two twin babies under a blanket

Giving birth to a single child is a very elaborate process. So, I can totally understand your freaking out when you learned you were carrying twins or even triples. Especially if it’s your first pregnancy. While it might seem an overwhelming situation, there’s no need to worry extensively. You just need enough information, and that’s why I am writing this article about giving birth to twins. I’ll try to cover all the stages and most possible issues: from pre-birth considerations, to delivery itself, to postnatal care.

Plan Your Hospital Ahead

Right now, you probably think: Wait, don’t I get to choose where I’ll give birth to my two bundles of joy? Sure, your choice will matter, but it’s highly recommendable to opt for hospital. You just never know how the whole process will unravel, and that’s why it’s important to have the conditions and support that only a facility can offer.

Now, as you are probably aware, no two hospitals were created equal. At some hospitals, you will be expected to care about your babies even though it’s almost impossible to stand up and walk. Others will treat all of you with more care.

Don’t get me wrong here: I’m all for baby-friendly hospitals that put you and your babies in the same room and stimulate breastfeeding. However, many women report they were treated pretty harshly after delivery, without regards for their physical, mental state, and the risks of postpartum depression.

So, it’s best not to flip a coin and hope that it will land on the right side. Do your homework, and do it diligently. Since you never know whether your labor will begin prematurely, you should plan your hospital months ahead. Make sure to ask whether they have a special care unit (not the same as intensive care!), and if they allow co-bedding in the neonatal unit. That’s because most parents of twins prefer to put their babies in a single cot, where possible.

two twin babies lying on a same bed

Early Delivery Is More Likely with Twins

The majority of twins will be born prematurely, before the 37th week of pregnancy. Your obstetrician will probably have the last say in it, based on a number of factors. The most important consideration here is whether they share a single placenta. If they do, the date for a planned delivery will likely be set sometime in the 36th week.

Vaginal or Cesarean Section Birth?

When it comes to twins, very often the recommendation would be to perform a c-section delivery. That happens in over 50% of all twins deliveries, and for good reasons. Even if your pregnancy was absolutely safe and without complications, it still doesn’t mean that the delivery would go without any issues.

The practitioners’ assessment will depend on the first baby’s position. If it’s positioned sideways or with its limbs or bottom towards the cervix, cesarean is the safest option. Likewise, if you’ve already had cesarean before, it will be the choice this time too.

Moms who plan on having a vaginal birth should be aware of a few facts. Firstly, it’s up to the team supervising your delivery to decide if they are going to switch from vaginal to cesarean at any given moment. Secondly, even if everything goes according to the plan, you will definitely need epidural anesthesia. Not that twin birth is more painful by definition. It’s just that the risk of complications is greater. And that means an intervention might be necessary at any moment.

In a very small percentage of all twin births, the delivery might be combined. If the first twin is born vaginally but complications emerge with the second, a cesarean will be the most likely emergency scenario.

However, all of this doesn’t mean that you should worry too much. While it’s important to keep those considerations in mind, here’s a simple truth. Giving birth to two babies doesn’t mean having two deliveries. Both you and the second baby will have much easier time once the first baby has come out. Plus, your practitioners will monitor both babies electronically, following their heart beats. Should your contractions stop after the first baby is born, you will get a drip to stimulate them again.

What Happens After Delivery?

You think you will be able to tell the difference between your twin babies? Don’t say that out loud. Chances are you won’t, even as a mom, and sometimes even if they are fraternal twins.

For those of you who aren’t familiar with twin types, here’s what it means. Fraternal twins come from two different eggs. Therefore, they each have their own placenta, and might not look the same. On the other hand, identical twins originate from the a single egg which was fertilized and then the embryo split into two halves. Even though they share the placenta, they might or might not share its inner or outer membrane.

But how to tell which is the case? Usually, an ultrasound in the third trimester will be enough. Also, the midwife will be able to tell when she examines your placenta. In rare cases, a DNA test is necessary to determine that. But it’s also a costly thing to do. So, it might be best to settle with what you see just by looking at them. Don’t freak out if you can’t really tell them apart. During their first year, differences will start to appear, however slight.

Many twins and almost all triples will need special care right after they’re born. But even if yours don’t, you will still be very confused about providing them with proper care. That’s why you should plan for certain things before hitting hospital. Make sure to bring a breast pump, since you never know if one or both of them will have trouble feeding.