Going through the process oflabor and delivery of your twins is easier when you feel you are at least somewhat prepared for the big event. Taking childbirth classes can provide you with support and information – especially if you have never given birth before.
Having your partner share in the information with you will help both of you get through it ( guys like information and knowing what to expect !) Have him carry a cell phone with a secret code or a pager to make sure he is with you for the big event. Remember with twins, they don’t always come when you are expecting them to and more often than not, they’ll be arriving early!
Watch this beautiful video about twin pregnancy and labor and delivery with twins.
Some of the signs and stages of labor to watch for and understand
If you feel the babies have ‘dropped’ somewhat and you are able to breathe a little easier – this is what is referred to as lightening. This pressure is what starts the cervix to open.
Another sign of impending delivery is the ‘bloody show’, where the mucous plug that has been sealing your cervix shut for so many months, finally lets go . Yes , it’s as gross looking as it sounds – but hey – this means that your cervix is starting to dilate !
Your water breaking is a big one – we all hear about it happening in strange places like taxi’s and restaurants. Chances are it won’t be quite that dramatic but you never know. If this does happen , especially if you are weeks before you should deliver, call your OB immediately. This is called rupture of the membranes and sometimes the doctors will do it for you with a large hook in the hospital to move things along – more so with a singleton pregnancy.
Contractions You’ve probably experienced contractions on and off throughout your pregnancy. These are called Braxton-Hicks and they are normal – your body’s way of practicing for the real labor and delivery of your babies. They are NOT regular, they usually happen if you are slightly tired or dehydrated and generally are just in front of your belly. They should go away with rest and fluids.
Now if your contractions start coming at regular intervals, say 7 minutes apart and are lasting between 30-60, start taking notice and write them down. Real labor contractions will continue whether or not you drink or rest, they will continue to get stronger and more uncomfortable. This is the first stage of labor.
**If you feel you have symptoms of laborCALL your doctor-especially if you are still early on in pregnancy- trust your instincts ! Sometimes labor progresses far more quickly than you are expecting. For information on what to expect if your babies are coming early click here
If you are delivering at the hospital, you’ll go to the labor and delivery unit, change into your stylish hospital gown and be examined to see just how far along you are. They will probably strap 2 big belts over your belly so they can monitor your contractions and the babies responses. This is known as electronic fetal monitoring.
If your due date is still way off they may try to prevent labor and delivery at this point by giving you IV fluids and possibly medication . If the doctor decides you are in labor but have at least a day before you deliver, they will likely give you corticosteriod injections to help speed up the lung development of your babies. This can make a big difference in their well being after birth.
Sometimes labor and delivery of your babies is induced by having the doctor rupture the membranes with the long needle ( looks like a big crochet hook!), or administering a drug called Pitocin which will stimulate contractions ( generally makes them come pretty hard and fast in my experience !)
Pain relief options
I think it’s wise to educate yourself on the various methods of pain relief BEFORE you’re actually in labor! Here’s a quick rundown of some of the usual options. Everyone is different in how they react to the various drugs and how aware they want to be during labor and delivery.
Demoral this is a narcotic and it is given through the IV or by a needle. It tends to make you very drowsy and take the edge of- some women say it makes them feel nauseous.
Epidural Block This is very common now for pain management – a small tube is inserted by needle into the lumbar space below the spinal cord. ( My hubby said watching this was far worse than watching labor!)The amount of medication is easily controlled and is commonly used for cesarean section deliveries , allowing the mother to remain awake and alert.
General Anesthesia this knocks you out completely and is usually only used for emergency deliveries.
From what I’ve read, about half of all twin pregnancies are delivered vaginally and half by c-section. You may have your heart set on a vaginal delivery but sometimes those babies have other ideas. You may wish to have a birth plan written out for labor and delivery of your twins. Depending on their positioning especially for the baby closest to your cervix – that baby needs to be HEAD DOWN ( called the vertex position.) If that baby is breech ( feet or bum first) then you will likely be scheduled for a c-section.
If the first twin is able to be born vaginally, it frees up more room for the second baby who may also be able to be born this way. The doctor may try to turn the baby from the outside called external version- OR , like in my case, just reach up and grab the feet of the second one and pull her out ! ( I always said it was the worst pregnancy but the best delivery ! 5 minutes – the bigger one came out head first and baby #2 was pulled out right after. Now sometimes, the second baby may need to be delivered by c-section so you really do need to be mentally prepared for that to happen – just in case.
Possible situations where a Cesearean section is necessary for safe labor and delivery
-the twins are breech or transverse( sideways)
– one of the babies fails to descend down into the birth canal
– you try labor but the cervix just doesn’t dilate fully
– placenta previa – where a placenta is blocking off the birth canal
– abruptio placenta – where a placenta separates from the wall of the uterus
– any type of fetal distress
– any serious health problem with the mother that could be made worse by going through labor.
Sometimes you know well ahead of time – as in a planned C-Section. Other times it happens as an emergency during labor and delivery. C-sections are major abdominal surgeries but they are now done so frequently that the risks are usually minimal.
In the operating room You will be dressed in a gown, given an IV line for fluids and medication and usually given an epidural unless it’s an emergency c-section in which case they would put you under general anesthetic and you’d sleep though the whole thing. Generally there are a whole lot of doctors and nurses in there – 2 of each for your babies. There will be a drape placed over your belly so you can’t actually see the surgery being done. Your stomach will be washed with antiseptic and then the doctor will cut through your skin and then through the uterus. The amniotic fluid is suctioned off and then the babies are pulled out one at a time ! Afterwards the placentas are removed, you ‘re given pitocin to start contractions to shrink the uterus and help stop the bleeding. Usually the whole operation only takes about an hour.
More on Labor and Delivery with Twins
VBAC with Twins| Twin Water Birth| Twin Vaginal Birth| Cesarean Twin Birth| Twin Birth Videos