Women pregnant with twins should wait a few more hours before doctors opt for C-section deliveries, according to new research that found labor is naturally longer with multiples.
Using the numbers from a national database of labor and delivery information from several clinical centers, lead researcher Dr. Heidi Leftwich and her colleagues found that twins required about one to three hours more than single babies in the first stage of labor. The researchers defined the first stage of labor as when the cervix opens until it is wide enough for the baby to pass through. They defined the second stage of delivery as the actual birth of the baby. Researchers then compared data from about 900 twin pregnancies with 100,500 singleton pregnancies. The single-birth pregnancies served as the control group. Researchers measured the time it took for a woman's cervix to dilate to 1 centimeter and found that in twin pregnancies, it took an average of 12.7 hours for the cervix to progress from 4 to 10 centimeters (which was defined as fully dilated). In single birth pregnancies, it took an average of 9.6 hours.
"Our data supports the suspected findings that labor progression of twin gestation is prolonged, compared to a singleton gestation. Women who are pregnant with twins should anticipate that their labor may take longer than if they had a singleton gestation," noted Dr. Heidi Leftwich, a maternal-fetal medicine fellow at the University of Illinois at Chicago. "Doctors could let twins labor longer before calling it 'failure to progress.'"
Before recommending a woman in labor for a cesarean delivery, doctors look at how labor is progressing using a tool called the "Friedman labor curve," which shows, on average, the time it takes for a woman to progress to 10 centimeters dilated. Devised in the 1950's Leftwich and her team of researchers worry that the tool may be outdated due to the fact that women (as well as newborns) are heavier now than compared to past decades. The researchers noted that twins, on average, weighed 1.7 pounds less than babies born in single births. They also noted that women with twins were typically older and were more likely to deliver their babies preterm.
Most importantly, notes Leftwich, is that labor progress in twin deliveries was not addressed in Friedman's original work.
Do you think more moms should wait before opting for a C-section delivery with twins?