Labouring Twins vs Labouring Single Baby

If you happen to find out you’re carrying twins, the pregnancy journey is going to be extremely different than just carrying one baby. This is true right up until the last moments of pregnancy: the stages of labour.

Labour is the time in pregnancy where the body gets itself ready to deliver the babies. This involves a lot of muscle contractions and dilation of the cervix. During labour, it is normal for a woman to feel a lot of pain and discomfort.

As for labouring twins, there are subtle differences and some things that someone labouring just one baby won’t experience. There are more things for the doctor and prenatal team to be aware of. There is more work that the mum’s body needs to do. It is literally double the effort to labour two babies.

Here are some of the things that need to be taken into account when labouring twins.

1. Timing is key

The delivery time is really important for twins. The final stage of labour is the delivery, which involves pushing the baby out of the birthing canal. When this happens, the baby and the placenta (the organ that has been providing nutrients and oxygen for the baby inside the womb) both come out.

When giving birth to twins, it is important that baby number two comes out straight after baby number one and the placenta, otherwise it will be deprived of oxygen. This is why doctors will be keeping a close eye on baby number two’s movements.

There is up to a ten minute time gap that doctors normally allow as the maximum. Of course, this is on a case by case basis. However, after this amount of time, there is more risk of complication or twisting of the umbilical cords.

2. It takes a little longer

The labour time generally increases with twins. This is because, obviously, there are two babies that need to be pushed out of the womb. One of the main reasons for this is because the uterus is stretched so much to hold the twins that it makes it harder for the cervix to dilate.

The muscles in that area are already working so hard to support the uterus, that working for dilation is more straining. The harder the muscles have to work to achieve dilation, the longer time it going to take. There is much to do with this, otherwise than prepare early on for a longer, more painful labour. Bringing plenty of things with you to the hospital to boost comfort is a good idea, such as a favourite pillow or favourite herbal tea to have throughout the time.

3. You will be monitored closely

Monitoring the heart rates is a key priority for doctors during labour. Given that there are three heart rates that need to be monitored, the doctor is extra attentive. During early labour, the heart rate of the babies is monitored with an external belt around mum’s waist.

As labour progresses, there will be two or three foetal heart rate monitors set up. All the while, mum’s heart rate will also be monitored as well during the process. This does mean a lot of cords and beeping going on in the delivery room, but it is obviously for very important reasons. The doctors can tell a lot about how the delivery is going based on these heart monitors. It also indicates whether medical intervention will be needed at any point.

4. Pain relief is recommended

Having an epidural is more encouraged when labouring twins than a single baby. In many cases, an epidural will be administered in a single baby delivery, but in the majority of twin deliveries women take the epidural.

Even when things are going well with the labour and the twins are in the right position, doctors will still encourage the epidural given the pain that is about to happen. Accepting this form of a pain relief is a wise idea, given that the labour is going to be longer and more painful when it comes to delivery twins.

5. There is more room for risk

An increased chance of a high risk labour happens with twins. High risk labours include when things go wrong, such as preeclampsia, cervical problems, or increased blood pressure. However, the odds are very good with delivering twins.

Thanks to support from doctors and prenatal teams, it is becoming easier and easier to ensure labouring twins doesn’t enter the high risk category. The main reasons for high risk labours come back to pre existing conditions. Other things that can contribute to a high risk pregnancy are pre-existing conditions such as being overweight or having a small pelvis. In these cases, doctors will have a recommended birthing plan.

6. Babies need to be in the right position

The positioning of the babies can influence how the labour goes with twins. At the beginning of early labour, the doctors will establish if the first baby is facing head down or not. If so, a smooth labour may begin.

However, the position of baby number two can change as baby number one pushes down on the cervix. This can often result in breeching, and sometimes the need for a C-section. Most of the time, doctors can manually turn the second twin during the labour. If not, an emergency C-section may need to happen, in which case doctors will be well prepared to guide you through.

7. The weight of the babies is less

The birthweight of twins is significantly less than that of a single baby. Given that twins are sharing the space in the womb as well as the oxygen and nutrients from the one placenta, it isn’t too surprising that they are generally lighter.

For full term single babies, the average birth weight is 3.1 kilograms. For twins, the average weight is 2.2 kilograms. That is a substantial difference, but remember that weight number is for both twins, so it is still double!

8. The cervix has to stretch for longer

The cervix muscles stretch more when labouring twins. The cervix is the opening of the birthing canal, which connects the uterus to the vagina. Therefore, the cervix needs to open to let the babies come out. In any labour, the cervix dilates to 10 centimetres, about to the size of a bagel.

In case labouring twins, due to the added pressure on the opening of the cervix, the chances that the cervix might dilate prematurely thereby creating a higher risk of preterm labour for the woman.

9. Two types of birth is possible

Having a mixed delivery is a common occurrence with twins. This is when one baby is born vaginally, and the other is born via a C-section. This will happen if the second baby takes too long to exit the womb after the placenta has come out, or if there is distress with the foetal heartbeat.

Unfortunately, this type of delivery means that mum needs to recover from both a C-section and a vaginal birth! This type of recovery is twice as difficult since it is both a surgical operation and intense stretching of the vagina. Extra TLC from loved ones is needed in this case.

10. Doctors will watch the umbilical cord closely

There is a risk of the umbilical cord knotting during a twin delivery. This is a very scary thought and is a major reason why doctors monitor twin deliveries so closely. Basically, the twins share the same placenta, but have their own umbilical attached to it.

Since the placenta exits the womb with baby number one, but is still attached to baby number two, there is some stretching that occurs. This stretching means that the umbilical cords have the potential to twist and knot together during the birth.

11. You might need a scheduled C-section

Planned C-sections are more common when it comes to twins. There are certain things that can make it near impossible for a woman to labour twins.

These can involve things like mental health issues, a narrow pelvis, or medical conditions. In the case of C-sections, twins are delivered within about 2 minutes of each other.

12. Pain is doubled during labour

Contractions become more frequent putting strain on the uterus, hence increasing the intensity of the pain. Carrying twins literally stretches the uterus to its maximum capacity. There is little room for movement inside the uterus for the twins at full term.

There is less room for movement of the babies inside the uterus. The muscles around the uterus therefore have to work even harder to contract and push.