Birthing Twins

Labor and delivery can be a scary thing for most pregnant women to think about, especially if this is their first pregnancy. You might be a little concerned about the labor process yourself – after all, there are a lot of things to worry about, including pain, pain medications, episiotomies and cesarean sections. But what can you expect from labor and delivery if you are carrying twins or higher order multiples? Well here is all the information that you will need to know when it comes to giving birth to multiple babies!

Differences Between Single and Multiple Births
If you are about to welcome twins or higher-order multiples into the world, you may find that your labor and delivery experience is a lot different from women who have given birth to single babies. Everything from the location of your birth to the number of people present during your delivery can change with multiple child birth, so it is a good idea to know what differences to expect. Here are some of the more common differences to expect with twin and multiple births:

  • Location: The location in which you actually give birth may be radically different from where you would have given birth had you had a single baby. Because of the high risk that multiple births involve, you will most likely have to give birth in hospital. You may also be required to give birth in an operating room, surrounded by lots of machines and lights, especially if you are experiencing labor complications. This is not to say you won’t be able to give birth to your twins at home or in a birthing center. However, you will find that most health care providers will advise you to give birth in hospital, in case of an emergency.
  • Onlookers: You might also find that you have a lot more people with you in you delivery room than you ever had with any single birth. Because you are about to give birth to two babies, you will be required to have more people on hand to help care for the little ones once they are born. You may have up to two obstetricians and two midwives on hand for the delivery. You will also need to have an anesthetist, should you require a cesarean section. Your partner and birth coach will also be in the room, along with a pediatrician. Some hospitals also allow students to look on during multiple births, as long as you give it the okay.
  • Medication: It is not unusual for health care providers to strongly encourage having an epidural instead of engaging in natural birth when it comes to birthing twins or multiples. Though you won’t feel anymore pain during a multiple birth than you would during a single birth, multiple births are more likely to be delivered via cesarean section. Should a c-section be required, an epidural will enable you to make the transition much more easily.

Vaginal Birth or Cesarean Section?

Women who are expecting twins or higher order multiples often wonder if they will be able to have a vaginal birth, or if they will be required to have a cesarean section. Well, as long as your labor is uncomplicated, it is entirely possible (and usually recommended) to deliver both babies vaginally. However, because multiple births can be so unpredictable, cesarean sections are often needed to help deliver twins and multiples safely. On average, about 50% of multiples are born vaginally, while the other 50% are born via cesarean section.

Birth Presentation
The major factor in determining whether or not you will need a cesarean is the position of your babies in your uterus. Unlike most single babies, who are typically born head-down, multiple babies can be born in various presentation combinations. This can make vaginal deliveries more complicated, particularly if one or both of the babies is breech or transverse (sideways).

If the first baby is head down, you will likely deliver this baby vaginally, unless you are experiencing other complications. Once the first baby has been born, you and your health care providers will then try to deliver your second baby vaginally, as well. This is typically possible if the second baby is also head-down, however, it may be impossible if the second baby is breech or transverse. Your health care provider will try to move the baby by pushing on your uterus, but this is not always effective. If your second baby remains in a breech or transverse position, you will likely require a cesarean section.

If the first baby presents in breech or transverse position, it is unlikely that you will be allowed to proceed with a vaginal delivery. Most health care providers feel uncomfortable delivering breech babies when caring for a multiple pregnancy. In this case, both babies will be delivered through cesarean section.

Other Complications
Other complications that can arise during labor and delivery may mean that you will have to have a cesarean delivery. Cesarean deliveries are often performed if:

  • you are suffering from preeclampsia
  • you experience placental abruption
  • labor is not progressing
  • one of the babies is too big to fit through the birth canal
  • one or both babies is showing signs of distress

Dealing with Twin Labor and Delivery

If you are expecting twins or higher order multiples, there are a few things that you can do to help the process go as smoothly as possible.

  • Make your birth plan well ahead of time. This will give you and your health care provider the opportunity to become familiar with the plan of action on delivery day.
  • Learn what to expect. Though anything can happen, you will be able to deal with it better if you become familiar with all aspects of birthing twins. Read up on both vaginal and cesarean births, so you will be able to deal with anything that may happen.
  • Be flexible. It is difficult to predict the course of a multiple birth, so try to roll with the punches a little and don’t worry to much if things don’t go as planned. However, if you are concerned or unhappy about what your health care provider is doing, be sure to speak up.

Recommended Link
Are you expecting twins? Do you already have your hands full with twins or more? Share your experience with other expectant mothers of twins and multiples at Pregnancy Stories.

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