Wondering about labor and multiple births process? Don’t be anxious or scared for nothing! If you’re expecting more than one baby, acquainting yourself with the peculiarities of a multiple pregnancy, its labor and childbirth issues will be helpful.
Often we hear about twins when it comes to multiple births, however, multiple pregnancies in triplets, quadruplets, quintuplets and so on, also abound even though rare. Triplets, for instance, occurs once in every 8,000 deliveries. If you are carrying twins, triplets or more in your womb, accept our congratulations for such multiple blessing.
Basically, there are two types of twins, namely monozygotic and polyzygotic twins.
· Monozygotic (identical twins) refers to a single zygote formed by the union of a single ovum and sperm, which eventually divides into two or more separate zygotes within the first 8 days of conception.
These divided zygotes, usually of same sex, then develop separately to form fetuses that are made up of exactly similar genetic characteristics. About 33% of twin pregnancies are monozygotic.
When fertilized egg divides after 8 days, twins that are connected (Siamese or conjoined twins), sharing internal organs, can be the result.
· Polyzygotic ( dizygotic or fraternal twins) refers to more than one zygote, where two eggs were fertilized by two different sperm and then implanted in the womb simultaneously; hence the babies differ in appearance and may also differ in sex.
It has long been established that In-Vitro fertilization and use of fertility medications such as Clomid increase the chances of conceiving multiple fetuses.
In some cases of more than three viable fetuses from fertility drugs – influenced pregnancy, fetal reduction is commonly carried out, if requested or necessary, to increase the chances of delivering healthy babies.
Multiple pregnancies are also influenced by factors such as genetic heredity, older moms who are believed to be capable of releasing more than one egg during ovulation, even obesity surprisingly increases possibility for a multiple pregnancy compared to moms of lower BMI before getting pregnant.
Here on PregnancyMama, we daily receive expecting moms, asking questions about issues that border on multiple pregnancies, especially labor and multiple births.
Let’s look at the issue of weight gain which is of much importance in a multiple pregnancy. Definitely, you’ll gain more pounds more than the single pregnancy 25-35 pounds normal weight gain. Your weight gain will depend on your pre-pregnancy weight and the number of fetuses you’re carrying.
Ideally, an expecting mom with average pre-pregnancy weight is expected to gain between 35-40 pounds when carrying twins and over 45 pounds when expecting triplets.
Importantly, symptoms of pregnancy are exacerbated in moms expecting more than one. Physical discomfort, backache, morning sickness, shortness of breath, varicose veins, indigestion, constipation, gestational diabetes, fatigue, swollen face, feet and ankles, may intensify with multiple pregnancies.
The process of birthing multiple babies is almost same as birthing a single one. However, more care and support are required in multiple births compared to single birth for the obvious reason that more of ‘everything’ will be involved.
Now let’s examine some of the labor and delivery issues peculiar to multiple births. Our aim is to put potential problems about multiple childbirths into proper perspective, so that you can have the big picture of what you’re undergoing. You may not experience any of these problems in your own case.
Preterm labor and delivery is one of the biggest risks or problems peculiar to expecting moms carrying more than one baby. It is not unusual when moms having multiple births approach labor anywhere from 2 to 5 weeks before the estimated due date.
A pregnancy that lasts 37 weeks or more is referred as full term, while any one delivered between 24 and 36 weeks are preterm. Preterm labor has been reported in 51% of cases of twins and 91% of cases in triplets. Although such preterm babies are underweight and weak, preterm delivery in multiple births makes sense if both the babies and mom are safe.
In addition, other pregnancy problems common to multiples include twin-to-twin transfusion syndrome, cerebral palsy, fetal mortality, fetal malformation, low birth weight, intrauterine growth restriction, placenta abruption and previa, pre-eclampsia, fetal breech presentation, hydramnios or polyhydramnios, maternal bleeding, among others.
In the event of such problems your healthcare provider can detect, diagnose and manage them accordingly. With adequate treatment, everything can go well for you regardless of whatever difficulty you may encounter.
When it comes to twin delivery, the good news is that about half are delivered through vaginal childbirth. The priority of most doctors when dealing with multiple pregnancies is to ensure the babies develop into maturity as much as possible in the womb, and delivered safely and alive. For this reason, the fetuses are closely monitored.
Natural birth of babies don’t take too long because the babies are usually small and hence less energy in required in pushing. They are born easily, often with shorter labor. When the first baby is born through vaginal delivery, the second would come even quicker.
Remember that sometimes things can get complicated during multiple births, especially situations that pose any threat to either the babies or mom. Cesarean section may become inevitable in the event of life threatening complications. Sometimes, any of the fetuses may be birth vaginally while others require C-section to be delivered.
Other factors that determine whether the babies will be born vaginally or by a surgery are the position and safety of your little ones in the womb, as well as your health. In any case, it’s a great deal when all your babies are delivered safe and alive no matter the birth method used.
More often than not, cesarean section is used for triplet childbirth because it is characterized as a high risk delivery. But in rare circumstances where Triplet A closest to the cervix is in head-down position, vaginally delivery may be attempted and can be possibly successful, in the event of no other complicating factors.
Generally, triplet deliveries usually end in a combination of vaginal and cesarean methods.
On a final note, acquaint yourself with available delivery options, and decide about your preferred birth method ahead of time. Interestingly, your doctor would guide you through the process and advise you accordingly if you’ll be classified within multiple births category.