Q&A: I'm so uncomfortable at 37 weeks pregnant with twins. Why can't my doctor just induce labor?
I'm so uncomfortable at 37 weeks pregnant with twins. Why can't my doctor just induce labor?
Carrying twins can be immensely miserable towards the end of pregnancy. It is hard to believe that the twins are still better off in than out, when you feel so bad, especially when you probably know of babies born at 37 weeks who have done well. I can certainly understand feeling that you are done!
About half of all twins are born early. Sometimes this is due to preterm labor or premature rupture of the membranes, and sometimes this is because a complication of pregnancy, like poor fetal growth or maternal preeclampsia, indicates that the babies are better off out than in. But in general, if all is going well, twins are better off inside their moms until spontaneous labor occurs or until they reach 38 to 40 completed weeks of gestation (no earlier than two weeks before the due date).
You may have been waiting for 36 weeks as a benchmark of when it is “OK to deliver” but that refers to spontaneous labor, not induction. Recent research on singletons has shown that outcomes are statistically worse when a gestation below 39 weeks is chosen for induction or scheduled Cesarean. While most babies do fine, statistically they are more likely than babies from spontaneous labors to end up in the newborn ICU. It seems that the signal for the timing of labor comes from the babies, and when they are born without waiting for that signal, more babies won’t do well, at least at first.
After 39 weeks, it is very unlikely for a singleton baby to need to go to the ICU, and the chances are independent of whether the timing of birth was chosen by the baby or by the family and healthcare team. For twins, we don’t have as much data. Some experts believe that the gestation where outcomes are the same as full term is 38 weeks for twins. Induction itself, though, may increase the chance of requiring a Cesarean. When the pregnancy is going well, waiting for spontaneous labor is usually preferable.
Hang in there! Remember you have made it this far, and we are only talking about days now. You are being a good mom suffering through these discomforts now to prevent your babies from the chance of having to suffer in the NICU. No question you are miserable, but you still should do the right thing. The best outcome is to have babies that are healthy and well, who can be with you, their mother, from the moment of birth on. You are almost there!