Signs That You're in Labor with Twins (And How to Labor at Home)

Are you expecting two? Learn the signs labor is near with twins, from spotting common symptoms to laboring at home before delivery time.

If only we knew exactly when and how twin labor will happen.

I knew having twins meant they were less predictable, and that the babies could come at any time. But when my labor started, I didn’t jump up and rush to the hospital. In fact, I didn’t even know I was in labor for a while.

The clock read 11pm, and I couldn’t sleep, as usual. But instead of the typical discomfort or even the pregnancy itching I had developed, I felt my uterus tightening.

“I think these are Braxton Hicks contractions again,” I told my husband. I experienced these types of “practice contractions” from time to time with my twin pregnancy, and chalked the discomfort to that.

But after doing the steps I usually did to ease the discomfort of Braxton Hicks, the tightening wasn’t going away.

Signs labor is near with twins

With twins, especially high-risk multiples, labor and delivery can come at any time. You could be in your doctor’s office for a routine checkup when she finds complications that mean you’re delivering that day. Or, you might find yourself nearing 38 weeks, counting down the days until you’re finally able to deliver.

The range really is that wide. As I say in my book, Expecting Twins:

“Not only is labor different in so many ways, but as twin moms, we also have unique circumstances to consider. The best we can do is educate ourselves about the most common and likely scenarios.”

So, how do you know if you’re in labor? As with anything pregnancy-related, you won’t find a one-size-fits-all answer to this complex question. And of course, the best place to turn to is with your doctor or midwife for advice tailored to you. Still, if you’re like me, knowing a little of what to expect can feel reassuring.

Take a look at a few signs labor is near with twins. Later, I’ll also share what to do when you realize you’re in labor but aren’t dilated enough to head to the hospital yet:

1. Tightening in the uterus

Braxton Hicks contractions feel like a painless, mild tightening in your uterus and can happen as early as the second trimester. They’re “practice contractions”—the uterus is tightening to prepare for the eventual labor down the line. Some women experience this for some pregnancies while others don’t at all.

If you feel a tightening in your uterus, see if it’s Braxton Hicks or the real onset of labor. How can you tell the difference? Braxton Hicks contractions are irregular and come and go at erratic times.

Certain steps can also rule out Braxton Hicks as the cause for the contractions. For instance, they should go away if you:

Lay on your left side so your blood is better able to flow through your body with less pressure.
Walk slowly around the room.
Drink water.

Monitoring these contractions is important. Track their frequency and see if there’s a pattern. If you do find a pattern, even after doing the above steps, you’re likely entering labor.

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2. Cramps

Another symptom of labor that expecting moms experience is cramps, like the kind you might feel during a menstrual cycle. If you feel abdominal pain and cramps, again, track when and how often they happen. Then, try the following to see if doing so relieves the discomfort:

Change positions.
Drink water.
Place a warm compress on the area that’s cramping.
Soak in a warm bath.

3. Pelvic pressure and backache

Like cramps, you might feel pelvic pressure or even backache as you begin labor. Your first twin might be dropping into position closer to your cervix and causing pressure, making you feel extra weight in your pelvic region.

If you feel this as well as backache, you’re likely in the first stages of labor.

4. Constipation and gas

Some symptoms disguise themselves well, making you think you’re just having constipation and gas. You might feel like you have to poop and can’t seem to push anything out, or bloated, like you have to pass gas. These can be so mild you might think drinking prune juice will relieve the discomfort.

In fact, this was the case with my eldest. Again, in the middle of the night, I thought I had constipation and tried to poop, but it turned out I was actually in labor. Another friend of mine experienced the similar feeling, and we laugh about how strange labor can come so unexpectedly.

If the gas pains and constipation persist, begin timing the discomfort to track how often they happen. If you see a pattern, you’re likely in labor.

5. Water breaking

Contrary to what we see on television, only a small percentage of women experience their water breaking. Still, it can happen.

Your babies are inside an amniotic sac, and when that membrane ruptures, the amniotic fluid leaks out. This is what we call your water breaking and is definitely a sign of labor.

Discuss with your health care provider what she suggests you do when your water breaks.

She’ll likely want you to labor at home and only go to the hospital when your contractions are a certain pattern apart. That said, note the time your water broke, since you’ll probably need to deliver within 24 hours, regardless of the pattern of your contractions.

How to labor at home

I thought my twin labor would go much faster than my singleton, since subsequent labors tend to go faster than the first. Our bodies are supposed to “remember” how to labor, so the time to give birth shrinks with each one.

Since my first baby was born after 14 hours of labor, I was surprised that this twin birth took a whopping 20 hours total.

“It’s because they’re twins,” my doctor explained. Had I had a singleton pregnancy the second time around, labor probably would’ve been much quicker. But with two babies, labor with twins can typically take longer, even as a second or subsequent pregnancy.

So, if you’re like me, you’ll likely be home during the early stages of labor. This is when your contractions are rhythmic, but still too far apart and too short to need to be in the hospital.

Most hospitals will admit you if your cervix has dilated to three centimeters. Your doctor will also tell you how many minutes apart your contractions should be before you go to the hospital.

What should you do in the meantime?

1. Rest

Your body will go through tough physical challenges in a few hours—reserve your energy for then. Try to sleep or take a nap, especially if your symptoms happen at night, and while they’re still somewhat mild.

Even if you can’t fall asleep, don’t do too many strenuous activities. Watch a movie lying down in bed, or move slowly around the house. Conserve your energy now so you’re not going to the hospital already exhausted.

2. Do last-minute preparations

By now you should have your hospital bag ready, but you might still need to add last-minute things you couldn’t do before. Things like contact lenses and eyeglasses, slippers, hairbrush, or phone that you couldn’t pack any earlier now need to go in your bag or purse.

You’ll also want to prepare your home for leaving. Check that all doors and windows are locked and that your pets have enough food, for instance. You’ll feel better leaving when you know you haven’t rushed and forgotten to do something.

Learn the 7 areas you need to cover when preparing for twins.

3. Call your babysitter

If you have older children, make arrangements with a babysitter to drive to your home. Give her enough time to head over but not so much time that she might not have much to do.

That said, if you could use the extra help, having an extra person while you labor can also be a smart move. She can help you gather what you need or play with your kids so you can rest.

And long before labor happens, ask her to have her overnight bag ready to go so she’s packed and ready to come over. She might have to leave at a moment’s notice, and packing her back can hold her back longer.

4. Eat and drink

Staying hydrated during labor is important, so make sure to drink water. This will also help ease some of the discomfort of the contractions, and helps to prepare you for labor.

Don’t forget to eat as well, since you probably can’t eat once you’re in the hospital until you’ve finally delivered the twins. Stick to easily digested and high-energy food, as well as simple soups and broths.

5. Breathe through your contractions

Each contraction will likely feel more intense and last longer than the one before. It’s not exactly reassuring to know that the discomfort only gets worse with each one.

For now, breathe through these contractions, using exercises you learned from a birthing class or your doctor. Remind yourself that the pain will go away eventually. Remaining calm and relaxed even during contractions reduces discomfort.

Conclusion

These were the types of symptoms and laboring at home that I knew nothing about, especially when dealing with twins. Hopefully in sharing what I learned, you now have a better understanding of what to expect (and what to do!) come labor time.

Notice tightening in the uterus, cramps, pelvic pressure, constipation and gas, and your water breaking. These signs could point to the onset of labor, or at least a quick call to your doctor. If so, make your way to the hospital depending on when your doctor told you to come.

But before then, be prepared to labor at home, waiting until your body is ready to deliver. Do last-minute preparations like packing your bag and locking all the doors. Call your sitter to watch your older kids, and eat and drink water now while you can.

Then, do your best to rest and breathe through your contractions. As uncomfortable as they may be, know that they won’t last forever.

Hopefully now you know a few signs labor is near with twins—whether labor happens in two hours or 20.

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