Birthing Multiples

Dominique W. Brooks
pregnancy, multiple birth

When you find out you're about to have a multiple birth, not only does your pregnancy change, but your expectations for birth change, too.

What Can I Expect During My Multiple Birth

Multiple births are considered higher risk than singleton births. You can expect more monitoring, more testing, and more interventions during the births.

  • You will probably be unable to have a home birth or water birth; although, you can check with your care provider if you have your heart set on one of these births.
  • Your care provider might ask you to deliver in an operating room, just in case you need a quick cesarean, rather than a labor and delivery room.
  • You will probably have many hospital personnel at your multiple birth. There will be extra nurses and more doctors, including a pediatrician.
  • You may be encouraged to have an epidural in case you need a quick cesarean. Remember that it is still your choice.
  • You have a much higher risk of having a cesarean.

You may also find that your twins, triplets, or other multiples will probably be smaller than singleton babies and may be easier to push out.

Cesarean and Multiple Births

On average, a higher percentage of multiples are born via cesarean than singletons.

  • If your babies are not positioned head down in the birth canal at your last prenatal visit, you will probably need a scheduled cesarean. If you do need to schedule a cesarean, talk to your doctor about what you can expect and what you can do to make the experience as meaningful as possible.
  • Your chances are also higher of laboring for a while and then having a cesarean. If you can, most doctors will want you to try to deliver vaginally. Again, talk to your doctor before you go into labor to discuss what your chances are of delivering vaginally and what to expect if you do need a cesarean after laboring.

Can I Still Have a Natural Childbirth?

Yes! However you will have to work very hard to have a natural childbirth, probably harder than if you had a singleton birth.

Before you arrive in the deliver room, you need to learn everything you can about comfort techniques for labor, including breathing patterns, massage, aromatherapy, and birthing positions. You will also need a supportive birthing partner to help you with comfort techniques. You will want to learn about possible interventions and how they can affect your labor and multiple births. Talk with your care provider and birthing coach about what interventions you will may need for your birth and how to continue to aim for a natural childbirth.

At around 30 or 32 weeks, you will need to go into your care provider to discuss your visions for your birth. Come up with a birth plan and go over every point with your doctor. Be prepared to compromise. For example, if you're planning to be off the fetal monitor and your doctor says it's not possible, you have to be prepared to work around being on a fetal monitor.

Other suggestions to help you achieve a natural birth with a multiple birth include:

  • Hire a doula to help you. She will have ideas to help you labor within the confines of the interventions you may have.
  • Be flexible and understanding if interventions become necessary for your births.
  • Most importantly, be patient with your care provider. She does have you and your babies' best interests in mind.

Preterm Labor

Nearly half of all twin pregnancies are born prematurely, meaning before 37 weeks, and the risk of preterm labor continues to go up with each higher-order multiples (triplets, quadruplets, and more).

You will need to be on the alert for preterm labor symptoms, which include:

  • Contractions that are more than ten minutes apart before 37 weeks
  • Rupture of your membranes
  • Increased pelvic pressure, backache, and/or discharge of bloody mucus.

If you see any of these signs before 37 weeks, contact your care provider immediately!

If you have premature babies, they might have to spend some time in the NICU and you may not be able to take your babies home with you when you are discharged from the hospital. If you want to breastfeed, get as much help as you can from the NICU nurses and lactation counselors or consultants. Remember that your babies will be smaller and may have difficulty staying awake to eat and they may have problems maintaining their body temperature. Depending on how premature they are, your babies may have other health issues to deal with as well.

Multiple Births: The Challenges and The Joy

While a multiple birth means that you may not be able to have the exact birth experience that you envisioned when you first got pregnant, you can work with your OB to try to have the best experience possible. The ultimate outcome is your healthy babies and some alterations in your birth plan won't seem so bad in the end.

Birthing Multiples