Highlights
- Twins are more likely to be born early, often before 38 weeks.
- Your doctor will most likely advise you to give birth in a hospital due to the higher chance of complications with a twin birth.
- About 1 in 3 of all sets of twin births are vaginal births.
- You may choose to have an elective caesarean, or your doctor may recommend a caesarean section because of potential complications.
- Even if you plan a vaginal birth, you may end up having an emergency caesarean section due to complications during labor.
In This Article
- Understanding Twin Births
- Vaginal Birth Options
- Caesarean Section Considerations
- Post-Birth Recovery and Care
- Special Care for Your Babies
- Tools and Assistance
Understanding Twin Births
Twins are more likely to be born early, often before 38 weeks. This makes it important to understand your birth options. Less than 1 in every 2 twin pregnancies continues beyond 37 weeks. Due to the likelihood of early birth, one or both babies will often need to spend time in the special care ward in the hospital.
Given the higher chances of complications with a twin birth, it’s a good idea to discuss with your midwife or doctor where you should give birth. You should also talk about your preferences for vaginal or caesarean birth. Typically, doctors or midwives will recommend giving birth in a hospital, as the birth of twins often involves more medical attention.
It’s common for more medical staff to be involved in the birth of twins. This may include a midwife, an obstetrician, and two pediatricians—one for each baby.
The process of labor for twins is similar to that for single babies, but twins are more closely monitored. To do so, an electronic monitor and possibly a scalp clip may be fitted on the first baby once your waters have broken. A drip may also be set up in case it’s needed later.
Vaginal Birth Options
About 1 in 3 twin births are vaginal births. The birth process for twins is similar to that of a single baby. If you’re planning a vaginal birth, your health team may recommend an epidural for pain relief. This is because, if complications arise, having an epidural can make it easier and quicker to assist the delivery.
If the first twin is in a head-down position (cephalic), a vaginal birth is typically considered. However, other medical reasons may make this impossible. If you’ve had a previous caesarean section, it’s important to discuss with your doctor whether a vaginal birth is the best option for twins.
In some cases, an assisted birth may be required, where tools such as a suction cup (ventouse) or forceps are used to help deliver the babies.
Once the first baby is born, the midwife or doctor will check the position of the second baby by feeling your abdomen and performing a vaginal examination. If the second baby is in a good position, your waters will be broken, and the second baby should be born soon after, as the cervix is already fully dilated. If contractions stop after the first birth, hormones may be added to your drip to restart them.
Caesarean Section Considerations
You may choose to have an elective caesarean section from the beginning of your pregnancy, or your doctor may recommend one later in pregnancy due to potential complications. In general, you are nearly twice as likely to have a caesarean section with twins than with a single baby.
The position of the babies plays a significant role in whether a caesarean section or vaginal birth is recommended. A caesarean section is required if the first baby is in a breech position (with feet, knees, or buttocks presenting first). You will also need a caesarean section if one twin is lying in a transverse position (with their body lying sideways).
Other conditions that may require a caesarean section include:
- Placenta praevia (low-lying placenta)
- Previous difficult deliveries with a single baby
- Other medical complications during labor
Even if you plan for a vaginal birth, an emergency caesarean section may be necessary if:
- One or both babies become distressed
- The umbilical cord prolapses (falls into the birth canal ahead of the baby)
- Your blood pressure increases significantly
- Labor is progressing too slowly
- Assisted delivery doesn’t work
In very rare cases, one twin may be born vaginally, and a caesarean section may be required for the second twin if it becomes distressed.
Post-Birth Recovery and Care
Giving birth to twins is often a joyous occasion, but it can also be overwhelming and stressful. It is essential for your body to recover, and this will take time. After the birth, make sure to focus on eating well, getting enough rest, and staying active to aid recovery.
Don’t forget to book a postnatal check with your maternity care provider or doctor around 6 weeks after giving birth. If you feel you need it earlier, it is okay to request a checkup before that time.
Caring for two babies can be very challenging, especially as families with twins are more likely to experience higher levels of stress, relationship strain, exhaustion, depression, and social isolation. It’s important to seek support from family, friends, and health professionals to help manage these challenges.
Special Care for Your Babies
Since twins are more likely to be born early, choosing a hospital with appropriate facilities is crucial. Your babies may require special care if they are born prematurely. Ensure that the hospital you choose has the necessary equipment and medical staff to care for premature babies.
Some key features to look for in a hospital include:
- Special care nursery or neonatal intensive care unit (NICU)
- Staff experienced in handling premature or sick babies
- Facilities that allow parents to stay as close to their babies as possible, ideally in the same location
- Cots that allow co-bedding (sleeping in a single cot) for twins, if desired
If you have one baby in the hospital and one at home, managing time between the two can be challenging. Ask the hospital if you can bring the healthy twin to visit the one in the hospital. Co-bedding may also be allowed during these visits.
For breastfeeding mothers, if one twin struggles to latch or feed effectively, you may need to express milk to ensure both babies are fed.
Check if the hospital offers support from community neonatal nurses, which can help you leave the hospital earlier and manage your babies at home with additional professional assistance.
Tools and Assistance
- Midwife and Obstetrician Support: Your healthcare team will monitor your pregnancy and guide you through your birth options, ensuring your safety and the safety of your babies.
- Neonatal Intensive Care Unit (NICU): If your twins are born prematurely, the NICU will provide specialized care to support their health.
- Pain Management: Options like epidural anesthesia are available to manage pain during labor and delivery, depending on your needs.
- Postnatal Care: Follow-up check-ups with your healthcare provider ensure your recovery, and additional visits may be arranged if needed.
- Lactation Consultants: These specialists can help with breastfeeding challenges and assist with establishing a feeding routine.
- Mental Health Support: Counseling and support services are available to help manage stress, depression, or feelings of isolation.
- Neonatal Nurses: These experts provide specialized care in the NICU for premature or sick babies, offering guidance and emotional support.
- Parenting Classes: Many hospitals and community centers offer classes for parents of multiples to provide practical advice and support.
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