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Your 40-week Journey - Twins and Multiple Births We are having more than one (part 3) - The position of twins How twins lie in the uterus

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Getting enough rest Taking it easy with twins or more

Your whole body is under greater stress when carrying more than one baby. It's important to recognize this and take sensible measures to ensure you get plenty of rest.

  • Try to have some time each day when you put your feet up. If you have other children, try to arrange for someone else to take them for an hour so you can relax.

  • Get to bed earlier in the evening to give your body a break.

  • When possible, get someone else to help out with household chores, cooking, and shopping.

NOTE

Being pregnant with twins means even more work for your body—so taking care of yourself is more important than ever

The position of twins How twins lie in the uterus

Twins can lie in a variety of positions in the uterus and these positions can determine how your baby will be born. One baby will always be lower than the other one, and this baby will be known as the twin A—it is closer to the birth canal and will generally be born first.

Q: What are the possible positions?
A: Babies can be in the head down position (cephalic) or buttocks or feet first (breech). Occasionally a baby may be lying across you diagonally, or horizontally (transverse). Twins can lie in any combination including: cephalic-cephalic, cephalic-breech, breech-breech, transverse-cephalic. These positions can change throughout the pregnancy. As with a singleton pregnancy (one baby), once the presenting baby closer to the cervix goes down into the pelvis, it will stay in that position ready for birth.
Q: Can I have a vaginal birth?
A: When both of your babies are in a cephalic position your obstetrician may offer you the chance to try for a normal labor and a vaginal birth. Sometimes, the first baby is in a cephalic position and the second twin is in a breech position. If this is the case, your obstetrician may suggest that you have a cesarean right from the outset. You can certainly actively participate in these discussions and it's important to share your feelings about the birth and birth choices with your doctor and delivery team. If the first baby is in a breech position and the second baby is in a cephalic position, then it is highly likely that your doctor will recommend that you have a cesarean delivery. If both your babies are in the breech position, you will almost certainly need a cesarean, as is the case if both babies are lying across you in the transverse position.

A transverse twin:

If one baby is lying across in a transverse position, a cesarean is likely to be recommended from the outset, especially if the babies are large.

Head down/breech:

If one baby is head down and the other baby is breech, the likelihood of having cesarean section delivery is quite high.

Twins head down:

The most common position is for both twins to be facing head down in a cephalic position, making a vaginal birth more likely.

Breech twins:

If both babies are facing head up in a breech position, you will certainly be advised to have them delivered by an elective cesarean.

Myths and misconceptions Is it true that…

Q: Morning sickness only happens in the morning?
A: Another myth is that morning sickness only lasts for the first three months. This is untrue, and morning sickness doesn't happen only in the morning; it can strike at any time of day or night. It's known as morning sickness because an empty stomach can lead to queasiness, and your stomach is usually empty when you wake up.
Q: Having sex will hurt my baby?
A: It's fine to have sex in normal pregnancies. You may be advised to avoid sex if you're high risk (if you've suffered frequent miscarriages or there is a danger of early labor) but generally, sex is fine throughout. Your unborn baby is protected by the uterus, amniotic fluid, layers of muscle tissue, and pelvis, and won't be able to feel your partner's penis—so there is no need for dads to feel squeamish!
Q: Your baby recognizes your voice?
A: Your developing baby can hear inside the uterus, and will be very familiar with the constant background of digestive noises and maternal heartbeat. Newborn babies have been found to prefer their mother's voice to a stranger's, which suggests they recognize the mother's voice.
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