Many healthcare providers like to have women delivering twins outfitted with an IV and an epidural—regardless of whether a vaginal or Cesarean birth is planned—in the event that an emergency C-section is needed, explains Denise Chism in http://www.amazon.com/High-Risk-Pregnancy-Sourcebook-Denise-Chism/dp/1565658582/ . If an epidural is in place, the mother may remain awake during an unexpected C-section.
Preterm labor of twins may also dictate other elements of the birth. "If you are laboring prematurely, your care provider will most likely want the babies monitored during the entire labor, which means you will be in bed during the labor," Chism writes, adding that, "Delivery of twins is most safely accomplished in the room where Cesarean sections are done."
But the Mothering Twins authors urge mothers who are hoping for a vaginal delivery to be vocal about their desires. They suggest that women discuss the following with their doctors:
- Freedom to change positions or walk around during labor
- Use of medication for pain relief or to stimulate contractions
- When and if electronic fetal monitors should be used
- What would necessitate a C-section
Mothering Twins also suggests that mothers explore their healthcare providers' attitudes toward delivering twins by inquiring about the number of twins they've delivered vaginally, by C-section, by both, and the situations in which those deliveries occurred.
Preparing for the NICU
If you're pregnant with twins, you need to come to grips with the distinct possibility that your babies will be born early, may be small, and may spend some time in the Neonatal Intensive Care Unit (NICU). Though baby product commercials are packed with emotional images of parents lovingly cradling their newborn minutes after birth, your reality may be a far cry from that scene. Your babies may be shown to you for just seconds and then whisked away.
Even if you believe you are prepared for that moment, when it actually happens it's difficult. "Most parents of prematurely born infants experience a similar sadness about being left out of the first meeting with their babies," Albi writes. "Though parents intellectually understand the reason for the babies being taken immediately to the neonatal intensive care unit for evaluation and treatment, their hearts may feel deprived."
Albi and her co-authors think it's helpful for parents visit the NICU in the hospital where they'll be delivering before the babies are born. Go in, look around, speak with the NICU staff and, if possible, with some parents who have had or currently have babies in the unit. Seeing what goes on, how parents and newborns are treated can help you mentally prepare for this possibility.
Because there are many opportunities for the birth of twins to take unforeseen turns, experts suggest that mothers pregnant with multiples be ready for anything. "Having multiples makes you very conscious of the unexpected and in many ways prepares you to be more flexible," the moms in Mothering Twins advise. "A lowering of expectations was one of several things that contributed to an overall positive birth experience for us."