Key takeaways
Twins, triplets or more are usually delivered before full term because risks rise towards the end of pregnancy
Spontaneous preterm labour is more common when you’re carrying more than one baby
Babies from multiple pregnancies are often smaller at birth and may need extra support in neonatal care
Premature babies are usually assessed against their full-term ‘corrected’ date rather than their actual birth date
Preparing for premature birth with twins and triplets
When you’re expecting twins, triplets or more, it’s natural to wonder when your babies are likely to arrive and how early they might be born. Around 60% of twin pregnancies end before 37 weeks. For triplets, about 75% are born before 35 weeks.
An earlier birth can be planned or spontaneous. Sometimes your healthcare team will suggest bringing delivery forward to protect your health or your babies’ health. At other times, your body may go into labour on its own before your planned date. Both situations can feel overwhelming, but understanding what to expect can help you feel more in control.
Your consultant will usually talk through delivery plans during your second trimester. You’ll discuss your birth preferences, look at the safest options and agree a likely time for birth if everything continues to go smoothly.
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When early delivery is recommended
The risks linked with multiple pregnancy (link to complications article ) increase after certain stages of pregnancy.National guidance, including recommendations from NICE, suggests planning birth a little earlier even when there haven’t been complications.
If your pregnancy is uncomplicated, your team will usually suggest planned delivery around the following times:
| Type of pregnancy | Recommended delivery gestation |
|---|---|
| Shared placenta babies (monochorionic) | 36 weeks |
| Babies with their own placenta (dichorionic) | 37 weeks |
| Triplets | 35 weeks |
Your own plan might differ slightly, depending on your health and how your babies are growing. Sometimes your team may recommend delivering even earlier. Conditions such as pre-eclampsia, growth concerns or changes on your babies’ monitoring can make it safer to deliver and continue care in hospital.
Preterm labour happens when labour starts before full term. You might notice regular tightenings or contractions that become stronger and closer together. You may pass a mucous plug, often called a ‘show’, or your waters may break. Because multiple pregnancy puts extra strain on your body, these signs are more common.
Premature tightenings can be part of normal pregnancy, especially with twins, triplets or more. But it’s always safest to contact your midwife or maternity unit straight away if you’re unsure. They may ask you to come in so they can check what’s happening and monitor your babies.
If labour does start early, it’s sometimes possible to slow things down for a short time. This can give doctors a chance to give steroid injections to help your babies’ lungs develop and to prepare the neonatal team. It isn’t always possible to stop labour completely, but even a short delay can be helpful.
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Choices and preparation for an earlier birth
You’ll talk with your consultant and midwife about how your babies are likely to be born, for example by planned caesarean or induction of labour. They’ll explain the benefits and risks of each option so you can make informed choices that feel right for you and your family.
Many premature babies need extra help in a neonatal unit. Just under half of twins and almost all triplets spend some time there. They’re often smaller than babies born at full term, so they may need support with feeding, keeping warm and gaining weight before coming home. You may also see more staff in the room at birth, as extra doctors, midwives and neonatal nurses are there to assess each baby quickly and move them to neonatal care if needed.
Practical preparation can give you a sense of control while you wait for your babies to arrive:
- Talk to your doctor and midwife about what to expect from an early delivery and neonatal care
- If you can, arrange a tour of the neonatal unit before birth so the environment feels more familiar
- Pack your hospital bag early, including premature nappies and unscented wipes, and bring it to every appointment
- Plan childcare for any older children as you may be in hospital for longer than expected
- Think about whether you would accept steroid injections to help your babies’ lung development if your team recommends them
Ongoing development and support after premature birth
Premature babies often reach milestones such as smiling, sitting, crawling and walking a little later than babies born at full term. Health professionals usually use a ‘corrected’ age, which is based on the date your babies would have been born at 40 weeks.
For example, many babies smile for the first time at around six weeks old. If a baby is born eight weeks early, you might expect that first smile at around 14 weeks after birth instead. Your health visitor, neonatal team and GP will plot growth and development using this corrected age and will let you know if there’s anything to worry about. Many children born early catch up over time, though some may need ongoing support.
At nursery or school, your children might need a bit more help with concentration, social skills or confidence. Regular conversations with teachers or key workers can help you spot any challenges early and agree what support would help them thrive.
You don’t have to manage any of this on your own. Check out our neonatal guide (LINK) or contact our helpline (LINK) whenever you need extra support or a listening ear.
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