Through a holistic and comprehensive approach to health and wellbeing, the Wellbeing Foundation Africa understands the socio-economic and health challenges faced by families with multiple births, the culmination of one multiple pregnancy, wherein the mother gives birth to two or more babies, especially during times of social and economic uncertainty. In Nigeria, like many countries around the world, families are grappling with the realities of inflation and a cost-of-living crisis. Multiple birth presents unique challenges that require specialised support and care, both before and after the babies are born.

Several factors influence the lives and livelihoods of parents with multiples, including social situations, psychological adjustment, and economic circumstances. It is often assumed that these areas of concern arise only after the babies have been born, but healthcare workers and clinicians must be aware that many of these indications are evident and seen in the antenatal period as well. Apart from the socioeconomic cost to individual families, multiple births also carry a significant cost to society, and our health systems.

A study by the Australian Birth Association calculated that nearly 200 hours per week are needed to look properly after triplets aged six months and to carry out essential household tasks. Given that there are only 168 hours in a week, this highlights the intense demands placed on parents and families of multiples. Both low-income and other parents reported experiencing reduced stress after sharing their concerns with a counsellor, further emphasising the importance and need of emotional support, and not just the physical support.

Since 2004, The Wellbeing Foundation Africa through the Alaafia Kwara Initiative and Twins and Multiple Births Assistance (TAMBA) Program Intervention has been dedicated to supporting families with multiple birth. Our network of self-help groups and women and young people’s voluntary cooperatives and associations, including frontline midwives and healthcare workers, provides a supportive and necessary listening ear within communities to identify parents in need of social care support interventions.
One of the families we have had the privilege of supporting continues to receive visits to their home to assess the health of their triplets and determine what additional support the family might need, post birth. The family lives in an incomplete building with their nine-month-old triplets. During the WBFA visit, the family shared that the triplets consume significant amounts of food, which is straining the family’s finances. Despite the challenges, the triplets are healthy and thriving, yet the economic distress is a difficulty in continuing the sustainability of care. With this in mind, WBFA provides meaningful financial contributions alongside the mental, physical and emotional support.

Our research and experience show that women with multiple births often worry about not knowing when or how labour may start, the process itself, and the potential need for a caesarean section. Women with multiple birth who went into labour are more likely to be induced than mothers of singletons, and this likelihood is thoroughly covered by Mamacare360 Midwives, to ensure mothers are partners in their own birthing journey.

Following a multiple birth, babies are twice as likely to have a Neonatal Intensive Care Unit stay as compared to singletons, and can stay for a month or more as well. These longer hospital stays and possibly more visits are also covered and explained by WBFA Midwives, and include onsite support as well, through the WBFA Mamacare360 NICU Plus Program, to assist in breastfeeding and lactation care, ensuring healthy mothers and babies.

Considering the case of one of our WBFA mothers, who gave birth to twins, she reported experiencing significant anxiety about the timing of her labour and the possibility of needing a caesarean section. Her twins were born prematurely and required an extended stay in the NICU, leading to prolonged hospitalisation for the mother and increased medical expenses. Through the support of the Alaafia Kwara Initiative and Twins and Multiple Births Assistance Program Intervention, the mother received the emotional and financial assistance needed to navigate this challenging period, while feeling in control of her own health and that of her children.

Our WBFA self-help groups and voluntary cooperatives play a crucial role in providing the necessary support to families with multiples. These groups offer a platform for parents to share their experiences, seek advice, and access resources. For many parents, this sense of community and mutual support is invaluable.

Parents of multiples clearly need specialist professional midwifery-led advice and support such as that provided by the Wellbeing Foundation Africa, Mamacare360 and WBFA NICU Plus programming. Without this support, help for women with multiple births is generally inadequate and slow to arrive. The research highlights that sharing concerns with a counsellor can also significantly reduce stress for both low-income and other parents.

The economic, social and health implications of multiple births are significant, impacting both individual families and society as a whole. At The Wellbeing Foundation Africa, we are committed to caring for these families and ensuring their wellbeing through comprehensive support programs, and frontline advice, easing the process for mothers, babies, their families and communities, improving overall wellbeing and working towards achieving the United Nations Sustainable Development Goals, in line with the Every Woman Every Child movement and UNICEF Child Survival commitments.

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