Antenal care with twins - what's different?

[HaylJay]

Hi

I have a 16 month old little boy and recently found out I'm having twins.
My hospital said I would be referred to someone who speaclises in multiple pregnancy.

I just wanted to know if anyone can tell me how antenal care with twins will differ to antenal care with a single pregnancy?

At my hospital they automatically class you as high risk which means consultant let care. I had all the usual midwife appointments plus consultant appointments. I also had more scans than single pregnancy (12,20,28,32,36) and they did the diabetes test. They also let the mother chose delivery - induction or c section at a planned date in the 37th week. I chose C-Section and they were happy with that choice.

Thanks for your response @Landy10
Can I ask was your care from the NHS?

I just want to know if I can expect something similar.
I'm worried about the birth tbh as I wanted to do it naturally but I've heard a lot of people say I will be expected to have an epidural in case they need to an emergency CS.
But I wondered if they could not just use GA if it came to that..
So many questions I have to ask them a thing my first appointment!

Yes NHS. I think all the trusts/hospitals have different policies. I was given a pamphlet about twin births from my hospital (main London hospital, lots of complicated type births and very experienced doctors) which said that 50% of twin births where a natural delivery is attempted result in emergency section for both babies and 7% of natural births attempted end in section for twin 2. So that made me go for the section straight off.
Also I was given very different views/advice by the midwives compared to the doctors so be prepared for that.

At my hospital you are classed as high risk, you are seen by a consultant and can't give birth in the midwife led unit.

I was assigned a consultant at 13 weeks and met him at 16 weeks.
I had dcda twins and was scanned at 14, 20, 24, 28, 32, 33, 34 weeks (it was weekly from 32 weeks). I got to choose my delivery but was encourage to aim for a vaginal delivery. I was seen fortnightly alternating between midwife and consultant from 20 weeks. You automatically have a gloucose blood test between 24-28 weeks.

After the birth twin mothers at my hospital are given a private room and bathroom (if avaliable).

Induction was booked for 38+0 but I delivered my emcs at 34+5.

Thanks everyone for your helpful responses

Very similar to the above, consultant led, more scans, no birth centre etc.
I was very much encouraged to have a natural birth depending upon the position of twin 1, with an epidural. I don't think the hospital would have a problem with GA in an emergency situation, but then neither mother (unconscious) nor birth partner (whisked out of room) would see the babies born.
Also no water birth option for me. Started off on labour ward but the actual delivery had to be in theatre. Loads of staff in there with us at the end but it didn't bother me.
I was induced at 38 weeks.
Congratulations, twins are awesome

Similar to others - NHS, consultant led, monthly scans and appts with consultant (mine were DCDA). I was given choice of type of birth, no pressure either way. Registrars all told me I needed to have an epidural, but I pushed back and consultant agreed to support that as long as I was willing to have a spinal block if required for ECS.

Also they wouldn't do the double/triple test for downs, so only screen was nuchal fold measurement.

Good luck!

Hi OP. I'm also expecting twins, later this year. Just wanted to add that as well as listening to professional advice and taking into account the standard procedures and reasons behind them, your birth is YOUR choice and there is nothing you would be "not allowed" to do.

I personally am having a home birth with my twins. I've had one natural water birth in a MLU with my DD, all was very straightforward and I was in active labour for 2 hours. It was an amazing experience for us both. She was born into a calm environment and I didn't have any recovery process at all, was out walking the dog with baby in a sling the next day.

Obviously this is my personal choice/past experience and I think my very straightforward previous birth was taken into account by the consultant. I'm choosing to only have one extra scan after my 20 week scan. I'm choosing not to be induced. I'm choosing to have the birth at home and not have any vaginal examinations and only intermittent monitoring. It is very much our own choices when it comes to our births, the hospital can encourage you in a certain way but as long as you make an informed decision they should agree with your preferences.

I've also agreed should there be any inclination of something not being right I will transfer to the MLU immediately (which is connected to my local hospital) and I am more than willing to go with the flow of things, I know you can't predict how these things will go. All I know for sure, and which my consultant has agreed with, is that twin 1's arrival should be treated as if it were a single pregnancy and if it was a single pregnancy there would have been absolutely no worries about me having a home birth. The only worry with twin 2 is that they may be breech (which you can still deliver safely with experienced midwives at hand) or in extremely rare cases (I heard less than 5% from my consultant) twin 2 lies transverse and doesn't want to emerge - in which case a section is necessary.

For me I wanted to give these two the opportunity to have the beautiful, calm and natural birth that my DD did and I don't see personally why that shouldn't happen, I am the kind of person who hates fuss and interventions and people so immediately going for all the hospital's "standard procedures" did not sit right with me.

Sorry for the super long post but I just wanted to give another side/opinion to twin birth and antenatal care. Hope everything goes well for you!

To answer your query about the epidural - they also like to have the line in in case baby 2 turns after baby 1 is born (due to there suddenly being lots of space in there). They would then need to attempt to manually turn baby 2, which is very painful, but they wouldn't have time to put the epidural in first

When I had my twins, I agreed to have the epidural put in just in case but didn't plan to use it (I had a relatively easy first birth before twins). However, once it was in I couldn't resist using it! I had a natural birth and everything was fine. I delivered in the operating room under doctor care and there were a lot of people in the room, with a team for each twin and me! One doctor held twin 2 in place whilst the main doctor delivered twin 1, to stop twin 2 turning. Overall, I didn't find delivering the twins any worse than my first single birth