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Twins and multiple births

Multiple babies show up during an ultrasound scan. If it comes completely out of the blue it can take a bit of adjusting to.

Many parents wonder whether they’ll be able to cope, but your midwife will be able to answer any questions you have and help you find the right support.

Speak to your midwife to be put in touch with a twins group for parents in your local area.

How pregnancy and birth are different

If you’re having more than one baby:

  • you’ll get extra care during pregnancy
  • your babies are more likely to be born early
  • you’re more likely to have morning sickness because of the extra pregnancy hormones – speak to your midwife if this becomes troublesome
  • the birth can sometimes be more complicated

Around half of women having twins give birth before 37 weeks. 1 in 5 give birth before 34 weeks.

Extra care during pregnancy

Extra care likely means:

  • more regular appointments
  • more scans
  • care from an obstetrician as well as your midwife

Conditions that can develop in pregnancy, such as high blood pressure and diabetes, are more likely when you’re having more than one baby. The extra care you have helps to reduce the chances of these things happening.

More about conditions that develop during pregnancy

How your babies lie in the womb

The most common way for twins to lie is both with their heads down – the best for birth.

There’s not a lot of room in your womb, so it’s quite common for one or both babies to be feet or bottom down (breech).

Some babies lie across your womb (transverse lie) and if this is the case with the first twin to be born, you’ll need a caesarean section.

If you’ve had a vaginal birth for the first twin but the second is lying across your womb, they may need help to turn so they can be born.

More about how your baby lies in the womb

Giving birth to twins or triplets

You may be asked to think about having a planned caesarean section to prevent issues for you and your babies. This is more likely if one or both twins is in a position that would make a vaginal birth difficult.

If you’re having twins and a vaginal delivery your obstetrician may suggest you have an epidural:

  • for pain relief should the second twin need to be turned, making it more comfortable for you
  • to allow a caesarean section to be carried out quickly should the second twin need help to be born

If you’re expecting triplets or more a caesarean birth’s usually recommended.

More about having a caesarean section

Feeding twins or more

Feeding twins can be hard work whether you choose to breastfeed, formula feed or a mixture of both. They often have different feeding patterns, just like any other 2 babies.

How you feed your babies is your choice and whatever you decide your midwife is there to help you.

Breastfeeding multiple babies

You can breastfeed twins or triplets – your body should make as much milk as your babies need. Keeping them both happy in the early weeks can be hard, so try not to worry if breastfeeding doesn’t happen easily straight away.

Your midwife will show you how to hold your babies, so they can attach and feed well. If they’re small you may need extra help while they gradually get better at feeding

You’ll have support to get feeding going well from your midwife, infant feeding advisor or a breastfeeding support worker

More about breastfeeding

Further information, other languages and alternative formats

Translations and alternative formats of this information are available from Public Health Scotland. They have prepared different leaflets, including:

Last updated:
15 December 2023

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