Twins and multiples

Forget about twins being double the trouble - they're double the delight! But what happens when it comes to giving birth?

In most twin pregnancies, your babies can be born vaginally without any problems, although you’ll need close monitoring throughout your labor.

Sometimes one twin is born naturally but the other needs assistance with forceps, vacuum extraction or, in some cases, a cesarean section.

About 40 per cent of twins are head down, and in 30 per cent the first twin is head down and the second is breech (bottom or feet first). In these cases a vaginal birth is still possible. In some cases both babies’ position will dictate how they’re born – if they’re both breech, you’ll likely be advised to have a cesarean. It’s likely your OB-GYN will also want to do a c-section if you’re expecting triplets or more.

Pre-term labor

More than half of twins are born before 37 weeks and most triplets can only hang on until 32-36 weeks, because there just isn't enough room inside you – so make sure you’re prepared, packed and ready for this in advance. Your OB-GYN should be able to give you some idea how long you’re likely to go.

The symptoms of pre-term labor (any time before week 37) are much like full-term labor. If you experience any of these signs, contact your OB-GYN immediately and tell them you think you’re in pre-term labor with twins:

• Your waters may break.

• You may notice a 'show', which is when the mucus plug that seals your cervix in pregnancy comes away as your cervix begins to dilate.

• You may experience some vaginal bleeding.

• You may have abdominal cramps or lower backache.

• You may experience four or more contractions in an hour.

   

  Assisted delivery

  Twins are at high risk for needing to be delivered by cesarean, and with triplets or more you’ll be advised to have an elective c-section. You can deliver twins naturally, under the guidance of your OB-GYN if she feels your labor is likely to be uncomplicated. She may recommend you have an epidural so you’re prepped if an emergency c-section is required.

   

  If you’re expecting twins and want to breastfeed, read our article on breastfeeding twins for advice.

   

  The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.