Birth of twins
Twins are more likely to be born early, often before 38 weeks, so it's important to understand your birth options. Fewer than half of twin pregnancies last longer than 37 weeks.
Because your babies are likely to be born early, there's a good chance one or both of them will spend some time in special care.
Because twins are often born prematurely, it's a good idea to discuss your delivery options with your midwife or doctor early in your pregnancy.
You should also discuss where you would like to give birth. A hospital birth is likely recommended because there is a greater chance of complications when giving birth to twins.
It is common for more medical staff to be involved in the birth of twins, such as a midwife, an obstetrician, and two pediatricians—one for each baby.
While the labor process is the same as for singleton deliveries, twins are closely monitored. To do this, an electronic monitor and a scalp clip may be placed on the first baby once your water breaks. You'll also be given an IV drip if needed later.
vaginal birth
About a third of twins are born vaginally, and the process is similar to delivering a single baby. If you're planning a vaginal delivery, an epidural is usually recommended for pain relief. This is because, should problems arise, it's easier and faster to assist delivery when the mother already has good pain relief.
If the first twin is in the head-down (cephalic) position, it's common to consider a vaginal delivery. However, there may be other medical reasons why this isn't possible. If you've had a previous cesarean delivery, a vaginal delivery with twins is usually not recommended.
If you have a vaginal birth, you may need an assisted delivery, which is when a suction cup (or forceps) or forceps are used to help deliver the baby.
Once your first baby is born, your midwife or doctor will check your second baby's position by feeling your abdomen and performing a vaginal exam. If your second baby is in a good position, your water will break, and this baby should be born shortly after your first delivery because your cervix has already dilated. If your contractions stop after your first delivery, hormones will be added to your drip to restart them.
Caesarean section
You may choose to have an elective cesarean section early in your pregnancy, or your doctor may recommend a cesarean section later in your pregnancy due to potential complications. Your risk of having a cesarean section is nearly twice as high if you give birth to twins as it is for a single baby.
The position of the babies may determine whether or not they need a cesarean delivery. If a breech baby—the baby born first—is in a breech position (feet, knees, or buttocks first), or if one twin is lying transversely (with their body sideways), you'll need a cesarean section.
Some conditions also mean you'll need a cesarean section; for example, if you have placenta previa (a low-lying placenta) or if your twins share a placenta.
If you've previously had a particularly difficult birth with one baby, you may be advised to have a cesarean section with twins. Even if you're planning a vaginal delivery, you may end up having an emergency cesarean section.
This may be due to:
- One or both children become distressed.
- Umbilical cord prolapse (falls into the birth canal before the baby)
- Your blood pressure is rising
- The work is progressing very slowly.
- Delivery assistance not working
- In very rare cases, you may deliver twins vaginally and then need a cesarean section to deliver the second twin if it becomes distressed.
postnatal
After delivery, your midwife will examine the placenta to determine the gender of your twins. Twins can be either fraternal or identical.
If your children need special care
Depending on where you plan to give birth, you may need to go to another hospital with appropriate facilities if pregnancy complications indicate a potential preterm birth. This may not be close to home, so be sure to check that there are enough beds for both of your babies in the neonatal unit.
Ask if the hospital you've chosen has a transitional care unit or a special care nursery. These are places where mothers can care for their babies if they need special care, but not intensive care. These hospitals are more likely to be able to keep you and your babies in the same place.
You may also want to ask if your hospital has cribs that allow bed-sharing (where your children sleep in one bed), and whether this is appropriate and if you would like your children to sleep together.
If you have one child in the hospital and another at home, you'll need to consider dividing your time between the two. When you visit your child in the hospital, ask if you can bring twins and if bed-sharing is allowed during visits.
If you want to breastfeed and only one twin can nurse effectively, you may need to pump milk to feed the twin who is having difficulty nursing. You may then need to place the twin who can nurse at the breast to encourage milk production so that you have enough milk to feed both babies.
Check if your hospital offers support from a community neonatal nurse, allowing you and your babies to leave the hospital early, for example if your baby is still tube-fed.
When you go to clinics for follow-up appointments, it's a good idea to ask not to be booked for early morning appointments. Leaving the house with two children, especially if one of them is sick, can be challenging.