Caring for Myself and My Twins: Audrey Schoen On Emotional and Physical Recovery After Giving Birth To Twins
An Interview With Lucinda Koza
Every woman should get pelvic floor physical therapy. While this should be standard of care for all women, twin mom bodies endure so much more physical strain that the possibility of disjunction is significantly higher. Twin mothers should insist on pelvic floor PT after the birth of their twins.. Even with early intervention and treatment, I still struggle with hypermobility and SI dysfunction that developed in the years following the birth of my twins.
Giving birth to twins presents unique challenges and demands a significant emotional and physical recovery process. The journey to regaining well-being while caring for newborn twins is complex and deeply personal. Balancing self-care with the needs of two newborns can be overwhelming, but it is crucial for the health of both the mother and her babies. By sharing these experiences, we hope to provide valuable insights, support, and practical advice to others facing similar challenges. As a part of this series, I had the pleasure of interviewing Audrey Schoen.
Audrey Schoen is a Licensed Marriage and Family Therapist in private practice and business coach for fellow therapists. Since receiving her Masters Degree in 2010, she has been fortunate to have opportunities to work with everyone from homeless domestic abuse survivors to CEO’s. Audrey brings a breadth of expertise to her work, including depth therapy, Brainspotting, and Accelerated Resolution Therapy to heal problems at their core.
In her role as a therapist, Audrey is dedicated to helping adults and couples create calm and congruent lives. As a twin mom and recovering people pleaser herself, she understands the complexities of balancing self, work, and life.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” better. Can you tell us a bit about you and your backstory?
I came into motherhood a bit later than I had planned. My 20s and early 30s were filled with education, CrossFit, swing dancing and so much more. I was incredibly intentional about creating a life I loved. My husband was in law enforcement, and his schedule provided me with a tremendous amount of autonomy. As a therapist, my flexible work schedule meant I could take time off when he was off. I also had a rich inner life, often listening to podcasts and audiobooks or spending time lost in thought as I went about my day.
I loved my career, my hobbies, and my friends. I especially loved being in charge of my time and energy. I knew from a young age that I wanted kids, and while I was excited to have a child, I felt nervous for the changes it would bring.
Can you share a little about your childbirth experience with us?
Growing up I decided that my goal was to have 2 kids before the age of 35. As I mentioned, I got started a bit later than I had planned and by the time my husband and I felt ready to expand our family, I was coming up on my 35th birthday. We figured we would keep our lives simple and just have one child. I was fortunate to become pregnant very quickly, but within just a few weeks, I was already feeling waves of nausea.
At my first prenatal appointment after telling the doctor how I had been feeling, just a quick look at the ultrasound confirmed my fear. “Well that’s why you’re so sick” she said, “It’s twins!”
If I’m being completely honest, I was pissed. I knew that my dreams of midwife care and the possibility of a home water birth were out the window. It meant frequent appointments, more ultrasounds, increased risks and a higher likelihood of a c-section. I knew the pregnancy was going to feel a lot different than I had hoped, but I was optimistic that I would still be able to carry the babies to term and even attempt a vaginal birth. As a long time athlete, I strangely looked forward to conquering childbirth.
Twin pregnancies can often be high-risk and include premature deliveries. If you had difficulties with your twin pregnancy, how did that inform the early days after their arrival? How did it inform the bonding process?
My pregnancy itself was incredibly uneventful overall. The babies grew steadily, and I physically carried them well. While I wasn’t able to exercise for much of it, I was able to get up and down off the floor with ease until the day we delivered.
As we approached the final weeks, my labs started to shift. My blood pressure was slowly increasing, and I was showing early signs of preeclampsia. I had been on track to attempt a vaginal delivery, and the hospital even had tubs I could labor in and an OB well versed in breech births. All those options evaporated when, at 35.5 weeks, they scheduled me for a c-section at 36 weeks even. With just 3 days notice before our delivery, I experienced the gamut of emotions. I was excited to meet my babies, but racked with grief over all the pregnancy and birth dreams I had lost.
While my c-section was unwanted, I had made peace with the fact that it was the safest option for both myself and my babies. The procedure went well, and my twins were born healthy and strong and they took to breastfeeding quickly. The twins born born on Friday, and by Sunday afternoon we were home.
This is where things got dicey. Less than 12 hours after we were released, I was back in the ER. My hands were swelling, my blood pressure was rising, and I couldn’t keep food down. I was admitted to the ICU and don’t remember much of the following 24 hours. I spent the next 6 days in the hospital away from my newborns as they tried to determine what was wrong and how to help me. I was absolutely determined to maintain breastfeeding, so I pumped between medications and my family and friends picked up milk to take home. My family rallied a team of grandmothers that cared for my babies around the clock, guided by our incredible doula. Another friend who recently had a baby even breastfed my twins for me. It was an incredible outpouring of support.
On day 5, they realized that I had suffered an acute allergic reaction to one of the pain medication used after my c-section and it had shut down my kidneys. With proper treatment I was able to finally return home to my twins. Spending that time away from them those early days was a mixed bag. I missed them terribly, and the medical trauma I experienced left a mark on me. But I also recall just how overwhelmed I had felt that day we first got home. By the time I returned from the hospital, the babies were on a fantastic feeding and sleeping schedule, and I was able to step in and feel confident about the systems that had been put in place.
The challenges didn’t stop there though.
A twin pregnancy makes demands of your body that are almost impossible to imagine. How does this change, or not change, once they are born?
Once we were all home and on the road to recovery, my focus turned to breastfeeding. One of my twins had a severe tongue tie that we had clipped, but it still wasn’t working and required a second laser revision. I was surviving on a 3–4 hour cycle of sleep, breastfeed, pump, bottle feed (also known as triple feeding). To keep up with the caloric demand (upwards of 1000 calories per day in just breast milk), I was eating around the clock, and kept a rolling cart full of food and drinks with me at all times. Then there were the cluster feeds and witching hours. Needless to say with 2 babies, there was no such thing as boob rotation, making those nights even harder and at times painful.
It took 3 months to wean off the triple feeds, and we enjoyed a few weeks with a good rhythm before the 4 month sleep regression hit. Looking back, months 4–8 were the worst. As they began developing at their own pace their sleep needs started to diverge. I suffered from severe sleep deprivation for months, due to differing sleep and wake cycles, even with the help of grandmothers. My mental health took a major hit. I experienced anxiety, depression, and even bouts of internal rage. As a therapist, I understood what was happening, so I knew I would be ok eventually, but it didn’t make those moments any easier.
If you cannot, like most people, accomplish the physical act of holding both of your twins at the same time, how does this affect you as a mother? Is there ever a sense of lack of control, or fear, or guilt?
Caring for two infants at the same time is not twice the work, it’s exponential. It’s rare, if not impossible to find those sweet moments you often see of mother and baby in a loving embrace. At any given moment one or more babies is crying. It’s hard to understand what it feels like to change one baby’s diaper while your other baby is screaming, and there is nothing you can do about it. It rips at your heart and frys your nerve endings all at the same time. Over and over 24 hours a day.
I know everyone has ideas about what kind of mother they will be. I had dreams of homemade baby food, reusable diapers, and mommy and me classes. Having twins changed everything. I quickly realized I had to find the path of least resistance and pick my ‘battles’ wisely. I HAD to prioritize my mental health and that meant doing things a lot differently than I had envisioned. When I was mentally well, I was a better mother and partner. One of the best predictors of a child’s wellbeing is their parents mental health, so I made that my main focus. It also meant shedding guilt and surrendering control. The days that I was able to do that successfully became my best days. The less I tried to control things, the more available I was to enjoy what was in front of me.
How have you been able to manage or overcome these feelings?
Over the years I have worked hard on my own identity as a mother, shedding many of the cultural pressures to be a perfect Pinterest mom. Being a mother is only one aspect of who I am and as my kids have grown, I have reclaimed and reintegrated other aspects of my identity. I attended therapy and received brainspotting treatment, helping me to process and overcome the traumas I experienced throughout the pregnancy, birth, and early years as a twin mother.
I also made some promises to myself. I would shower before noon every day, go outside at least once a day, and leave the house three times a week. Keeping those promises to myself made a huge difference on a day to day basis.
As my kids got older, I transitioned them into daycare so I could get back to seeing clients, and spend some much needed kid free time with myself and my husband. I found that having them in someone else’s care made me a better parent, and I didn’t need to feel guilty for doing what was best for all of us.
In a perfect world, what do you think moms of twins need to ensure this transition into motherhood is a healthy one?
Of course I would love for these mothers to also have a therapist well versed in the realities of mothering multiples. Having the mental health support to improve your coping, manage guilt, and speak freely is an incredible resource. But there is only so much you can do in therapy, without real, physical support.
I wish all mothers, but particularly mothers of multiples, could get postpartum support for at least 6 months. So many mothers come away from twin births with some level of complication or physical challenges, either themselves or their babies. The reality of caring for two infants is just too much to bear in our isolated, individualistic culture. People are not designed to care for one infant in a vacuum, let alone multiples.
Can you please share “5 Things You Need to Recover Emotionally and Physically After Giving Birth to Twins”?
1 . Physical Support
The first thing every twin mom needs is help. All kinds of help. Physical support like housework, cooking, shopping, diaper changes, etc. As a mother, your only job should be to keep those babies alive and maintain your own mental and physical health. I remember in the first month in particular, I was eating so much that my husband had to buy groceries every three days. I kept a rolling cart with 3 water bottles and snacks with me at all times. I had daily visits from each grandmother to make sure I had everything I needed, which allowed me to focus on feeding and sleeping.
2 . Pelvic Floor Physical Therapy
Every woman should get pelvic floor physical therapy. While this should be standard of care for all women, twin mom bodies endure so much more physical strain that the possibility of disjunction is significantly higher. Twin mothers should insist on pelvic floor PT after the birth of their twins.. Even with early intervention and treatment, I still struggle with hypermobility and SI dysfunction that developed in the years following the birth of my twins.
3 . Emotional Support
Motherhood is raw and messy, and twin motherhood is exponentially more. Mothers need someone they can say all the difficult, ugly, even taboo things out loud to. Most moms have scary thoughts during rough moments. The cluster feeds, the purple crying, the 8th night time wakes up.. and it’s only 3am. Having twins just means more of them, more often. Speaking from personal experience, when those thoughts stay in the darkness of your mind, they feel powerful. But when we can speak them out loud to someone who truly gets it, they lose their power. I had several close friends, including another twin mom, that allowed me to be honest without judgment about the thoughts and feelings I experienced. Simply being able to have another mom hear and validate what I was going through allowed me to feel so much less alone.
4 . Space to Grieve
Being a mother means grieving the life before kids, but being a twin mom also means grieving the life you imagined with one baby at a time. The quiet feedings, the bedside co-sleeper, wearing your baby to the grocery store, or mommy and me classes. So many of the opportunities and resources available to mothers of singletons are just not accessible to twin moms. A huge part of recovering emotionally for me was spending time grieving both the past life I lived and the future I had imagined. Allowing myself to acknowledge those losses made room to accept my reality and make it something I could be happy with.
5 . Great Gear
Great gear made twin motherhood easier. A sleek double stroller with click in car seats, various swings, play mats, and a giant playpen. I trolled the local online marketplaces and snagged used baby gear. I realized quickly that each baby had their own preferences, and getting things second hand made it experiment until we found something that worked for us. I also enjoyed using the pick ups as a great opportunity to practice leaving the house with both babies, without worrying about having to get them out of the car or spend time at a destination. And the change of scenery helped break up the monotony of being home. On that note, one of the best pieces of advice I got was to pack a light diaper bag and have a well stocked car. On multiple occasions I left the house without the diaper bag, but it didn’t matter because my car kit had everything I needed.
Has your sense of self shifted, or morphed, with the birth of your twins?
Absolutely. I am more committed than ever before to balancing my identities, maintaining my wellbeing as a foundational component of my family’s health, and shedding the unrealistic cultural normative standards placed on women. I am also much more bold in my personal and professional life, and a lot more willing to do things imperfectly.
Wonderful. We are nearly done. Is there a person in the world, or in the US, with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. :-)?
I would love to meet P!nk (Alecia Beth Moore). She is a picture of imperfect, real, authenticity. She uses her status to take a stand on important issues and to support causes and organizations. Over the years her music seems to have followed my development as a person, a woman, and a mother.
If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
I wish we could dismantle the current cultural expectations and pressures that come with modern motherhood. So many mothers I work with are being crushed mentally and emotionally by the weight of the expectations placed on them. We need permission to do things imperfectly, to get it wrong, to NOT read to our kids every night.
We all have a choice. We can try to hold ourselves up to all the recommendations and expectations of “good mothers,” kill ourselve trying, often making day to day life full of conflict and chaos. OR we can ease up a bit on ourselves and our kids, ebb and flow with the energy of each day, and choose peace and ease. If that means we don’t read a book at bedtime for a while, because the thought of doing so fills you with dread and stress, then so be it. Of course it’s good for your kids to read every day, but if those experiences are bathed in stress and irritability, it’s not going to make reading a very attractive activity for your kiddos. And it’s not going to make you and your kids feel close and connected. Your kids benefit from having a relaxed, fun, and present parent.
Mothers need to be free to experiment with what works for them, without shame or guilt. When we allow ourselves that freedom, we are often able to find the path to creating our own family rhythms and rituals. Ones that honor ours and our families’ needs.
How can our readers follow your work online?
You can get in touch with me or find my other publications on my website AudreyLMFT.com
Follow me on Instagram @AudreyLMFT or TikTok @Audrey_Out_Loud
Thank you so much for joining us. This was very inspirational.
About the Interviewer: After becoming her father’s sole caregiver at a young age, Lucinda Koza founded I-Ally, a community-based app that provides access to services and support for millennial family caregivers. Mrs. Koza has had essays published in Thought Catalog, Medium Women, Caregiving.com and Hackernoon.com. She was featured in ‘Founded by Women: Inspiration and Advice from over 100 Female Founders’ by Sydney Horton. A filmmaker, Mrs. Koza premiered short film ‘Laura Point’ at the 2015 Cannes Film Festival and recently co-directed ‘Caregivers: A Story About Them’ with Egyptian filmmaker Roshdy Ahmed. Her most notable achievement, however, has been becoming a mother to fraternal twins in 2023. Reach out to Lucinda via social media or directly by email: lucinda@i-ally.com.
Caring for Myself and My Twins: Audrey Schoen On Emotional and Physical Recovery After Giving Birth… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.