SafeMotherhood
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TYPES OF BIRTH

TWINS AND MULTIPLE BIRTHS

Having twins is unusual, but if you are healthy and your pregnancy is normal, you can expect to give birth vaginally without medical intervention, if you wish.

Your hospital may have policies on the delivery of twins - for example, on monitoring or inducing labour. Expecting twins does make medical problems such as high blood pressure more likely and twins often arrive before their due date.

However, there is no evidence that inducing your labour (unless you have specific medical problems) is helpful. Monitoring two babies' hearts using a hand held sonicaid it just as appropriate as electronic monitoring for twins, if things are progressing smoothly.

Moving around, standing up and feeling able to follow your body's instincts is as important if you are having twins as it is in a singleton birth.

Students and other medical staff may want to be present at the birth. However, three midwives (one for you and one for each baby) are all you need. If the babies are being born earlier than 38 weeks or are expected to arrive in poor condition, you may need a paediatrician for each baby and if medical complications arise during labour, you may need an obstetrician.

With twins, the first stage of labour follows the same pattern as for a single baby, but may go more slowly. You can choose all the pain relief options available (see Pain Relief).

The babies will be born one at a time. After you have given birth to your first baby, the midwife will check the position of the second baby. If he is head-down you will be able to go on to give birth again. If the second baby is in the breech position, you may be offered a forceps delivery to help this baby out quickly.

Rarely, the second baby is lying awkwardly and if it is not possible to manipulate him or her into a better position, a caesarean is your only option.

The third stage of labour proceeds in the same way as with a singleton pregnancy. If the twins are identical, there will be one placenta, but if they are non-identical, two placentas will be expelled after both births.
(See Special circumstances/twins and multiples)