Twin Pregnancy - A birth story from a mum of twins

One of my patients recently gave birth to twins. She's shared her experience below. Thank you to Julia Holland for taking the time to write this down to share with other expecting mums (especially those expecting twins!).

My recent labour and birth of my twin boys was the easiest and most favourite part of my entire pregnancy. Everyone puts so much focus on the delivery aspect of pregnancy but for me this has always been such a small, quick part of the overall long and tough process of getting pregnant, carrying the pregnancy and then caring for your baby/babies once they are born. I would give birth again over and over if I didn’t have to go through the conception, pregnancy and looking after baby part 😊

My pregnancy with the twins was incredibly challenging, both physically and emotionally, and the stress of carrying two babies safely to term definitely took its toll on my mental health (not to mention the fact that I could barely walk towards the end as I was so huge!). I couldn’t wait to give birth and relieve myself of all that pressure, plus begin to feel like myself again physically (or at least begin that long process!). I was literally counting down the days towards the end. I had constant vomiting and nausea for the first 16 weeks which had me lying comatose by the heater on my living room floor for most of that period (with the one silver lining of COVID being that enforced working from home allowed me to work from the floor or my bed and not have to see anyone or get out of my pyjamas for much of that time). I ended up in hospital with severe constipation complications at about 10 weeks, and then was admitted for surgery to fix a twisted ovary full of enlarged cysts midway through my pregnancy so it certainly wasn’t all smooth sailing. Towards the end of the pregnancy I needed a few iron infusions as my levels were pretty low, which is common with twins, and there was some concern with the slow growth of one of my twins which required me to be scanned every week from about 30 weeks onwards and caused quite a bit of stress as I was only ever one scan away from being told the babies had to come out if the results weren’t good enough.

In the end I was booked in at my selected private hospital for an induction at 35+5 due to the ongoing growth (and in that final week also reduced movement) concerns with my smaller twin, and I had everything organized for the day including care for my older kids, my anaethetist and paedatrician selected for the delivery room and also my favourite midwife Vicky scheduled to be working whilst I would be in labour. However I should have known by now that babies have no respect for even the best laid plans and will come when they decide, and not necessarily when best suits you. I went into labour the night before my scheduled induction, however I remember being unsure if it actually was labour at the time as it felt different to when I was in labour the previous times with my two girls and so I wasn’t sure if what I was feeling then was “the real deal” or not.

I was sent to the hospital by my obstetrician to be checked out, and of course it was a busy night in the delivery suite so I was essentially left to my own devices as it was deemed I couldn’t be in proper labour as I didn’t look like I was in enough pain!  When I was finally checked I was 7 cm dialated apparently, despite having quite manageable contractions, and within seconds it felt like there were a lot of people in the room setting up for the impending delivery. I was quickly given an epidural, which was a condition from my obstetrician for attempting a vaginal birth with twins in case the second baby was breech and had to be manually extracted (but one I was all too happy to comply with as pain relief has always been my good friend in labour.)  The epidural was given at about 2am and I managed to rest a little bit before the first twin came out (after about 5 pushes) at 5am followed 5 minutes later by his brother (also head first) who took a few more pushes as he was the bigger twin. I expected both boys to be rushed away to special care immediately as this had been what happened with my middle daughter who was born 4 weeks early, and so when they were checked and I was actually allowed to hold them for a little while before they went to the special care nursery I was almost in shock and didn’t know what to do as I hadn’t expected this would be possible. I was very lucky not to tear at all (I listened closely to my obsterician’s pushing instructions) and was up on my feet walking around within an hour or so post birth once the epidural had worn off. Whilst I was completely exhausted from having had no sleep all night and just giving birth to two babies, the physical relief I felt at having just lost over 6kgs of babies and placenta from my small frame was instantaneous. It might have been the hormones talking but I had never felt better than in that moment. 

Advice I would give to mums to be about birth?

• Don’t be afraid to talk openly and respectfully with your care team/OB about birthing options and what you would like in an ideal world – I was desperate to try for a vaginal twin delivery as I didn’t want to go through the tough recovery of a c-section with newborn twins and two children at home if I could safely avoid one. My obstetrician listened to me and let me try for this scenario, provided that certain criteria were satisfied at the time of delivery with respect to the twins overall health and positioning.

• However whilst you can and should have an idea in your head of what you would like/wouldn’t like your birth experience to be you also need to be flexible and open-minded and realise that a safe delivery is the best delivery (and that babies don’t like sticking to plans!). So the less plans you make (including written birth plans) the less likely you are to be disappointed if things do go awry in delivery, which they often do.

• Being pregnant after a pregnancy loss is tough – you are always expecting the worst and can find it hard to relax and enjoy the pregnancy when you know it can be taken away instantaneously. Once you make it through the first trimester try to allow yourself to feel happy about finally being pregnant when you have tried so hard to get there and celebrate passing the various milestones but also don’t be afraid to ask for help and talk to a professional if you need to.

• The labour and birth part is such a tiny part of not only the entire pregnancy but also of your child’s entire life so don’t focus on or stress about it too much beforehand. It will be over before you know it, and what is really important is that your child arrives safely and the ensuing months and years that you spend together with them.

• Knowing when you are in actual labour is not always that easy to determine – if in doubt go to the hospital or call your obstetrician (especially if it isn’t your first birth) as it might not always be as obvious as you think and just because you aren’t screaming the house down in agony doesn’t mean that you aren’t in labour.

• Each birth gets easier so hang in there!