What to Do When Twins Are Overdue

The nursery is painted, the mobile's hanging over the crib, and dozens of adorable onesies are perfectly folded in a dresser drawer. So where are the twins?

Your OB gave you a due date 7-8 months ago, but your little ones are not appearing on schedule. Your friends and family keep asking, "When's the big day?" Now that it's passed, you don't know what to say.

Your OB gave you a due date that was 40 weeks from the first day of your last period. Due dates aren't set in stone, though. Pregnancy calculations can be off by a week or two, especially if you didn't remember the exact date of your last period.

Most twins arrive between the 36th and 37th weeks of pregnancy; it is rare they go the full 40 weeks. When babies haven't arrived by week 42, they're considered late -- or post-term. 

Why are my babies late?

No one is sure why some babies make a delayed entrance into the world. Nothing you did or didn't do during your pregnancy caused your babies to take up an extended residence in your womb.

However, you may be more likely to deliver late if you:

  • Have never been pregnant before
  • Have had babies born late in the past
  • Have other women in your family who delivered past their due date
  • Were yourself born late

 

Can being born late hurt my babies?

Delivering more than two weeks after your due date can have some risks. The perinatal mortality rate (stillbirths plus early neonatal deaths) at greater than 42 weeks of gestation is twice that at term (4-7 deaths vs. 2-3 deaths per 1,000 deliveries).

Possible problems with a post-term delivery include:

  • Breathing problems in the babies
  • Slowed or stopped growth because of placental failure/aging 
  • A drop in the level of amniotic fluid -- the liquid that surrounds and protects your growing babies
  • Fetal distress -- a slowed heartbeat and other signs the babies are in trouble
  • Breathing in the first bowel movement (meconium)
  • Need for a cesarean section (C-section) or forceps delivery because the babies are big
  • Stillbirth

Continued

Will my doctor induce me if I'm late?

That depends on your original due date and your babies' health. Your doctor may decide to induce labor after you're one week overdue. Or the doctor may want to wait just a little longer to see if you go into labor on your own.

Meanwhile, your doctor will check you about twice a week to make sure your babies are still doing well. You may have one or more of these tests:

  • Non-stress test, which uses a fetal monitor to track your babies' heart rates
  • Ultrasound to check your babies' growth and movement
  • Measurement of the amniotic fluid
  • Exam of your cervix to see whether it has thinned and widened (dilated) to prepare for labor

If there's a problem with your babies or you still haven't delivered 2 weeks after your due date, your doctor will probably induce labor. Inducing can reduce the chance that you'll need a C-section.

The doctor will give you a medicine called oxytocin. This medicine will make your uterus contract to begin the labor process. During labor, the delivery team will take special precautions -- especially if your babies passed their first bowel movement or your amniotic fluid is low.

Don't sweat an overdue set of twins

It's normal to be anxious about your twins' arrival, but try to relax. As long as your doctor says your babies are healthy, it's OK to wait.

Enjoy this little bit of extra time. You'll appreciate it soon enough, when you're changing diapers and feeding your babies 'round the clock!

WebMD Medical Reference Reviewed by Nivin Todd, MD on January 16, 2019

Sources

SOURCES:

American Academy of Family Physicians: "Post-term Pregnancy: What You Should Know."

American Academy of Family Physicians: "Pregnancy: What to Expect When You're Past Your Due Date."

Agency for Healthcare Research and Quality: "Management of postterm pregnancy."

UpToDate: "Postterm pregnancy."

News release, ScienceDaily.

American College of Obstetricians and Gynecologists. “ACOG Practice Bulletin” No. 55, Sept 2004.

© 2019 WebMD, LLC. All rights reserved.

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