From the moment you found out that you will be having twins or more, you may have worried about how the whole pregnancy would turn out – from caring for two babies in the womb to bringing them out into the world. As you approach your third trimester, you may have started looking for information about the labour signs in twin pregnancies.
It may be true that multiple or twin pregnancies are at risk of having a preterm birth. More than half of twins are born earlier, with more than 10 per cent born preterm before the 32nd week.
However, before you panic at the possibility of preterm labour, the statistical probability is that most twin pregnancies without other complications are born full-term, within the last two weeks of the third trimester.
Of the 70 per cent of earlier births, many were born within a few weeks before their due date. Fewer are born severely premature at 24-48 weeks.
With that in mind, you can relax and watch out for labour signs in a twin pregnancy.
What are the labour signs of twin pregnancy?
If you are expecting twins, you are more likely to experience early delivery and labour signs. This can be due to frequent fetal movement. However, before you fall into the trap of mistaking false labour for actual labour, here are some signs you need to watch out for.
Understanding Contractions
Sometimes, preterm birth is silent. You may not feel your cervix dilating or effacing. You could not even feel contractions, especially if you are a first-timer pregnant.
Your uterus or “womb” contracts throughout the whole period of pregnancy. These irregular, “practice” contractions are Braxton Hicks contractions and they start as early as the second trimester.
However, as your body prepares for labour and delivery, the timing, regularity, and intensity of the contractions will significantly increase. The pattern and frequency of contractions can give you a sign that labour has begun.
Occasional or irregular contractions are usually normal. Meanwhile, recurring contractions at a rate of more than 4 times per hour may result in concern and will require further monitoring.
You should report the following signs to your healthcare provider:
- More than four or five times contractions per hour
- Rhythmic or persisting pelvic pressure
- Cramps, like in the menstrual period
- Severe backache
Image source: iStock
Knowing Your Body
Every mother may experience contractions in different ways. These contractions may produce a sensation of pain, hardening, pressure, heaviness, tightening, or cramping. These sensations can be felt in your abdomen, pelvis, lower back, or even upper thighs.
You must need to spend some time getting to know your body to understand how well the contractions manifest in your twin pregnancy.
One of the best ways to tune into contractions is by lying down quietly on your left side. Place your hands on your belly. You would feel protruding baby parts, such as a head, elbow, or rear end and these will feel hard and bumpy.
Feel for a softer part so that you can feel your uterus and not your (twin) babies’ movement. At rest, your womb will feel soft and fleshy. But, when contracted, it will become hard and tight, like a flexed muscle.
Other labour signs in twin pregnancies
While contractions are the main signs of preterm labour during your twin pregnancy, you can’t count on them to let you know what is going on. However, there are other signs that can tell you when labour is already ongoing.
If you would experience the listed signs below, it is better to notify your doctor quickly.
- Having diarrhoea
- Heavy vaginal bleeding or discharge
- An uneasy sense that something is wrong (it’s your maternal instincts kicking in)
While some of those signs may be totally unrelated to preterm labour, it’s better to get in touch with your doctor for safety measures.
Additionally, twins are usually born earlier, often before 38 weeks. So, it is important to understand your birth options.
Because your twin babies are likely to be born early, there is a possibility that one or both of them will spend more time in special care.
Labour and Delivery in Twin and Multiple Pregnancies
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As some twin babies are born prematurely, and there could be a possibility of preterm labour, it is also smart to discuss
birth options with your midwife or doctor early in your twin pregnancy.
You should also discuss where you would like to deliver your twins. Of course, to avoid any complications, your doctor might advise you to do it in a hospital.
Moreover, it is common to have more medical staff in the birth of your twins.
Can You Have a Normal Delivery with Twins?
There are about one-third of all twins born naturally or “vaginally” and the process is similar to that of a single baby.
If you are planning a natural birth, your doctor will recommend that you have an
epidural for pain relief. Thus, if problems may arise, it might be easier and quicker to assist the delivery.
If the first twin is in a
cephalic or head-down position, it is common to consider a vaginal birth. However, there could be other medical reasons why this would not be doable. If you have had a previous cesarean delivery, it is suggested to avoid natural birth with twins.
If you will have a vaginal birth, you might need an assisted birth. In assisted birth, a doctor would need to use a suction cup (ventouse) or forceps to help deliver your baby.
Once your first twin is born, the midwife or doctor will check the position of the second twin. They would feel your abdomen and will perform a vaginal examination.
If the second baby is in a good position, the
waters will break. Then, the 2nd baby should be born after the first as the cervix is totally
dilated.
If contraction stops after the first baby, hormones will be added to the drip to restart them.
Giving Birth to Twins via C-Section
The safer, more preferred option for multiple pregnancies is giving birth via caesarean delivery. You can choose to have an elective cesarean from the outset of your pregnancy. Or, your doctor may suggest a c-section later in the pregnancy as a result of possible
complications.
You are nearly twice as likely to have a cesarean if giving birth to twins than delivering a single baby.
Furthermore, your babies’ position may determine whether they need to do the labour in a c-section or not. If the first twin to be born is in a breech position (feet, knees, bottom first), or if one twin is in a transverse position, you will need a cesarean section.
Regardless of which type of delivery you and your doctor chooses, what’s most important is to bring the babies out as safe and as healthy as possible.
According to experts, mums who are pregnant with twins have the following:
- About a 40 per cent chance of carrying their pregnancy to early term (37 weeks) or after
- A 60 per cent chance of delivering preterm or at least less than 37 weeks
- An 11 per cent chance to deliver your babies before 32 weeks of pregnancy
This reference review from the American College of Obstetricians and Gynecologists (ACOG) also claims the average duration of twin pregnancy is 35 weeks (preterm), compared to 39 weeks (full-term) of a single baby.
- Early term: 37 to 38 weeks and 6 days gestation
- Full term: 39 to 40 weeks and 6 days
ACOG also added that preterm birth is the most common complication of twin pregnancy.
Mums, always take good care of yourself and your babies. As your due date approach, you need to be ready and choose or seek help from your doctor for the best delivery and labour that will suit your condition.
Image from | pexels.com
This article was written by Nathanielle Torre and republished with permission from theAsianparent Philippines.
Here at theAsianparent Singapore, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.
