A twin pregnancy means a different follow-up and also a particular childbirth. Procedure, vaginal or cesarean delivery, possible complications… The answers to your questions about the birth of twins.

The birth of twins takes place by natural means (vaginal birth), when the first twin presents itself upside down, if the placenta is well placed and if the health of the babies and the mother is good.

In the case of vaginal birth of twins, the birth of the first baby is the same as the birth of a single baby. However, both babies are monitored during delivery and if the second twin shows signs of distress, the first baby’s exit is speeded up (use of forceps).

After the release of the first baby and a period of muscular calm in the uterus, which lasts 15 to 30 minutes, the contractions resume! The second pocket of water is broken. If the second baby does not present favorably, it can be returned by the medical team (intrauterine obstetric maneuvers). The second baby is born 5 to 25 minutes after the first.

The delivery of twins presenting a greater risk of cesarean section during labor, of resorting to forceps and intrauterine obstetric maneuvers (painful gestures for the mother), it is medically recommended that the mother-to-be have an epidural. This local anesthesia makes it possible to perform obstetric maneuvers without resorting to general anesthesia.

The birth of twins takes longer than a normal birth and there are two relapses. The epidural allows the mother not to suffer during this real marathon.

In more than 40% of twin pregnancies, childbirth is done under cesarean section. Cesarean section can be planned:

• when the twins share the same placenta and the same amniotic fluid bag (risk of twins curling up with each other with their umbilical cords)
• when the twins present by the breech, when the first twin comes by the breech and the second by the head …
• depending on the size of your pond.

The decision to give birth by vaginal or cesarean delivery is made around the 36th week of pregnancy. A cesarean section can also be performed urgently during labor, especially in cases of fetal suffering, and may be performed for the birth of the second baby.

Having twins is more risky than having a simple birth. This explains why a complete medical team is present during the birth of twins: anesthesiologist, midwives, obstetricians, pediatricians …

In particular, the birth of twins presents a higher risk of bleeding, because the uterus is very distended. Delivery (delivery of the placenta) is most often directed (caused by the injection of a drug to make the uterus contract). In the event of complications (absence of normal delivery or incomplete delivery), the obstetrician-gynecologist performs artificial delivery or uterine revision.

Usually, an induction of labor is done between 38 and 39 weeks of amenorrhea (WA) if the birth of twins has not occurred before.

Note: the main complication of giving birth to twins is premature delivery. 50% of multiple pregnancies are premature (before 37 weeks).