Parents who are expecting twins often opt for cesarean sections in an effort to lower the risk of complications during delivery. A recent investigation indicates that this may be an unnecessary precaution for moms and babies.
First study of its kind
Due to the higher risk of adverse prenatal outcomes during a twin birth, researchers from a number of institutions across Canada decided to see how planned c-sections would affect labor when compared to vaginal deliveries. A group of 1,398 pregnant females who were between 32 weeks and 38 weeks in their pregnancies were assigned to two groups: planned c-sections and standard labor deliveries. Doctors than tracked fetal or neonatal death and serious neonatal morbidity among the fetuses as units.
Although participants who were in the c-section group delivered earlier than those in the planned-vaginal-delivery group, there was no difference between the two when it came to outcomes. This indicates that there is no apparent increase or decrease for risk of morbidity based on delivery method. Based on this information, researchers concluded that there was no benefit for mothers expecting twins to undergo planned cesarean sections.1
"The study shows that women who are pregnant with twins can achieve the same results for their babies by planning a vaginal birth compared with planning a cesarean section, as long as they have obstetricians who are competent, skilled and safe," Dr. Jon Barrett, author of the study, explained to LiveScience.2
That being said, there are still some risks of which parents who are expecting twins should be aware.
Mothers who are carrying two babies will want to take some added precautions during their pregnancies. Additionally, there are some things that not everyone knows about when it comes to two buns in the oven. For instance:
- In order to ward off birth defects, many women carrying twins increase their intake of folic acid. Dr. Manju Monga recommends 1 milligram daily – compared to just 0.4 milligrams per day for a single pregnancy.3
- Two babies means higher levels of human chorionic gonadotropin – this is what causes morning sickness in expecting moms. However, this should still subside within 12 to 14 weeks.
- A twin pregnancy increases the mother's risk for developing gestational diabetes, which often results in the need for a c-section delivery. Women who had gestational diabetes are likely to develop Type 2 diabetes later in life.
- Preeclampsia is more common when a female is carrying two babies, although the reasoning behind this is unknown. Symptoms include high blood pressure and protein in the urine.
- Earlier than expected labor is more common with twins rather than single pregnancies. Doctors say that as long as the babies are carried for 34 or more weeks, there should be no cause for concern with preterm labor.
In addition to other common occurrences of twin pregnancies, c-sections are needed in many cases. This can be for a variety of reasons, including a breech position for one of the fetuses. Other reasons for a cesarean section to be performed include:
- One of the babies has an abnormal heart rate or shows signs of developmental problems.4
- If the mother has active genital herpes or HIV, previously had a c-section or uterine surgery or is suffering from a severe illness.
- Problems during delivery, such as taking too long or one of the babies is too large to deliver naturally.
Although c-sections are performed to remedy a number of problems during labor, these procedures come with their own risks.
1 The New England Journal of Medicine, "A randomized trial of planned cesarean or vaginal delivery for twin pregnancy" October 3, 2013
2 LiveScience, "For twin delivery, c-sections no safer than vaginal births" October 2, 2013
3 WebMD, "11 things you didn't know about twin pregnancies" June 3, 2008
4 National Institutes of Health, "C-section" July 23, 2012"