quick clicks

twins today articles

twins today q&a

community & groups

research baby names

prepare a birth plan

content channels

ip channel rss feeds

read birth stories

read parenting stories

recommended books

e-newsletters

safety recalls

ip diaries

ip store

mom of the month

dad of the month

editor's letter

letters to the editor

Expert Q&A

	By David L. Fay, M.D. Family Physician Associate Director, Waukesha Family Practice Residency Program

If twins are 37+ weeks, good birth weight for gestational age and vertex (both), is there any reason that labor and delivery be considered "high risk"? Must we have constant monitoring of both twins? Is there any reason that we "should" have an epidural "just in case"? Can we use mobility and positioning to move the babies into the birth canal (or must I be on my back)?

Despite the better prognosis given your situation, all twin deliveries are considered high risk because there is a higher chance of having complications. A second vertex presentation can change to breech while the first twin is delivered, cords can become entangled, or other unpredictable consequences can occur.

No studies have been done to assess whether or not intermittent monitoring is safe in twin deliveries, but all experts recommend constant monitoring.

There is no reason that an epidural must be used.

Changes of position have not been adequately studied for fetal malpresentations and have not been well studied in twins. Few practitioners would feel comfortable with different positions for the delivery, and position change is difficult at best with all the monitoring equipment.

View more Q&A by this Expert