Where There Is No Doctor 2011 269
6. TWINS. Giving birth to twins is often more difficult and
dangerous—both for the mother and babies—than giving
birth to a single baby.
To be safe, the mother should give
birth to twins in a hospital.
Because with twins labor often begins early, the mother
should be within easy reach of a hospital after the
seventh month of pregnancy.
Signs that a woman is likely to have twins:
• The belly grows faster and the womb is larger than usual, especially in the last
months (see p. 251)
• If the woman gains weight faster than normal, or the common problems of
pregnancy (morning sickness, backache, varicose veins, piles, swelling, and
difficult breathing) are worse than usual, be sure to check for twins.
• If you can feel 3 or more large objects (heads and buttocks) in a womb that
seems extra large, twins are likely.
• Sometimes you can hear 2 different heartbeats (other than the mother’s)—but
this is difficult.
During the last months, if the woman rests a lot and is careful to avoid hard work,
twins are less likely to be born too early.
Twins are often born small and need special care. However, there is no truth in
beliefs that twins have strange or magic powers.
TEARING OF THE BIRTH OPENING
The birth opening must stretch a lot for the baby to come out. Sometimes it tears.
Tearing is more likely if it is the mother’s first baby.
Tearing can usually be prevented if care is taken:
The mother should try to
stop pushing when the
baby’s head is coming out.
This gives her birth opening
time to stretch. In order not
to push, she should pant
(take many rapid breaths).
When the birth opening is
stretching, the midwife can
support it with one hand
and with the other hand
gently keep the head from
coming too fast, like this:
It may also help to put
warm compresses
against the skin below the
birth opening. Start when
it begins to stretch. You
can also massage the
stretched skin with oil.
If a tear does happen, someone who knows how should carefully sew it shut after
the placenta comes out (see p. 86 and 381).