All about twins, triplets and more

If you are expecting twins, triplets or more you will experience of all of the same joys of pregnancy as a woman carrying one, only with a little extra

Table of contents

  • 1 – All about twins, triplets and more
  • 2 – Giving birth to twins
  • 3 – Giving birth to triplets
  • 4 – Giving birth to quadruplets or more
  • 5 – Natural birth or caesarean?
  • 6 – Twin positions in the womb
  • 7 – Giving birth to the second twin
  • 8 – Pain relief and monitoring
  • 9 – People in the room when giving birth to multiples
  • 10 – Support groups for multiple births in Australia

All about twins, triplets and more

Congratulations if you are having twins, triplets or even more! Essentially multiple pregnancies progress in much the same way as singleton pregnancies. In fact, before the widespread use of ultrasound up to 50 percent of twins were not discovered until the time of birth.

Carrying multiple babies

Women carrying more than one baby often experience more physical changes during pregnancy and perhaps feel more uncomfortable and tired, especially during the last three months (or third trimester).

Common complaints such as morning sickness, insomnia, backache, heartburn, haemorrhoids and perhaps difficulty walking in late pregnancy may be more exaggerated. You may need to modify your lifestyle more and perhaps stop work earlier than anticipated. Planning for these changes (financially and practically) and sourcing out additional help and support can help you to rest more during the pregnancy and organise additional help for when the babies arrive.

Once a multiple pregnancy is discovered, the woman’s pregnancy and birth care generally becomes more involved, often leading to more tests and perhaps more medical interventions, because the pregnancy is now classified as higher risk.

However, even though the chances of health complications are slightly higher for the pregnant woman and her babies (discussed in health variations for multiples) it is still good to know that at least 50 percent of twin pregnancies progress normally and result in the normal birth of  two healthy babies born at term of adequate weight, without complications. The higher the order of multiples (triplets, quads etc.) the more chance complications may arise.

Giving birth to more than one baby

Many women are surprised (and perhaps relieved) to find out that the labour and birth process for having twins naturally can be very similar to women having one baby. Labour contractions are not more painful and you don’t need to go through labour twice, but you will need to push out two (or more) babies – one after the other. If the pregnancy has progressed normally, the twins are well and in a good position, your need for intervention should also be similar to singleton births.

Induction and augmentation

The reasons for induction of labour with a multiple birth are similar for women having single babies, as are the various methods that can be used to induce labour. Reasons can include high blood pressure, going overdue, diabetes, cholestasis, or one or both of the babies not growing as expected. Because most women having twins start labouring a little earlier, around 37 to 39 weeks, induction is not usually necessary.
For the few women who go to 40 weeks or beyond, it may be that feeling ‘over the pregnancy’ is a reason to consider inducing the labour. Be aware that induction can help in medical circumstances where it is needed and is then worth the possible risks involved. If you are choosing to induce the labour electively (for social reasons) then you should be aware that this could set you up for further interventions.
Some caregivers are more likely to suggest induction before 40 weeks with twin pregnancies, especially if they feel the babies are big enough, rather than wait for labour to start spontaneously (this also eliminates that chances of having the babies on a weekend or during the night!)

Augmentation

Augmenting labour with an oxytocin drip or by breaking the first twin’s amniotic sac (the waters) can be done if your contractions slow down or your caregiver feels your labour is not progressing fast enough. An oxytocin drip may also be used if your waters break and the contractions do not start in the hours following. The reasons for augmentation are similar for women having one baby. This is discussed in depth in augmentation.

next – Giving birth to twins

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