Twins & Multiples

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Signs Of Preterm Labor With Twins

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Did you know that going into preterm labor doesn’t immediately mean that you’ll be having a preterm baby? Nonetheless, with a twin or multiple pregnancy, it’s important that you know when you’re experiencing fake labor pains and when you’re in actual preterm labor.

Read on for the signs of preterm labor with twins and what to do to prevent going into premature labor.

Twins and preterm labor

All moms want their pregnancy to proceed without a hitch — that means carrying their babies to full term and birthing healthy babies with no complications and even delivered naturally. For singleton pregnancies, full term means about 40 weeks, with most single babies being born at 39 weeks.

With twins, the average length of pregnancy is 35 weeks, with most twins being born before 37 weeks to avoid a difficult birth.

Preterm labor is defined as labor that happens before the 37th week of pregnancy. True preterm labor occurs when there are real contractions (i.e. not Braxton Hicks) and when the cervix starts to thin out or dilate.

Contractions alone don’t indicate that you’re in preterm labor. First, most pregnant moms experience painless contractions (aka Braxton Hicks) as they near their due date and the uterus starts “practicing” for labor. Second, it’s not actual labor unless there are any changes to the cervix, which only a doctor can diagnose.

This is why it’s a good idea to familiarize yourself with the signs of preterm labor and to get yourself to a hospital if you feel that you’re experiencing actual labor pains.

Though preterm labor is usually spontaneous, it can also be induced when necessary. If you have preeclampsia, for example, your doctor will induce your labor to prevent the condition from progressing and to avoid life-threatening complications.

Maybe you haven’t given it much thought until now, but preterm labor isn’t at all uncommon. It happens in about one out of every 10 births and raises babies’ risk of health and development problems. Recognizing when something feels “off” may help you save your children’s lives.

What causes preterm labor when you are expecting twins?

Doctors still aren’t sure what causes premature labor. But there are some conditions and lifestyle choices that can up your risk of giving birth early. These include:

  • Being 35 years old or older
  • Being pregnant with twins or multiples (fraternal twins and identical twins)
  • Having an older child (or children) who were born prematurely
  • Having a condition/s that affects your uterus or cervix, or having had surgery on your reproductive organs
  • Having certain pregnancy complications like spotting
  • Having a short cervix
  • Being underweight or overweight before you became pregnant
  • Conceiving again less than six months after the birth of your last child
  • Having certain health issues like diabetes, kidney disease, and high blood pressure
  • Contracting an illness or infection while pregnant
  • Smoking, drinking, and doing drugs
  • Not getting sufficient prenatal care
  • Being under a lot of stress

preeclampsia with twins

As mentioned, no one really knows why some moms go into early labor. A pregnant woman who can’t tick any of the boxes above can still have preterm labor — it’s a mystery. That’s why, again, you need to know what to look for and what to do in case you go into premature labor.

Signs of preterm labor with twins

Babies need to stay in the uterus as long as possible so they have sufficient time to grow and develop. According to the March of Dimes, if you experience any of these before 37 weeks, you may be in preterm labor:

  • Cramps that make your abdomen tighten like a fist (especially if you’re feeling more than four contractions an hour)
  • Vaginal discharge that increases in volume or becomes watery, bloody, or mucus-like
  • Increased vaginal or pelvic pressure, like your babies are pushing down
  • Spotting or bleeding
  • Low back discomfort that’s not eased by a change in position or movement
  • Reduced movement by your babies
  • Fluid leakage (your water may have broken)

If you’re unsure if it’s false labor pains or real labor, don’t just blow it off and assume you’ll feel better after a nap. Call your doctor.

what causes preterm labor with twins

Twin Pregnancy: Risks of preterm labor 

Babies who are born prematurely usually weigh less than 5 pounds. Being this small can increase their chances of developing health problems, some of which have lasting effects. For babies, the risks of preterm labor include:

  • Anemia
  • Jaundice
  • Breathing difficulties
  • Hearing problems or loss
  • Vision problems or loss
  • Underdeveloped organs
  • Cerebral palsy
  • Intellectual disabilities
  • Behavioural disabilities
  • Learning disabilities

That may sound terrifying but, thankfully, not all babies born prematurely go on to have development issues. And if it looks like you won’t make it to 34 weeks, your doctor will give you corticosteroid injections to help with the development of your babies’ lungs and give them a better chance of being born healthy.

In addition, going into preterm labor doesn’t always mean that your babies will be born premature. Most women who are treated in the emergency room for premature labor end up delivering their babies closer to full term. According to the American College of Obstetricians and Gynecologists, only about 10% of women in preterm labor actually give birth within the next week.

How to prevent preterm labor in a multiple pregnancy

There’s really not much you can do to keep from going into preterm labor, as doctors aren’t even sure yet what causes it. Still, taking better care of yourself should help improve your chances of a healthy pregnancy. Here are some steps you can take to lower the odds of premature labor.

If you notice signs of preterm labor with twins, you should contact your doctor or quickly get yourself to the hospital and have yourself examined. Once it has started, you’ll likely be given medication to relax your uterine muscles.

If preterm labor stops naturally or is stopped by the medication, your doctor may decide to monitor you for a day or two before sending you home.

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