Twins Birth: Crucial Insights Revealed
Pregnancy with twins can present unique challenges, particularly when it comes to delivery. Here are some key factors, timing considerations, and delivery options to help expectant mothers better understand the process.
Delivery options for twin pregnancies are influenced by various factors. These include the chorionicity (whether the twins share a placenta), fetal presentations (such as breech), the risk of complications like cord entanglement or twin-to-twin transfusion syndrome, and the maternal-fetal health status.
The average recommended time for twin delivery varies but is generally around 37 weeks for monochorionic twins and about 38 weeks for dichorionic-diamniotic twins. This is to minimise prematurity risks without prolonging pregnancy too long. Some studies suggest delivery by 36 weeks in certain twin pregnancies, but the optimal timing is still under discussion among specialists.
In high-risk monochorionic pregnancies, cesarean delivery is often recommended as early as 32 weeks due to the risks associated with cord entanglement. Vaginal delivery might be considered in less complicated cases or when twins present favourably.
Factors such as optimal fetal positioning may help position the twins for standard delivery and facilitate efficient turning during labor, although there isn't concrete scientific proof to support this.
Induced labor or caesarean section may be used for the delivery of twins, depending on the mother's health and the babies' condition. Twin babies are often born pre-term or prematurely, so it's essential to discuss delivery options with the doctor well in advance.
In the case of monochorionic twins, the doctor may advise a c-section if there are any complications. Staying active during pregnancy and maintaining a healthy lifestyle by eating healthy food and regularly exercising can improve the chances of having a normal delivery with twins.
In some cases, one baby may be born vaginally, and another may be born through a c-section, although this is rare and happens in only 5% of cases. A c-section is more likely for mothers carrying twins, but it's not always necessary. The doctor may advise a twin caesarean birth in cases of placenta covering the cervix opening, previous caesarean delivery, or if the babies are smaller.
During twin birth, the mother will not go through labor twice; the first stage labor or cervix dilation will happen only once. Caesarean delivery may be recommended if the first twin is in a breech position, if the twins are in a transverse position, or if there are complications.
Breastfeeding is beneficial for recovery after twin delivery, as it releases the feel-good hormone oxytocin and helps lose pregnancy fat faster compared to mothers delivering single babies. If the second twin is in the breech position, the doctor may turn the baby either externally or internally.
Recovery from twin delivery, whether vaginal or c-section, may involve more postpartum blood or lochia, and a longer time for the breasts and belly to return to their pre-pregnancy shape. In a vaginal birth with twins, the first stage labor occurs only once, while the second stage labor happens with each baby having its pushing stage.
Twin delivery may require extra help and medical intervention, even in cases of normal or vaginal delivery. If the babies are born later than 38 weeks, the risk of stillbirth may increase due to the placenta's inability to support the babies.
In summary, the delivery of twins can be influenced by various factors, including chorionicity, fetal growth and position, presence of complications, and maternal-fetal health status. The optimal timing for delivery is typically 37 weeks for monochorionic twins and 38 weeks for dichorionic twins, with earlier cesarean delivery possible in high-risk monochorionic pregnancies. It's essential to discuss delivery options with the doctor well in advance to ensure the best possible outcome for both mother and babies.
[1] American Pregnancy Association. (2021). Twin Pregnancy: Facts, Complications, and Delivery. Retrieved from https://americanpregnancy.org/pregnancy-complications/twin-pregnancy/
[2] March of Dimes. (2021). Twins. Retrieved from https://www.marchofdimes.org/complications/twins.aspx
[3] National Health Service (NHS). (2021). Twins and multiple births. Retrieved from https://www.nhs.uk/conditions/pregnancy-and-baby/twins-multiple-births/
[4] Royal College of Obstetricians and Gynaecologists. (2021). Twins and Multiple Pregnancy. Retrieved from https://www.rcog.org.uk/en/patients/patient-leaflets/twins-and-multiple-pregnancy/
[5] UpToDate. (2021). Management of twin pregnancy. Retrieved from https://www.uptodate.com/contents/management-of-twin-pregnancy
Maintaining a healthy lifestyle during pregnancy through eating healthy food and exercising regularly can improve the chances of having a normal delivery with twins (health-and-wellness).
Optimal fetal positioning may help position the twins for standard delivery and facilitate efficient turning during labor, although there isn't concrete scientific proof to support this (parenting).
