[MamaRabbit]

I'm planning a UC for my twins. Read lots and lots about twins (regarding birthing), but there's really not lots to read! So far, I have two questions that I have not found solid answers for, and no I won't need to worry about either immediately, but it's more a curiosity thing. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol"><br><br>
1. Palpating twins. I know how to palpate singletons, done it on myself and others, understand what I'm feeling, etc.. One of the few physical skills I can learn living over here. But twins? I know it's way too early and doesn't matter positions at this point, but how do you do it? What do you feel for? What strikes you as just way different from singleton. Maybe I'm making this too complex for myself, but it's just gotta be different.<br><br>
2. Cutting the cords. After baby A is born, I've read many conflicting bits of information. Ranging from it's dangerous to not cut cord immediately to it's OK to wait. Supposedly type of twins is important for this, but can someone explain it better? FWIW, mine are (most likely) fraternal with their own placentas (slightly fused at 12 weeks) and own sacs.<br><br>
TIA! My DH told me that one day when I'm a midwife, I'll really appreciate the first-hand experience of twin pregnancy, birth, and breastfeeding!

 

[Jane]

Palpating is the same - really, just a little more complicated. You'll see soon.<br>
If the twins share a blood supply because the vessels have crossed over, you need to cut the first cord to prevent bleeding out the second one. You might read more about monoamniotic twins and twin-to-twin transfusion syndrome to understand why that happens and why it's not usually a concern for fraternal twins or identical twins with their own sacs and separate placentas.<br>
Everything else about cord care between twins is a theorectical exercise in trying to imagine what will keep the placenta attached until after twin B. You don't want any separation because the uterus can't contract to stop bleeding when there's still a baby inside. So, some practicioners advice immediate cord clamping to keep as much blood inside the placenta as possible, so it's not "empty" and ready to come off the uterine wall. Some suggest leaving it attached as a total physiological process. All suggest making sure not to disrupt the placenta - don't yank or pull on the cord, don't leave a hemostat attached to the end that drags (use a plastic cord clamp instead). I think some of it is dictated by the circumstances...is the woman birthing in the OR, where the doctor is planning a breech extraction for twin B just 3 minutes after A is born? Is is a natural water birth where there might be 1 hour or more between births? That changes things a lot.