Multiple Births

 

The birth of twins, is likely to be a far more monitored process, with double the staff in the delivery room, in the case of any additional problems arising. This needn't be the case though, as many multiple births proceed in the normal way with both babies being born vaginally and with as little medical intervention as possible. As straightforward as some births may be, there are those that require added assistance in an attempt to offer your babies the best welcome to the world.

 

Premature labour

As mentioned earlier, it is common for twins to arrive sooner than the usual 40 week period, and it is for this reason that it is important to recognise any signs that may suggest that you are about to go into labour. As with single pregnancies, many signals may only indicate 'false labour', but it is still essential that you contact your doctor or hospital as soon as possible - rather safe than sorry!

 

Symptoms	Description and Action
Severe backache	If you find yourself suffering from backache that seems to reach a point and then fade, it could indicate the start of contractions. Contact your doctor immediately, or go to the hospital
Bleeding	At the onset of labour many women, experience a small loss of blood-stained mucus, which is commonly known as the 'show'. Contact your doctor immediately, or go to the hospital
Contractions	'Braxton-Hicks contractions' are common throughout all pregnancies, but if these contractions become severe, recurring approximately every 15 minutes, it could indicate that you are in labour. Contact your doctor immediately, or go to the hospital
Abdominal pains	These pains may be very similar to that of period pains, and it could indicate early labour. Contact your doctor immediately, or go to the hospital
Leaking	Leaking small amounts of fluid is a common discomfort of pregnancy, due to added pressure on your bladder. Should this occur too often, it could mean that your membranes are leaking. Contact your doctor immediately, or go to the hospital
Ruptured membranes	If you experience a sudden gush of water from your vagina, it could mean that your waters have broken and that labour is about to start. Go to the hospital immediately

 

Pre-term babies:

With most twins arriving before the expected date, they are most likely to be very small and almost fragile, so great care must be taken to ensure that they are delivered as carefully as possible. This may require a forceps delivery or the administering of an epidural to prevent a forceful delivery.

Differing positions:

Babies from singleton pregnancies, have ample space to be able to correctly position themselves for their birth, but this is not always the case with multiple pregnancies. Although twins are normally in the correct position at the start of labour, there are those where one twin is in the correct cephalic (head down) position, and the other breech, but provided there are no additional complications it is possible for both to safely survive vaginal delivery. If in the case of both babies being breech, a caesarean section may be the only option.

The second arrival:

The second twin almost always has a more difficult delivery than the first, and is usually the main reason for medical intervention. This being due to the altered position, having to endure a double-take of contractions and the uterus is normally compressed after the delivery of the first.
After delivering the first twin, the doctor will check the second twin's heartbeat and assess her position in the womb. If she is lying across (transversely), your doctor will manipulate her into the correct position from the outer side of your abdomen. If this method fails, your doctor may attempt to turn her internally.

Most doctors aim at achieving the shortest as possible interval between the two births, hoping for a space of no longer than five to fifteen minutes. In order to encourage the birth of the second twin, hospital staff may rupture the amniotic sac. If this method does not restart the contractions you may be given a syntocinon drip to speed-up the labour process. In the case of the second twin becoming distressed or being unable to be turned around into a correct position, a caesarean section will become inevitable.

Pain relief:

Pain is an integral part of every childbirth experience, although the severity may differ quite considerably from one woman to the next. The pain experienced during childbirth is due to a number of reasons, these being, the stretching of the cervix in the first stage; the pressure and widening of the birth canal in the second stage; and the delivery of the placenta in the third and final stage of labour. There is also of course the pain involved in some of the medical procedures that may be necessary to assist the delivery. However, in spite of all these discomforts, there are means and ways of making the birthing experience a little less painful, by the administering of certain drugs such as Pethidine and an Epidural anaesthetic. Above all, these pains do indicate that, it won't be too long before you are cuddling your newborn creations to your breast - So hang in there!