My friend was initially delighted by the news that she’d be having twins; fairly quickly after, however, her thoughts of matching outfits and twice the cuddles turned to thoughts of twice the labor. I wasn’t sure what to think about her concerns, though I did my best to reassure her she didn’t need to worry so much. After all, there are women who have more than twins and aren’t in labor for days upon days. What was the truth about her double duty, however? Was she facing twice the labor concerns just because she was getting twice the babies?

At the top of the priority list for doctors of women carrying twins is getting those twins as close to full term as possible. While the majority of twins will be born prior to 37 weeks, the longer the babies are kept inside the womb prior to birth, the better chance they have to develop and thrive. In keeping with this concept, practitioners will also be focused on keeping both babies healthy and safe throughout the pregnancy, labor and delivery processes. Though the length and intensity of labor for women delivering twins is not necessarily longer or more difficult than that of singleton deliveries, there are often more complications related to planning for the delivery of twins.

Despite popular belief, more than half of twins are born vaginally. It is far less common for women to have planned C-sections for the delivery of twins, and even less common is emergency delivery by C-section. When a mother goes into labor with her twins, however, she will need to be closely monitored throughout the process to ensure the safe delivery of her babies. The most pressing consideration when making labor and delivery plans for twins, is the positioning of both babies. Like singleton babies, each twin can be head down, breech, or transverse (meaning the baby is lying sideways across the uterus). The positioning of each baby, and their positions in relation to each other, will make a major difference in how labor and delivery are approached.

If a practitioner recommends a woman have a planned C-section due to the positioning of the babies, it will likely be scheduled for after 37 weeks. In some situations practitioners may recommend an earlier delivery. For those women who are going to attempt a vaginal birth, the practitioner will want to keep her under close observation throughout the entire process to ensure the babies remain in positions that are safe for vaginal delivery, and that neither experiences distress. Though very rare, there are instances in which one baby is born vaginally and the other either flips into a different position or experiences a dangerous situation such as an umbilical cord prolapse and will need to be born via C-section.

Source: Papiernik, Emile. What Interventions are Useful in Reducing the Rate of Preterm Delivery in Twins? Clinical Obsetrics and Gynecology, March 1998, Volume 41, Issue 1, pp 13-23.