Dr. Barbara Luke, the director of a highly successful prenatal program for mothers of multiples at the University of Michigan in Ann Arbor, has summarized some of the recent advances in prenatal care in a new paperback published by HarperPerennial, 'When You're Expecting Twins, Triplets or Quads'.

The 300-page paperback (published in the fall of 1999) covers all facets of pregnancy, injecting dozens of first-person perspectives from women who have been a part of the Multiples Clinic in Ann Arbor, into chapters with such titles as 'The Food Factor: Eating Right When You're Pregnant with Twins or Supertwins', 'Pregnancy Complications: How to Lower Your Risk', 'Giving Birth to All Those Babies' and 'Survival Tips for Those Crazy First Months at Home'.

And the book keeps an even-keeled approach to the pregnancies, detailing the challenges that most pregnant mothers of multiples will face, but offering words of support in several different areas, including the possibility of breast-feeding multiples, having natural childbirth vs. a C-Section, carrying multiples for close to full-term and delivering healthy, large babies. In particular, the book excels when giving out proper dietary advice for expectant moms of multiples.

Dr. Luke states that her Michigan clinic has produced triplets that weigh an average of 35 percent more at birth than typical triplet births and that two out of every three newborns from mothers at their clinic weigh more than five and a half pounds at birth (double the average of multiple-gestation pregnancies).

The book frankly explains the challenges await the mother of multiples but tries to present a strategy to prolong the pregnancies as long as possible. With 50 percent of twin pregnancies, 90 percent of triplet pregnancies and virtually all quads-and-higher pregnancies resulting in premature births (prior to 37 full weeks), 'Expecting Twins' divides a pregnancy into six time zones and sets a goal for moms of making it through their current time zone (weeks 20-24, weeks 25-28, etc.) and make it into the next zone. For several reasons (health, costs, size of baby), the longer the pregnancy and less time at the hospital for the mother the better, and Dr. Luke's book tries to guide women to as close to full-term pregnancies as possible.

One interesting aspect of multiple births that Dr. Luke discusses is that most twins, triplets and quads are better prepared to be born prematurely than singletons. "Multiples generally are more mature developmentally than are singletons of the same gestation age, and they are therefore ready to be born two to three weeks sooner," Dr. Luke relates. So, despite the facts that most multiples are born pre full-term, that's not necessarily a tremendously dangerous situation, a theme which is hammered home throughout the book.

When You're Expecting Twins, Triplets, or Quads is full of solid advice for mothers-of-multiples-to-be and we highly recommend it for all parents.