Delivering Twins: What You Can Expect

Regardless of whether your physician puts you on bed rest, most medical personnel urge women carrying twins to be on the lookout for signs of premature labor. "An expectant mother of multiples must be keenly aware of her body and babies in order to detect any threatening changes," Elizabeth Noble says in Having Twins. "It is much better to check with your doctor when in doubt (and don't be put off with, 'You're just carrying twins—of course it's a bit uncomfortable') rather than waiting until it is too late and labor is established."

So should you be concerned? Not necessarily. But you should be aware of the following symptoms of premature labor:

• Contractions at regular intervals
• Menstrual period-like cramps
• Sensation of fullness in pelvic area
• Vaginal discharge
• Flu-like feelings
• Diarrhea
• Lower backache

If you go into premature labor—as long as the water hasn't broken for one or both of your twins—there are a few things that can be done to try to stop labor. "When your medical team diagnoses signs of early labor, they may admit you to the hospital or treat you as an outpatient," write Patricia Maxwell Malmstrom and Janet Poland in The Art of Parenting Twins. Options include hospitalization, complete bed rest, using an at-home contraction monitor, and medications taken either orally or intravenously to stave off contractions.

Noble agrees that it is possible in some instances for labor to be stopped if it's too early. "If you can detect preterm labor in its early phases, before the cervix has undergone significant changes and before the membranes have ruptured, it can sometimes be stopped with rest and increased fluid intake," she says.

Positioning of Twins

Once it's been determined that you're in labor, one of the first things you'll want to know is which ways your babies are facing. The positioning of the babies will have a tremendous impact on whether you'll be able to attempt to deliver them vaginally or whether your doctor will insist that you have a Cesarean section. Sometimes, a woman will deliver one baby vaginally and have a C-section for the second baby.