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Home Birth

Twin Birth | Is Twin Birth Risky?

Emily Brittingham, IBCLC, BHSc
by Emily Brittingham, IBCLC, BHSc
Medically Reviewed by Emily Brittingham, IBCLC, BHSc on
Last updated October 6, 2023
Reading Time: 4 min
Twin Birth Is Twin Birth Risky

If you’re an expectant mother who’s pregnant with twins, congratulations! Being a parent of twins is special and unique. People are genuinely fascinated by twins, because twins are fascinating.

Whether the twins will be your first birth experience or your first baby was a singleton, its common to have concerns about giving birth to twins.

This article will share some information about the level of risk involved in multiple births, specifically twin births.

Can I carry twins to full term?

There is a higher risk of early labor for twin pregnancies.

Globally, the preterm birth rate is around 11% of the annual birth rate. In Australia, around 7% of all births are preterm, with 63% of twin pregnancies resulting in preterm birth.

A full term pregnancy for a single baby is 40 weeks. For a twin pregnancy, the average birth occurs between 32 and 36 weeks. In this respect, each twin pregnancy carries a risk of preterm labor.

The risks associated with premature birth include:

  • Prolonged hospital stay after birth
  • Admission to neonatal intensive care unit
  • Severe morbidity in the early weeks of life
  • Long-term neurological disabilities
  • Readmission to hospital in the first year of life
  • Higher risk of chronic lung disease.

Women who are pregnant with multiple babies have a higher risk of gestational diabetes and pre-eclampsia.

Can I prevent preterm labor?

Although preterm labor cannot always be avoided, there are certain things you can do to help lower your risk.

They include:

  • Quitting smoking
  • Abstaining from alcohol
  • Avoiding illegal drugs
  • Following a healthy diet
  • Avoiding stress
  • Getting plenty of rest.

Not all women who are pregnant with twins have complications. Many will carry a pregnancy close to full term and give birth to healthy babies. Because a high percentage of women carrying multiple babies go into labor early, any twin pregnancy is considered higher risk than a pregnancy with a single baby.

If you have a multiple pregnancy, it’s very important you attend all of your prenatal appointments. This makes sure that any health condition you or your babies experience, and which could result in preterm birth, is known early.

Twin births: how is labor different with more than one baby?

Giving birth to more than one baby at a time can be a daunting idea for an expectant twin mother, but giving birth to twins doesn’t need to evoke fear. The bonus of having twins is that you get to have two babies from only one labor.

For a twin vaginal birth, your body works in a similar way to how it would if you were giving birth to one baby.

In the first stage of labor, your cervix dilates. For women who have not previously given birth, this stage can take about 12 to 14 hours. For women who have given birth before, the first stage might be shortened by several hours.

Once your cervix is fully dilated, you will push your baby out until she is fully born. For multiple births, there are two separate pushing stages. The average time between the birth of the two babies is 15-20 minutes. The second baby is usually much easier to birth than the first baby.

After both babies have been born, the last stage of labor is delivering the placenta. This is often the easiest stage. After the placenta is delivered, the umbilical cords are clamped and cut.

Is a vaginal birth safe with twins?

Provided there are no medical reasons for a caesarean section, a vaginal birth is safe with twins.

If you are planning on giving birth vaginally, your healthcare provider might want to check that the first baby is in a head down position, as this is the optimal position for a natural birth.

It’s common for the second twin to be in a transverse position in utero. The position of the second baby mightn’t affect whether your babies are born vaginally or via a caesarean section, as it’s possible that the second twin will turn after the first twin has been born.

Unfortunately, this does not always happen and it can be hard to predict. In some cases the first baby will be successfully born vaginally, while the second baby will require an emergency c-section.

Another factor determining the safest birth option is the positioning of the placenta. If you have a low lying placenta (or placentas), you might not be able to have a vaginal birth. There is a higher risk of caesarean section for women with placenta previa.

You can read more about this in BellyBelly’s article Placenta Previa | What You Need To Know And Do.

Even if your babies are not in a ‘good position’, talk to your healthcare provider about your birth options. Your care team will be able to give you the best advice as to whether vaginal birth is still possible.

What are the 7 types of twins?

You might be surprised to learn that there are seven different types of twins.

They are:

  • Identical twins, when one fertilized egg splits in half. They are also referred to as monozygotic twins
  • Fraternal twins, when two separate eggs are fertilized at the same time. They are also referred to as dizygotic twins
  • Half identical twins, when an egg splits in half before fertilization
  • Mirror image twins. This is a version of identical twin where their features are mirror images of each other
  • Mixed chromosome twins, when two separate eggs are each fertilized then mould together
  • Superfetation, when fraternal twins are conceived at different times
  • Superfecundation, when two eggs are fertilised at different times by sperm from different men.

Sometimes it’s not possible to know which type of twins you are carrying until they have been born. DNA testing can confirm whether you have identical twins or non identical twins.

For further reading, you can refer to the following BellyBelly articles:

Fraternal Twins | What Are Dizygotic Twins?

Identical Twins | 9 Fascinating Facts About Twins

6 Week Ultrasound | Pictures, Twins and What To Expect

9 Best Tips For New Parents Of Twins.

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Emily Brittingham, IBCLC, BHSc

Emily Brittingham, IBCLC, BHSc

Emily Brittingham is a qualified International Board Certified Lactation Consultant (IBCLC) with more than 7 years of experience in the profession.

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  • Amy Cameron, RM, IBCLC
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    Anne Macnaughtan
  • BellyBelly Ed
    BellyBelly Ed
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    Sarah Buckley
  • Dr. Jack Newman MD FRCPC
    Dr. Jack Newman MD FRCPC
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  • Emily Brittingham, IBCLC, BHSc
    Emily Brittingham, IBCLC, BHSc
  • Emily Robinson
    Emily Robinson
  • Fiona Peacock
    Fiona Peacock
  • Gloria Lemay
    Gloria Lemay
  • Graham White
    Graham White
  • Heather Hack-Sullivan CPM, LDM, BS in Midwifery
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