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Welcome to your Third Trimester (part 20) - How your babies lie in the uterus

- 9 Bad Habits That Can Cause Miscarriage
- How to have natural miscarriage
- Foods That Cause Miscarriage
- Signs Proving You Have Boy Pregnancy
You are 30 Weeks and 3 Days 67 days to go…

Natural birth has many advocates, but the best birth is one that delivers your baby safely with minimum trauma for both of you.

Your baby today

It can come as quite a surprise to see that your baby will be increasingly making all sorts of expressions. Here the baby had his mouth turned down but the next minute will be yawning, grimacing, or peacefully sleeping.

Many women want a natural delivery, with no pain relief or other medical intervention. Giving birth naturally is for some reason perceived as the “best” way, and to do otherwise means that you somehow “failed” at childbirth. This pressure means that women can feel guilty or even depressed if they needed pain relief or a cesarean section, for example.

Bear in mind that some women have higher pain thresholds and can get through labor with simple breathing or relaxation techniques, while others need more help. Pain is subjective, no one else can feel your pain; if it is too much for you, then ask for help. Your options  will be explained to you by the doctor.

Childbirth is hard work, but the experience should not be so painful that it scars you. Being pain-free may mean that you have a more enjoyable, even empowering, labor experience. If you do decide you want pain relief, an epidural is the most common option—more than half of women having a baby in a hospital receive one.

… Natural birth
Q: I want a natural birth but everyone says I’ll change my mind once I’m in labor. Are they right?
A: Mom: Nothing can prepare you for the discomfort of labor, and I found my carefully laid plans were unrealistic and impractical when the pain kicked in. No matter how well prepared you are, you may change your mind during labor, and it’s worth being prepared for that. I did feel a bit disappointed that I couldn’t manage without pain relief. It helps if you focus on what’s important—delivering a healthy baby. If you achieve this aim, you’ve succeeded, no matter what happens along the way. I would say to stick it out for as long as you can, but you’ll be doing yourself and your baby no favors if you both become exhausted and distressed.

Doctor: Many women are shocked by the intensity of the birth experience, and soon forget about their idealistic birth plan. It’s better for all involved that you allow for contingency plans, and keep an open mind. Pain relief and interventions are designed to make the experience better for you and your baby, and will not be offered unless they’re necessary, or you feel that you can’t do without them. Some women get through labor naturally; others need some help. A lot of women do change their mind about “going natural,” and there is nothing wrong with that. A mom who has her pain under control will find that the delivery is much quicker, and she’ll have much more energy for her new arrival.

Having a natural birth is high on the list of many women’s priorities, but it’s a good idea to prepare mentally for medical intervention, in case it becomes necessary.

Twins

Just a few weeks to go. By now, you’re probably quite large and, of course, excited at the imminent arrival of your twins, or more. However, you may also be concerned about how you will manage during and after the birth.

Getting ready for the birth

Although multiple pregnancies and births are more likely to have complications, they are now safer than ever as advances in prenatal and postpartum care have dramatically improved the outlook for premature babies—the main concern with multiples (see How your babies lie in the uterus).

You can prepare for the birth by getting plenty of rest. Putting your feet up, or even having a nap during the day, helps improve the blood flow to the placenta, which in turn helps your babies grow. Practicing Kegel exercises  is important with a multiple pregnancy since your pelvic floor muscles are under additional strain.

A shorter pregnancy

Twins or more usually arrive earlier than singletons. Space in the uterus is one factor. In addition, with multiple pregnancies the placenta becomes less efficient toward the end of pregnancy. As a result, the average length of pregnancy is shorter: for twins 36 to 37 weeks is considered typical, for triplets the average pregnancy is 33 weeks, and for quadruplets pregnancy lasts about 30 weeks. The average birth weight for each twin is 5 lb 8 oz (2.5 kg) at full term.

You may deliver even earlier than this, since nearly 50 percent of twins are born prematurely. However, nowadays expert care for premature babies means that about 75 percent of babies weighing 3 lb 5 oz at birth, and 57 percent of babies weighing 2 lb 3 oz at birth, survive.

Preparing for more than one

Even if your twins are identical they’re individuals, and relating to them as separate people will help their development and your relationship with them. Even in pregnancy, some expectant moms notice how different their babies are from their different movement patterns in the uterus.

Thinking ahead
Bonding with twins

Often, expectant moms of twins or more worry about how they will bond with more than one baby. It’s true that bonding can be harder with twins, and even more so with higher multiples. After all, it’s hard to fall in love with more than one person at a time, especially when you’re exhausted caring for two babies or more. Being aware of this and arranging extra help for after the birth may ease your anxiety. Also, accept additional offers of help that allow you to rest or spend time with one twin. If someone offers to take the twins out, you might consider one twin going and the other spending time with you.

How your babies lie in the uterus

In the final weeks, your babies will take up their positions for the birth. The most common position is with both babies lying vertically. With 75 percent of twins, the first is head down (cephalic); the second twin may be head down or breech, or one twin may lie across the uterus (transverse). You may suspect their position from the kicks, but only a scan confirms this.

A cesarean will be recommended if you have triplets or more, or your first twin is breech or transverse (25 percent of cases). A vaginal delivery is most likely if both twins are head down. If the first is head down and the second is transverse or breech, there are different opinions as to the best type of delivery, which you can discuss with your obstetrician.

Both babies head down (cephalic)

One baby head down, and one breech

Both babies in a breech position

One baby head down and one transverse

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