All about twin birth

Twins are more likely prone to be born early, frequently before 38 weeks, so knowing your options is critical. Half of all twin pregnancies end at 37 weeks.

Due to the risk of your babies being born early, one or both may require special care.

Because twins are often born prematurely, talk to your midwife or doctor early on about your options.

Discuss where you want to give birth. Twin births are more likely to require a hospital birth due to the increased risk of problems.

Twin births typically involve a midwife, an obstetrician, and two pediatricians, one for each baby.

While the birthing process is the same for single babies, twins are attentively watched. This may require an electronic monitor and a scalp clip once your waters have ruptured. You’ll get a drip in case you need it later.

Birth through the cervix

About one-third of all twins are born vaginally, just like a single infant. If you’re planning a vaginal delivery, an epidural is usually advised for pain treatment. It’s easier and faster to help birth when the mother is already pain-free.

If the first twin is cephalic (head down), a vaginal birth is usually considered. But there may be medical reasons why this isn’t doable. A vaginal birth with twins is not suggested if you’ve had a previous caesarean.

A suction cup (ventouse) or forceps may be used to help deliver the infants if they are born vaginally.

After the first baby is born, the midwife or doctor will feel your abdomen and examine your vagina. If the second baby is in a good position, the waters will be broken and the cervix will be fully dilated. Hormones will be introduced to the drip if contractions stop after the first birth.


You can elect a caesarean section from the start of your pregnancy, or your doctor may prescribe it later due to difficulties. Twins are roughly twice as likely to require a caesarean as a single infant.

The babies’ location may decide whether a c-section is required. If the presenting baby is breech (feet, knees, or buttocks first), or if one twin is transverse (body sideways), you will need a caesarean section.

A caesarean section is also required if you have placenta praevia (a low-lying placenta) or if you have twins.

If you had a difficult birth with a single baby, you may need a caesarean with twins. Even if you intend a vaginal birth, an emergency caesarean may be required.

This is because:

  • one or both babies cry
  • Prolapsed umbilical chord, delayed labor, high blood pressure, and ineffective aided delivery
  • In rare situations, a woman may deliver one twin vaginally and subsequently deliver the other via caesarean section.

After birth

Your midwife will check the placenta after delivery to identify the twins’ gender. Fraternal and identical twins exist.

For exceptional needs babies

If difficulties in your pregnancy signal an early delivery, you may need to transfer to another hospital with sufficient facilities. This may not be close to home, so make sure the neonatal facility has enough beds for both babies.

Inquire about the hospital’s transitional care or special care nursery. Parents can care for their babies who need special but not intensive care. These hospitals can keep you and your infants together.

Please enquire if your hospital offers cots that allow co-bedding, if this is appropriate and you want your babies to sleep together.

If you have a baby in the hospital and one at home, you will need to plan your time accordingly. Ask whether you can bring their twin and if co-bedding is allowed when you visit your baby in hospital.

If just one twin can feed effectively, you may need to express milk to feed the other twin. To feed both babies, you may need to put the twin who can feed on the breast to stimulate milk supply.

Check if your hospital has a community neonatal nurse to help you and your baby leave sooner, especially if your baby is tube-fed.

When making follow-up appointments, ask not to be booked into early morning sessions. Leaving the house with two babies, especially one sick, can be tough.

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