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Why Are Twins Often Born Early

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Twin pregnancies are often a pleasant surprise for any couple. However, twin pregnancies are relatively shorter than singletons. Giving birth to twins early is not without risks. In this article, we’ll find out why twins are often born early and how this impacts the mother and her twins.

What causes preterm labor in twins?

Preterm labor can be caused by a lot of different things. However, parents and doctors may determine the signs of preterm labor so the proper measure might be done. Parents might be expecting their twins at a later date. However, twin pregnancies greatly vary in duration and it is important to know the tell-tale signs of preterm labor to seek medical attention immediately in case emergency c-section or induced delivery might be necessary. You may keep an eye on these signs which are often precursors to preterm labor:

  • Separation of the placenta from the uterus
  • Early dilation of the cervix
  • Hormonal changes in the mother due to stress
  • Bacterial vaginosis
  • Chronic urinary tract infections

Why are twins often born early?

Twin pregnancies are generally shorter than singletons. However, this doesn’t mean that twins are always born prematurely. In addition, Braxton Hicks contraction is often mistaken for real preterm labor even if it lasts a lot shorter than actual labor. This might get you rushing to the hospital, even though your twins aren’t ready to come out yet.

Twins are born early because of some complications which are unique to twins or are more common in twin pregnancies. Moreover, certain complications in twin pregnancies might force early delivery in twins and multiples. Preterm labor is the most common reason why twins are born early. In addition, pregnant moms with multiples are often predisposed to preeclampsia which is an increase in blood pressure and protein in the urine of the pregnant woman.

Twins with either one or two placentas and amniotic sacs are at risk of placental abruption which is the detachment of the placenta to the uterine wall. When this happens, early delivery might be inevitable. Otherwise, it can be very risky for the mother and the twins if they are not delivered soon after the placenta detaches. In addition, In addition, a ruptured amniotic sac is also known as “water breaking” may also occur earlier in twin pregnancies which may also cause earlier delivery in twins.

In twin pregnancies, the umbilical cord may get entangled in one or both of the twins in the womb. In this case, doctors may recommend induced labor or premature delivery so that the twins and the mother may avoid further complications along the way.

Growth restriction in one of the twins might occur, so the doctor might recommend delivering the twins early. Moreover, even though twins are born generally smaller than singletons, the twins must not have a very big size difference from one another. Otherwise, growth restriction might have been occurring to the other twin and they need to be delivered earlier than expected to prevent complications or loss to the growth-restricted twin.

There are certain complications that multiple pregnancies are predisposed when to compared to singletons. However, the length of the pregnancy may vary depending on the condition of the mother and her twins. Doctors would often attempt to delay the delivery of the twins to support the development of their lungs and brain. But, twin pregnancies are predisposed to certain complications which might cause twins to be delivered earlier than expected. 36-37 weeks is the full-term for twins, but few twin pregnancies even reach full-term.

What are your chances of having surprise twins at birth when you experience preterm labor?

Even with medical advancement, twins are not always detected with fetal dopplers and modern-day ultrasounds. Furthermore, surprise twins at birth might be a welcome surprise for any couple. Unexpected twins at birth might be rare. However, it might be one of the reasons why you need to deliver your babies early. Twin pregnancies are shorter than singletons, so it is not shocking that you might need to deliver your babies earlier.

Surprise twins at birth might be rare. However, there is still a remote possibility that it can happen to any pregnant woman. Urine tests and blood work might give you a clue that you might be carrying twins. But, if it is a hidden twin, you might just need to trust your gut feeling that you have twins in your womb since ultrasounds might not detect the second fetus. Besides, some countries might not even have the ultrasound technology to detect the second fetus accurately.

The chances of having surprise twins at birth during preterm labor are probably less than 1% because the chances of getting twins are just about 3% of all recorded pregnancies in the US. However, if you attempted to have a folic acid twin pregnancy, you might be able to tell whether your preterm labor is caused by an undetected surprise twin or not.

Is preterm labor risky for your twins?

There are certain risks attributed to preterm labor in twins. That is why doctors often recommend full-term twin pregnancies as much as the mother and twins can handle with fewer risk factors. However, even with all the proper health care and nutrition, some twins might need to be delivered on or before 32 weeks. Here are some of the risks of preterm labor in twins:

  • Jaundice
  • Anemia
  • Hearing or vision problems or loss
  • Underdeveloped organs
  • Cerebral palsy
  • Cognitive problems


If anyone asks you, “Why are twins often born early?” You can confidently tell them that twin pregnancies are really shorter than singletons, so it is not very surprising if twins are delivered before 37 weeks. However, earlier deliveries might cause your twins to be predisposed to certain health conditions. Proper prenatal checkups may help you avoid or manage certain risks with your twin pregnancy.

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