Pregnancy and labor are two very exciting yet intimidating life-changing scenarios, whether it’s your first or fourth child. And when it comes to twin labor and delivery, it’s only natural for anxieties to run high. From the type of twins you’re birthing to your preferred method of delivery, anyone experiencing a multiple pregnancy is likely to have a few questions that should be addressed with a healthcare professional. Below, we’ve got you covered with everything you need to know about twin labor and delivery, so you feel as prepared and confident as possible when the time comes to meet your babies.
Most Twin Pregnancies Result in Early Labors
Over half of all twin births occur before 37 weeks, with the majority being born by 38 weeks. As you can imagine, triplets and other high-order multiple births are even more likely to be born prematurely. As a result, when preparing for your twin birth, you should be conscious of the fact they may require some time in special care. There are some cases where the onset of preterm labor can be halted, however, sometimes the risk to the mother or baby is too great, and intervention becomes a necessity.The chance of premature labor is something that must be taken into consideration when determining the best delivery methods for your twins. So, when talking with your OBGYN, you can expect plenty of advice on staying healthy, getting plenty of rest, maintaining adequate hydration, and practicing good nutrition to provide optimal care for your growing twins.Vaginal Birth with Twins is Possible
Many women are under the misconception that twin birth must occur via cesarean delivery. However, statistically speaking, approximately one-third of all twins are delivered vaginally. And the process is, by all accounts, like that of a single birth. You will be encouraged to take advantage of an epidural, not just for pain relief, but in case of any issues that may arise. That way, it is much quicker and more convenient to assist with the delivery.When your doc is evaluating whether vaginal delivery is a safe choice, there are a few factors they must consider. First, if you’ve had a previous cesarean section, it’s not typically recommended that you deliver twins vaginally. Otherwise, if a doctor confirms that the position of the second baby is head down, a vaginal delivery is entirely possible.Cesarean Sections are Necessary in Some Cases
If you’re pregnant with twins, you may have the option of having an elective cesarean delivery. Otherwise, a C-section may be recommended later in pregnancy due to potential complications. Ultimately, women are twice as likely to require a cesarean for multiple births than one. Alternatively, the doctor will also monitor the positions of each twin to determine the best course of action. Naturally, both babies in a head-down position are ideal. If the first baby is in a breech position with its butt, feet, or knees down, your doctor will recommend a cesarean. The same goes for when either twin is in a transverse position or laying sideways. Other reasons you may require a C-section include:- Umbilical cord prolapses
- Placenta praevia (low-lying placenta)
- High blood pressure
- Labor is taking too long
- The babies become distressed
Labor is Generally the Same with Single and Multiple Births
While you’re likely stressed at the thought of giving birth to two babies – there is some good news. Twin labor and delivery is the same as single births, most notably because the woman only has to go through labor once. Once a woman is fully dilated, each twin will have its pushing stage. So, while you’ll have to go through the pushing stage twice, the second twin is typically born much easier than the first. In the case of cesarean delivery, the process remains the same as if a single baby was being born.There is a Higher Chance of Complications in Twin Labor and Delivery
If you’re dealing with a multiple pregnancies, this header is undoubtedly the last thing you want to hear. However, being pregnant with multiples doesn’t dictate whether your pregnancy will be problematic. Common examples of complications in twin labor and delivery include:- Preterm labor and birth
- Anemia
- Gestational hypertension
- Birth defects
- Miscarriage
- Abnormal amounts of amniotic fluid
- Twin-to-Twin Transfusion Syndrome
- Postpartum hemorrhage

How Does it Feel to Go into Labor with Twins?
The process of labor and delivery with twins is very similar to that of single births. However, one major difference with multiple births is that labor can come at any time. You may feel contractions, or you might find yourself in your doctor’s office for a checkup, only to discover complications that make it so you must deliver that day. Below are some common signs that you might be in labor.- Tightening in the uterus
- Pelvic pressure and backache
- Cramps
- Gas and constipation
- Water breaking
What Causes Preterm Labor with Twins?
Premature labor is when a woman experiences contractions and true labor at least 3 weeks before the due date. Sadly, babies that are born prematurely have a much higher chance of having health and development problems. When there’s more than one baby in the womb, the risk of preterm labor is much greater for several reasons. Below are some of the more common reasons for preterm labor in twin pregnancies.- Preeclampsia
- Placenta problems
- Premature rupture of membranes
- Growth restriction
- Monochorionic pregnancy
How to Prevent Preterm Labor with Twins
There’s no way to prevent premature labor entirely whether it be a single or multiple pregnancy. However, it is possible to reduce the overall risk. Here are some of the things a woman who is pregnant with twins can do to decrease the risk of preterm labor.- Drink a lot of water
- Get plenty of rest
- Focus on getting plenty of quality calories and carbs
- Cut back your activity level
- Eliminate all smoking, drinking, and drug use
- Avoid major stressors
- Manage any existing health issues accordingly