Multiple Birth Problems

Multiple Birth Problems

Only about one in 80 of all pregnancies results in twins, and this is not necessarily a problem. However, all twin pregnancies are watched closely because premature labour is likely, making a double risk for the babies. They are premature, and, being twins, they are already smaller than other babies. A woman expecting twins usually has medically-supervised bed rest for several weeks before they are due, and if labour starts early the doctors may try to stop it by giving drugs through a drip in the arm.

Twins do not always make the labour harder, but it may be longer than average because the uterus is stretched more tightly and contracts less efficiently. Premature twins are delivered most often after the mother has had an episiotomy* because this reduces the pressure on their heads. Being more fragile they are less able to withstand the rigours of a spontaneous delivery.

Just over half, and especially the first, of all twins are born in the vertex presentation. If the second baby is a breech it will be delivered as such. However, if it is lying crossways it may be possible to turn it externally after the first twin has been born, otherwise an internal version will be attempted. The mother is given a general anaesthetic and the doctor uses two fingers to try to gently pull one of the baby’s feet down through the cervix to turn it into a footling breech. If this does not work, a Caesarian section must usually be carried out.

Giving birth to triplets, quadruplets, quintuplets or sextuplets is very rare. However, for those women on certain types of fertility drug treatment it is more than a remote possibility.

Difficulties that may be associated with a twin pregnancy and labour are likely to be increased in a multiple birth. Again, premature delivery is the major hazard the babies face and being so small and fragile, a Caesarian section may be needed to protect their heads from spontaneous delivery. Multiple babies usually need to be kept and attended to in incubators for the first days of life.