twininfo.co.uk

Combined Vaginal/Caesarean Birth

Chief Site Editor — Thu, 30 Sep 2010 12:22:23 +0000

One baby being born vaginally with the second twin being born via caesarean occurs in only about 3-4% of all twin births. Usually this is done if there is an emergency with the second baby such as a cord prolapse (where the cord comes out with or before the baby, cutting off its oxygen supply), severe malpresentation (like a transverse baby that cannot be moved) or placental abruption (when the placenta tears away from the wall of the uterus prematurely).

Caesarean Birth

Chief Site Editor — Wed, 29 Sep 2010 12:38:06 +0000

Although having twins does increase the risk of you having a caesarean fewer than half of twins are born this way. Whilst the position of your babies will play a large part in the decision as to what type of birth you will have there are also other reasons for having a caesarean. These include. placenta previa, placental abruption and labour complications such as foetal distress. If you give birth by caesarean prior to labour the date will most likely be set around 37 or 38 weeks. If you go into labour prior to the scheduled date your caesarean will likely happen then. There is no real difference in the surgery or recovery from a caesarean with twins other than you will be advised to only hold one baby at a time for the first six weeks. This can be easier said than done, particularly if you are breasfeeding! The babies are usually born no more than a couple of minutes apart.

Vaginal Birth

Chief Site Editor — Thu, 23 Sep 2010 13:38:07 +0000

More than half of twins will be born vaginally. The process of labour is the same as with one baby, but the babies will be very closely monitored. This often means you are unable to use certain facilities available to other labouring mums, such as the birthing pool. Also, because medical intervention may be required you will almost certainly not be able to deliver your babies in a birthing centre but will have to deliver on the main labour ward. Some hospitals require that all twin mothers give birth in the operating room, even if they have a vaginal birth. You may be given a drip in case it is needed later and an epidural will often be recommended. Once the first baby has been born, the midwife or doctor will check the position of the second by either feeling your abdomen and doing a vaginal examination or via an ultrasound. If the second baby is in a good position to be born, the waters surrounding the baby will be broken and the second baby should be born very soon after the first because the cervix is already fully dilated. If contractions stop after the first birth, hormones are usually added to the drip to restart them. This means the second baby is usually born no more than 20 minutes after the first. The second baby often changes position once the first is born. If the second baby is breech your doctor may decide to allow the baby to deliver breech, to turn the baby externally or internally or even do something called a breech extraction (pulling baby out by the feet).

Twin Birth

Chief Site Editor — Thu, 23 Sep 2010 13:35:54 +0000

When you are having twins more people will usually be present at the birth no matter how you deliver your babies. There is usually at least one midwife, an obstetrician, and two paediatricians, one for each baby.

Vaginal Delivery of Twins

Caesarean Delivery of Twins

Combined Vaginal/Caesarean Delivery of Twins

Signs of Premature Labour

Chief Site Editor — Thu, 23 Sep 2010 13:01:09 +0000

Here are the common signs of premature labour. Contact your doctor if you have any concerns about your pregnancy.

More than four or five contractions per hour
Regular contractions that increase in frequency
Rhythmic or persistent pelvic pressure
Cramps, similar to period cramps
Backache
Diarrhoea or upset stomach
A change in vaginal discharge
Vaginal bleeding
Uneasy or urgent sense that something is wrong

Signs of Labour

Chief Site Editor — Thu, 23 Sep 2010 12:55:17 +0000

Signs that labour is beginning

Regular contractions
During a contraction, your abdomen gets tight and then relaxes. You may have had these throughout your pregnancy, particularly towards the end. Before labour, these are called Braxton Hicks contractions. When you’re having regular contractions that last more than 30 seconds and begin to feel stronger, labour may have started. Your contractions will become longer, stronger and more frequent.

Other signs of labour
You may or may not also have the following signs:

Backache or the aching, heavy feeling that some women get with their monthly period.
A ‘show‘ either before labour starts, or early in labour. The plug of mucus in the cervix, which has helped to seal the womb during pregnancy, comes away and out of the vagina. This small amount of sticky pink mucus is called a ‘show’. You lose a small amount of blood with a show, mixed with mucus. If you’re losing more blood, it may be a sign that something is wrong, so telephone your hospital or midwife straight away.
Your waters breaking. The bag of water surrounding your baby may break before labour starts. If your waters break before labour starts, you’ll notice either a slow trickle from your vagina, or a sudden gush of water that you can’t control.
Nausea or vomiting.
Diarrhoea.

Mums Eye View

Chief Site Editor — Wed, 22 Sep 2010 13:26:14 +0000

We concieved via IVF so knew we were expecting twins from very early on in the pregnancy. From around 7 weeks I suffered from hyperemesis, which is severe nausea and vomiting in pregnancy. Due to this I spent the first few months going in and out of hospital to be rehydrated via a drip. Thankfully the sickess started to ease up from around 14 weeks and by 20 weeks I felt much better and did nothing but eat! I was constantly ravenous! I would have breakfast before work, then a second mid-morning breakfast, at work lunch, a sandwich mid-afternoon, tea and then supper!

At 27 weeks pregnant I began to experience contractions and other signs of labour so was admitted to hospital. I was given injections to stimulate the twins lungs in case they were born early and was also put on a drug to try stop the contractions. I was transferred to a hospital 2 hours drive away as our local hospital had no room in Neonatal Intensive Care for the babies if they were born. Fortunately everything settled down and I went home but had to take it easy for the rest of the pregnancy. This was very boring and frustrating sometimes but well worth it as I ended up carrying my twins until 38 weeks when I had an elective (planned) caeseraean section. Their birth weights were 6lb 9oz and 6lb 11oz.

In honesty I did find the pregancy really hard and there was no let up on the exhaustion or discomfort as often happens in a singleton pregnancy. It’s a bit like being on a rollercoaster though in that you can’t get off it once you’re on it so you just have to see it through! From 20 weeks my husband slept in the spare room so I could have the bed to myself. This helped a bit with the discomfort as I could prop pillows all around me and also allowed me to turn on the light and read with a cup of hot chocolate when the babies were kicking and wouldn’t let me go back to sleep! From about 34 weeks I found the easiest way to get comfortable was to sit on a birthing ball rather than the sofa. By the end I was incredibly uncomfortable but the minute the babies were born I felt the internal pressure of carrying them ease and I felt much better, despite having just had surgery. I won’t lie, physically and mentally it was one of the hardest things I’ve done but one look at my twins (or my jitterbugs as we call them!) laughing at each other now (they are 9 months old) and I’d do it all again in a heartbeat.

Share your experiences of twin pregnancy below…..

Weeks 36 – 40

Chief Site Editor — Tue, 21 Sep 2010 14:34:35 +0000

Babies

Your twins are becoming larger and stronger as they approach what most doctors consider full term for a twin pregnancy, around 37/38 weeks. They will have very little, if any, space to move around now in the womb. Most twins will weigh in around 5-7 pounds at birth. If your babies are much smaller than this, they might have to remain at the hospital until they reach a healthy weight to go home.

Mum

Although some twin mums manage to carry their babies until 40 weeks most will give birth around 37 – 38 weeks. You should feel very proud of yourself for making it this far and by now you probably can’t wait for the pregnancy to be over! Most women carrying twins to this point will suffer from aches and pains, sleepless nights, frequent trips to the bathroom, heartburn, swollen feet, breathlessness, an enormous, cumbersome belly and all sorts of other things that cause discomfort . You should by now have a birth plan in place and should be on the lookout for any signs of labour.

Weeks 32 – 36

Chief Site Editor — Tue, 21 Sep 2010 13:22:57 +0000

Babies

This is the month that the babies development becomes different to that of a singleton pregnancy. Your twins are approaching five pounds each and measure about 46cm in length. Due to the cramped conditons in the uterus their weight gain will be slower than that of a single baby. The babies lungs are beginning to produce surfactant, which will help their lungs to expand for their first breath. The placenta is still functioning well and nourishing the developing babies to allow them to gain the important final layer of fat. The positions that the babies are in at this point are not likely to change before delivery. If your babies were born now, they may need to spend a little bit of time in the intensive care unit.

Mum

There may be an increase in Braxton-Hicks contractions and you should be aware of the signs of premature labour by now as many women will naturally go into labour by week 36 of a twin pregnancy. You are probably finding it really difficult to rest or sleep comfortably. Heartburn, frequent urination and breathlessness may also become worse as your uterus continues to grow. Your hips may feel like they are spreading and the diameter of your pelvis has probably increased a little by this time. Your extremities may swell more now and some women notice a thin, watery substance coming from their breasts. This known as colostrum and, if you decide to breastfeed your babies, it will be the first nourishment they get until your milk comes in. Your appetite may decrease due to the limited space your stomach now has in your body.

Weeks 28 – 32

Chief Site Editor — Tue, 21 Sep 2010 12:30:22 +0000

Babies

Your twins are putting on a lot of fat now and by the end of the week 32 each baby will weigh around four pounds and measure approximately 40cm. They are still developing at about the same rate as singletons at this point of the pregnancy. During this month, the head will become more in proportion with the body and all organs and systems, except the lungs, are operational. Their skeletal structure is now complete, and the bones will now start to store calcium and iron.

Mum

By this point in the pregnancy you will probably feel absolutely exhausted and will find it difficult to get comfortable in any position. Your uterus is taking up an incredible amount of room in your diaphragm and this may make breathlessness worse. Backache is also becoming worse as the weight you are carrying increase. You should now be familiar with the babies patterns of movement and some mums can feel when their babies have the hiccups.