Preterm Labor With Twins

What is Preterm Labor?

twin pregnancy early labor

Preterm labor with twins (also know as premature or early labor) is basically labor that happens before 37 weeks gestation. It is always a topic of concern during twin pregnancy considering that approximately 50% of twin births are premature. Although there are still an overwhelming number of healthy premature twin births, when they are born between 32 and 37 weeks, it's much better to be informed about the possibility of early labor, as well as the signs, symptoms and treatments.

Why You May Be at Risk

There are a few groups of women who are generally at the greatest risk of preterm labor with twins. They include women with particular cervical and/or uterine abnormalities, women who have experienced a prior preterm birth, and, of course, women who are carrying twins or more. Some women may even have to deal with all of these factors during pregnancy. That said, the actual cause is often unknown. Because early labor can be triggered by a problem with the babies, the mother, or both, there is just no definitive answer.

Common Signs of Preterm Labor With Twins

early labor signs

There are several symptoms of preterm labor to familiarize yourself with (listed below). It's also good idea to talk to your doctor about your particular risks, as well as paying close attention to your body during twin pregnancy. Sometimes it may only be a gut feeling to go on, so always follow your instincts and call your doctor if you are ever in doubt.

  • Having regular contractions every 10 minutes or less, with or without pain, within ½ to 1 hour.
  • Bright red blood coming from your vagina in any amount.
  • Pain that feels like menstrual cramps, with or without diarrhea, for any amount of time.
  • Any sharp, dull or prolonged pain occurring in your abdominal area lower back, or upper thighs.
  • Puffiness and/or swelling of the face and/or hands. (Typically a sign of preeclampsia, which is high blood pressure during pregnancy. This can play a major role in early labor with twins).
  • Any significant change in vaginal discharge.
  • A feeling of pressure in your lower abdomen.
  • Leaking or gushing of clear, odorless, watery fluid from your vagina.
  • Unexplained fever, vomiting or extreme fatigue.

*NOTE: This list is in NO WAY meant to be used as actual medical advice. Instead, it should be seen as an informative guide on some of the most common signs and symptoms of premature labor with twins. Again, ALWAYS consult the proper healthcare provider regarding any questions or concerns you have.

Treatment for Preterm Labor With Twins

preterm labor with twins

Preterm labor with twins is usually diagnosed and/or treated in the hospital. If you have indeed been diagnosed, there are a few different treatment options (usually decided by your doctor or midwife). They generally include the following

  • The use of medication, such as, magnesium sulfate (a tocolytic that will slow contractions of the uterus) which may be given as an injection or intravenously.
  • Cervical cerclage (a procedure in which the cervical opening is sutured) is sometimes used when a woman has an incompetent cervix.
  • Antibiotics may be used to treat an infection, as it may be the cause of early labor.
  • As a precaution or even last resort, corticosteroid medications may be given to help mature the lungs of the babies in the event of their premature birth. *The immaturity of the lungs in preemie twins is a common and sometimes very serious problem.
  • Home uterine activity monitoring (HUAM) Although some research suggests that HUAM is expensive and has no proven effect on delaying early birth, it may still be helpful to women who cannot feel their contractions.
  • Bedrest is another common treatment for delay and prevention of early labor. It may be prescribed in varying degrees from complete to partial bed rest.

*It should be noted that preterm labor is not always treated. If your pregnancy has progressed to close to 37 weeks or if there is a serious medical problem regarding mother, baby or both, labor is generally allowed to continue.


There are a few good things you can do for your body that could play a big role in preventing preterm labor and birth of your twins.

  • Get the proper prenatal care throughout twin pregnancy!
  • Do not smoke, drink, or use drugs of any kind.
  • Keep yourself well hydrated.
  • Get plenty of rest.
  • Always listen to your body.
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