Twin labour and birth

When I found out I was having twins, one of the biggest questions that kept going round my head that terrified me was ‘what is it like to give birth to twins?‘.

I knew what it was like to be in labour and give birth naturally, (with Ventose) as I had my older son, but the thought of giving birth to 2 babies, I just couldn’t comprehend! I think I spent the rest of the pregnancy blanking it out, not thinking about it. This seemed to work for me, as my labour with the twins went very well. I did attend a one day antenatal class however, through TAMBA, which was very good. I would recommend attending some form of antenatal class, so you have some idea of what may happen.

It is well known that more twin pregnancies end in premature labour than singleton. Full term for twins is 37 weeks.

Around 30% of twins are born premature, where as for singletons the figure is around 10%. For this reason, I would advise anyone pregnant with twins to prepare themselves for the possibility of their babies needing to be admitted to the neonatal intensive care unit.

Twin labourA picture of mum in labour with twins being monitored

Labour with twins is pretty much the same as labour with one baby, except you are monitored very closely and you often tend to have lots of students wanting to watch and assist!

Signs of labour

  • Ruptured membranes (waters breaking) – clear fluid from the vagina
  • Blood or mucus from the vagina (a show)
  • Pain in the lower tummy, back or pelvis
  • Heavy feeling in the pelvis
  • Regular contractions (tightening of the tummy) every 10-15minutes

If you have any of these symptoms you should contact the labour ward or your midwife.

Pain relief

Possibilities include:

  • ‘gas and air’ – breathed in with each contraction
  • Pethidine injection
  • TENS machine (Transcutaneous nerve stimulation)
  • Epidural

Presentation of the babies

Every hospital has their own policies on when to induce twins, whether it be 37, 38, 39 or even 40 weeks. It also depends on the type of twins you are carrying and their presentation. If they are both head down, that’s great, you could be heading for a vaginal delivery, however, the babies could be presenting in a variety of ways. For example, my twin 1 was head down, whilst twin 2 was breech. Luckily, as long as the 1st twin is head down then you have the potential to deliver naturally, including the 2nd one breech, which is what happened to me. However, if twin 1 is breech, you may be asked to consider a caesarean section.

There is also the possibility of the twins being transverse (lying sideways). This happened to my friend and she had an elective caesarean section.

Every situation is different, so it is important to discuss your own individual case with your doctor.

Twin birth

Twin vaginal delivery

Giving birth to twins vaginally, is essentially the same as a single baby, only you have to do it twice!

You have the same pain, the same amount of contractions etc. The biggest difference is the amount of monitoring that will be undertaken. I had 3 straps across my belly, 1 to monitor twin 1’s heartbeat, another to monitor twin 2’s heartbeat and a 3rd to monitor my contractions. So if you want to be active in labour, it is very difficult! I did feel chained to the bed, but having said that, I didn’t feel like moving about that much anyway. I did find it very reassuring knowing that the babies were being monitored so closely.

The actual birth of the 1st twin is just the same as any other vaginal delivery, you have pain, you have to push very hard when told to and then your gorgeous baby arrives and you get to say hello! It is such a wonderful moment, enjoy it! Then, you realise you have another baby to push out and you have to start pushing again. The length of time between the twins varies greatly. I have friends who delivered naturally only 2/3 minutes apart, but on the other hand my twins were an hour and a half apart!

There is no getting away from the fact that giving birth to twins is painful, (but no more painful than a singleton) and is extremely exhausting! However, it is all so worth it, the moment you meet your babies, the pain is not forgotten, but it doesn’t matter anymore.

Caesarean section

Over half of twin births are delivered by caesarean section. This could be planned (elective) or an emergency.

Possible reasons for the need for an elective caesarean section may include:

  • Babies position, eg, breech or transverse
  • A previous caesarean section
  • A previous difficult vaginal delivery
  • Placenta previa

Possible reasons for the need for an emergency caesarean section:

  • Foetal distress
  • Prolapsed umbilical cord
  • Babies moving into difficult positions
  • High blood pressure
  • Slow progress in labour

Elective caesarean sections are usually carried out using an epidural, so that you are awake but do not feel any pain. In theatre a screen is raised across your chest so you cannot see what is happening. Your partner is usually allowed in with you and is there to hold your hand. The Doctor then cleans your tummy and makes a cut across your bikini line and delivers your babies. If the babies are well, they are sometimes handed straight to you, or they may be taken aside to get checked out first.

In the case of needing an emergency caesarean section, an existing epidural will be topped up, or you may need a general anaesthetic where you will be asleep through the procedure.

It does take longer to recover after a caesarean section and the cut may be painful for several days. You will be unable to drive for around 6 weeks and you should be avoiding lifting, bending and stretching. However, this can be difficult with looking after 2 new babies. It is important that you try to get some help for a while if at all possible.







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