I can't imagine what we might have done that would have made such a drastic difference in their eating habits.
But the twins defy my logic.
The other day, I tried an experiment.
I gave the boys hot dogs, PB&J, cheese and green beans for lunch. As expected, Matthew ate all of his hot dog and most of Jonathan's. He had seconds and thirds on green beans. He had one bite of PB&J and none of the cheese.
Jonathan ate two bites of hot dog. He ate all of his PB&J and polished off Matthew's. He ate his own cheese and his brother's and then asked for more. He had seconds on the green beans, but didn't finish his second serving.
Matthew ate the meat and lots veggies.
Jonathan ate the carbs, non-meat protein and a moderate amount of veggies.
This is the pattern that has been developing over the past few months.
I don't get it.
The twins have the same DNA. They have always been offered the same foods at the same times. I would expect some differences in their eating habits; Even though they are identical twins, they are different people with minds and preferences of their own.
But this goes beyond that.
They are emulating the opposite habits of their older brother and sister.
That might make sense if they were around them more often. But, thanks to school, the four children usually eat only dinner together. And at dinner, our oldest son eats what we eat with either beans, or a soy- or whey-based product as a meat substitute.
They don't see his PB&Js or her rolled up salami.
I just don't get it.

Chicken Soup for the Soul: Twins and More

I am not generally a sentimental person.
The twins do have baby books.
They are those bulging manila envelopes on the shelf next to my desk.
The older kids have boxes.
I don't save birthday cards. I don't read romance and I rarely read inspirational books.
But I bought Chicken Soup for the Soul: Twins and More anyway. I'd gotten to know the co-author, Susan Heim, who is mom to 5-year-old fraternal twins and two teen-aged boys. Susan has agreed to write the foreword for my yet-to-published book, a compilation of interviews with stay-at-home moms.
She is a wonderful person and an insightful author so I thought I'd check it out.
I can't put it down.
And I'm not just saying that because of my connection with her.
I really can't put it down.
The stories are short enough that I can read one while the twins are bathing, another while they are watching Diego and another before bed when everyone is fast asleep.
They are addictive.
Some are sweet.
Some are sweetly sad.
Some are just fun.
Susan first hooked me with It's Twins, a book of advice and stories from other twin parents. She has other books to her name and she does it all while staying home with her kids. She is my inspiration.
Well, sort of.
I asked her one day whether things get better as the twins get older.
She laughed (virtually. I could hear it in the exclamation point after, "So far, I would have to say it hasn't gotten much easier!").
That was not inspiring.

Budding artists at last

Once a month, I tape sheets of white paper to the trays of the boys' highchairs, slide Matthew and Jonathan into their seats and hand them crayons. I take my own crayons and demonstrate, drawing squares, smiley faces and hearts.
Then I watch as they chomp on the crayons and shred the paper.
Today, I prepared for the same scenario.
But today was different.
Today, they colored.
The pictures are not all that interesting. They are a compilation of scribbles. But what is interesting is this: Jonathan and Matthew did not watch each other or follow one or another's lead. They did not even wait for my demonstration.
On this very same day in this very same moment, they each independently picked up their crayons and put the waxy sticks of color to the paper. They simultaneously achieved the appropriate mix of fine-motor-skill development, curiosity and desire that enabled them to produce scribbles.
And when they were done?
They ate the crayons.

Jonathan's first-ever work of art is on the top. Matthew's is below.

Watch the hips

We are hitting the road again for a week, the last vacation until next summer. The Boys will return when we do.

I was waiting for my daughter at dance camp last week when I ran into a mom who has a son about the same age as the twins. She was leaning over a box of used tap shoes, looking for a pair that would fit her daughter. Her toddler was standing beside her, chewing on a pacifier and clinging to her leg.
She asked where the twins were.
"I left them with a sitter," I said. "I can't bring them in here. They'll scream if I leave them in the stroller and they'll run into two different studios if I let them out."
She looked down at her son.
"Not him," she laughed.
That's when it hit me.
That's the difference between the twins and so many of their singleton peers.
Many toddlers find the world to be a frightening place. They might venture a few feet away from mom or dad in unfamiliar territory, many more than a few if they are certain their parents will chase after them. But, for the most part, they have a necessary sense of wariness about their surroundings.
They either wander closely or, like her son, they cling.
Not the twins.
Jonathan and Matthew are full of confidence and lacking in fear no matter where we drop them. They have a routine. They rarely bust into cabinets, yank cloths off tables or topple lamps immediately.
They are team and, like any good team, they have a strategy.
First, they explore the entire perimeter, traveling in opposite directions, sometimes faking right or left, but ultimately waiting for the just right moment to put their game plan into action. They wait until the defense is at ease with their movements, until their opponents mistake their intensity for dullness, for a love of repetition.
They simply wait.
Circling, circling, circling.
Until finally their guardians let their guard down.
The break from their circular pattern is sudden and well-executed. They dash in opposite directions, their eyes focused on their targets, energized to tackle any and all obstacles in their way. They are fierce in their purpose and determined to win whether the trophy is an open garbage can, a glass of water perched on the edge of a counter or an adventure in a forbidden room in a house.
We know they way they operate.
We have reviewed the tapes.
So, as we travel to Minneapolis this week, where they will meet many of their aunts, uncles and cousins, and see their grandma and grandpa for the first time since they were babies, I have this to say to their Uncle David and Aunt Jean, who are hosting this reunion.
Beware.
Don't be distracted their sweet smiles, their infectious giggles or their blond curls.
As my high school soccer coach used the say, if you want to play good defense, watch the hips.
It's all in the hips.

The quints in our backyard

Okay, so these bunnies are quintuplets, not identical twins. But my husband found them under the Little Tykes play set where the boys play in our backyard. I had to share. Only a few days later, they were already running around the yard.

Reaching out: bonds beyond their own

At 8.5 years old, my oldest son gets not a moment's peace. Riley came down the stairs this morning, bleary-eyed, hungry and sad from the loss of a favorite stuffed animal on a recent trip and he wanted to tell me about it.
He didn't get a chance.
His voice was drown in the cries and pleas of two younger brothers who stretched out their arms toward him as he lie on the sofa and threw their heads down on its cushions when he failed to pull them up with him.
Eventually, Riley gave in.
When I came back in the room with his Ovaltine, he was covered with toddler hands and feet. They climbed over his lap, poked at his face and giggled in his ears. His own tears had dried and so had theirs.
Though the bond between identical twins is, indeed, close, these two little guys have found places in their world for their big brother and their older sister.
Huge, special places.
Riley is their rough-houser and cuddler. He chases them round and round the furniture; he roars in their faces; he sneaks them out of their cribs when they are crying and holds them. During the school year, he cannot leave the house until he has had his "fix," he says.
Kiersten took a while to warm up. She has anxiety issues that include obsessive-compulsive disorder and mild sensory-integration disorder. So drool, wet diapers and (ew!) poopy diapers were a big turn off to her at first. She wanted so badly to hold them when they were babies and she tried, but she just couldn't handle it.
As they have grown, so has she.
She will be seven at the end of the summer and she has followed the example of her older brother. Though she can still smell a dirty diaper from a mile away, she enjoys teaching them how to play songs on their toy piano, how to build a tower with blocks and how to pronounce the few words they know.
She reads to them, begs to hold them on her lap and even helps put on a fresh diaper now and then. If they get injured, she often cries more than they do. They sometimes call her "mama."
They adore her.
They adore them both.
I used to worry that the older kids would be jealous of the bond between the boys and that the boys would create their own world, sealing out their older siblings. But there was no need for concern.
They have invited them in and Riley and Kiersten have accepted.

Zygosity: why does it have to be so hard?

When we first found out our twins were, indeed, identical, I believed that the intial mistake in their zygosity was just a fluke. Their placentas were, after all, on opposite sides of the uterus. According to my OB, it was so highly unlikely that they were identical that he hadn't even considered it.
From what I understood, cases like ours were rare.
Not so.
Over and over again, I hear of twin parents who are told that their twins are fraternal, but who still simply cannot tell their twins apart. They post photos of their twins on online bulletin boards, hoping for answers.
Like us, those parents are told that the placentas were tested at the hospital. The babies can't be identical: just look at the results, the doctors say. The parents scratch their heads and try to persuade themselves that the hospital and the doctor must be right.
What doctors don't say is exactly what kind of test the hospital has conducted.
Here's what they do: Hospital simply conduct a physical test of the placentas. The lab tech studies the membranes to determine whether they were two fused placentas or one shared placenta.
That's it.
DNA has nothing to do with it.
In our case, that was a no-brainer.
Matthew and Jonathan each had clearly distinct placentas and, so, the results on my OBs computer said "fraternal." He assured us that many twins look identical when they are born and that they would differentiate as they got older.
That never happened.
If anything, they look more alike.
We finally had our boys tested when they were infants. It was easy. We received a kit in the mail for about $170 and rubbed large swabs gently inside their cheeks. We put the swabs in the test tubes the lab provided and mailed them off in the box the company gave us.
The results were supposed to take three weeks.
We learned the boys were identical a week later.
Every single one of those parents I have met online later learned through DNA testing that their instincts were correct: their twins (and sometimes two of their triplets) were indeed identical despite the protests of their OBs.
I'm not sure why some OBs still subscribe to the old theory that two placentas equals fraternal twins. Their information is outdated and so much evidence exists to prove that their methods are faulty. Just take a look at this 1999 study. The author urges OBs to change their evaluations if for no other reason, because the twins simply have a right to know.
So why does it have to be so hard?