Safest gestational age to deliver twins?

Hi everyone,

I have a doctors appointment in the morning and want to discuss labour and induction (if need be) but want to have my facts straight first. I know I have read somewhere that the safest time to deliver twins is 36-38 weeks - has anyone seen this or know where I can find this info again? I also see on here that most mommies were induced at around 38 weeks - was this your decision or your doctors?

FYI: We are almost 36 weeks and never actually discussed the labour issue..... a bit relaxed I think

Thanks a mil!

 

My doctor won't let twins go past 37 weeks because he thinks its too risky. My c section was scheduled at 36 and 7 but I went two days early. I have heard of a lot of people having safe deliveries at 39 or 40 weeks. It just depends on your doctor You made it far already! Good luck with the birth of your babies!

 

I think it depends on your doctor. My OB would not let me go past 38 weeks. Since Baby A was breech, I had a scheduled c-section at 38 weeks.

 

38 - 40 weeks is full term regardless of how many babies you are carrying.

 

My doctor wanted me to deliver at 39 week. A 36-week (gest) baby is still a month early.. even if it is twins. I made it until 38 weeks.

 

I was told 37 weeks was full-term for twins. That said, my dr. would have let me go to 40 weeks (as long as everything was okay) with my twins, but said she *knew* I wouldn't. I was induced at 38 weeks b/c DS dropped off of his growth curve at an ultrasound. I delivered the next day at 38w 1d. GL!

 

My doctor thinks the week of 39 is safest, so we have our c-section scheduled for then as a last resort back up. We're still hoping baby A turns head down, though!

 

Thanks! My appointment has changed to Thursday, so I will just ask him then. I do recall him saying (a few months ago) that we should expect them the first week of November - that would put us between at about 38 weeks.

 

There are so many different opinions out there. My doctor said that about 60% of twins come between 34-36 weeks, and he would take mine out if they were still in there at 38 weeks.

Last night in my breastfeeding class at the hospital, they told us that 37 weeks+ is term, 35-37 weeks is "near term" and 35 weeks or earlier is premature. So everybody says something different.

We also learned that babies don't start practicing sucking until 38 weeks so babies born before that may having breastfeeding issues at first.

 

Here are the things to weigh: there are studies showing that there is a greater risk of stillbirth for twins past 38 weeks. That fact is out there. But there are also studies that show twins born at 40 weeks have better lung function and fewer preterm-related issues and NICU time. Twins do not develop faster than singletons. The average time of spontaneous labor in a first time singleton mom is 41w 1d, in a mom with children it's 40w 3d. So, inducing or surgically delivering twins at 38 weeks is intentionally bringing them into the world potentially 3 weeks early. Not an insignificant time.

My pediatrician was the only doc who wished me 40 weeks with my twins. I love him for it, and he did so in the best interests of my girls.

That's the choice and discussion you have to make with your doctor. The higher (but still low) risk of stillbirth vs. the effects of birthing a few weeks earlier than your babes might ideally need. It's actually an enviable dilemma to have as a twin mom. I chose castor oil induction at 39w, but can totally respect MoMs who choose a week earlier or later.

Good luck!

 

I guess it really depends on your Dr. and hospital. My high risk OB wont let me go past 38 weeks. She said many studies show that twin (or any multiple) placentas age slightly faster then singletons do b/c of the increase in hormones. 38 week twin placentas are about as aged as a singleton going to 43 weeks. So there is a risk to both babies as the placenta(s) start to shut down. I do believe the studies that talk about the stillbirth risk after 38 weeks are based off that finding b/c as the placenta shuts down it raises the chance of stillbirth.


37 weeks according to the Ob/gyn association is the very earliest a fetus can be considered full term. Even for twins. The problem is most twins are delivered between 35-37 weeks b/c not every womens uterus can go that far with so much weight. So the "average" for twins is about 35-37 weeks but that doesn't mean it's the "safest". The longer you go the better BUT just like with a singleton there comes a point where you've gone to long (with a singleton that would be 42-43 weeks and with twins that is 38-39 weeks). So I guess to answer your question the "safest" or "ideal" time would be after 37 weeks but before 39 weeks. HTH

 

My doctors wouldn't even schedule my c/s until I was past 37 weeks. They scheduled it for 37weeks 5 days, and I was so happy in hindsight that they waited. My little peanuts were very healthy, but at 5lbs 15oz and 5lbs 11oz they were so tiny. (And those are good weights for twins!) All the same, with what they lost in weight initially they were both down around 5lbs even a few days after birth. Honestly, I can't imagine being comfortable bringing home a baby any smaller than that. It was around 6 weeks before they were the same size as my first baby at birth (8lbs). To me, all the aches and pains of the final weeks are well worth it to bring home the biggest babies you can. And I still admit the possibility of two things being due to their being a little bit early...

1. reflux issues (it seems like many twin moms here with little babies that are a bit early have more of these issues.) Reflux might not seem like a big deal, but trust me when you deal with a puking baby for 6 months to a year, it's a big deal.
2. my ds had a hernia...most of the time these are resolved in utero for boys, but I think there is some evidence that early birth can correlate to them being born with hernias that do not resolve on their own. He needed surgery at age 2, and it was very traumatic on both of us. Who knows if this would've been the case had we waited another week... but I wouldn't mind going back in time to try!

Obviously there are certain circumstances in which earlier birth is truly better...like id. twins in the same sac or sharing a placenta...or evidence of failure to grow or distress. I'm only reflecting my opinion that in the case of 2 placentas, 2 sacs, healthy looking, growing babies...IMHO let them in there as long as you can, up to 39 weeks if possible!

 

My OB wouldn't go past 38/38.5 weeks, I delivered at 37.5 weeks via scheduled C-Section (we did it earlier than 38 weeks due to a placenta previa - so she didn't want me going into labor)
:good:

 

This is awesome, thank you!

My doctor wouldn't let me go past 41 weeks with DS (we made it to 40+4), but would not discuss inducing until we reached 40 weeks, so I know he is very "pro letting it happen naturally".

My goal has always been to get to 37 weeks, so if we make it that far I guess I can handle another week or two But I know there are some risks of going too long - as a few people have said, there is so much conflicting info so I will see what my doc feels comfortable with.

 

My doctor would let me go 2 weeks late with my first, she was born 9 days late. With twins, they'll prefer to deliver 38 weeks + a few days. My hospital won't deliver electively before 38 weeks without medical reason (which I didn't). In my case it turned out 38w2d. They were close to 8lbs a piece.

I've posted this study before, it's about 4 years old, but the table in the bottom shows it quite well. There is quite a difference between 36 weeks and full term babies, but the difference between full term and going 40 weeks is much smaller. I also believe that everything before 37 weeks is premature, no matter how many babies, so delivering before 37 weeks can be risky, especially if they turn out smaller than expected. I think that's why most docs think 38-39 weeks is a safe middle of the road to get them out.

http://www.ispub.com/journal/the_internet_journal_of_pediatrics_and_neonatology/volume_5_number_2_27/article_printable/what_is_the_optimal_gestational_age_for_twin_delivery.html

 

Well last night DH and I decided that we would go as far as we could, but after doing more research this morning, I think I will talk to my OB about inducing between 38 & 39 weeks - that is next weekend, YIKES!

My son was born at 8lbs 2 oz, and I thouht he was small, so I would very much like "biggger" babies! I have put in a request for at least 6lbs each 7 lbs would be ideal!