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Delivering twins question

Discussion in 'BLS Discussion' started by b2dragun, Jan 7, 2010.

  1. b2dragun

    b2dragun New Member

    EMS Training:
    Just out of curiosity...Lets say twins are being delivered. If they are fraternal twins there will be two placentas, which is where my question comes in. After the first baby is born what usually happens first, the second baby being delivered or the first placenta being delivered? I ask because it takes up to 30 min for the placenta to be delivered (book number) but I have also heard of twins being born apart by over 30 minutes. I was watching tv and of course I am thinking emt logistics and what I would do.

    Thanks for the input
  2. juxtin1987

    juxtin1987 New Member

    Turlock CA
    EMS Training:
    I wondered the same thing a few months ago and did some research on it. Delivering twins in the prehospital setting, from the sounds of things, is just not a good idea. You have noway of determining positioning of child b, so even if child a is in a normal position for delivery, child b may very well be breech. The second consideration, which directly applies to your question, is the placentas. After delivery of child a, the uterus may begin to contract and detatch BOTH placentas, which is technically abruptio while child b is still in the uterus. As far as which is delivered first, child b or child a's placenta, it's typically child b, however as i mentioned there is an increased chance in multiple child birth of the uterus contracting once child a has been birthed, which would lead (in a natural setting) for child a's placenta coming out first, however a situation like that in a hospital setting would go straight to c-section.

    So to directly answer your question it would be child b. But let's hope you never have to find out first hand.
    Last edited by a moderator: Jan 8, 2010
  3. Jeffrey_169

    Jeffrey_169 New Member

    Amarillo, TX
    EMS Training:
    Sure sounds like a nightmare to me. I am fortunate to be a 6 birhts in my time, but never a multiple birth.

    Don't get me wrong it is a wonderful, and even miraculous, occasion, but I agree with juxtin1987; I would not want to deliver them prehospital.
  4. CountryEMT-bGurl

    CountryEMT-bGurl New Member

    EMS Training:
    I worked in the Nursery/Labor and Delivery for 3yrs. You usually see the placenta, then the next baby! And yes it isnt uncommon for the next twin to be deliverd 30min apart! It also depends on if they are in the same sac or if they share a placenta. it can be baby-baby placenta, or baby-placenta, repeat.
  5. medic417

    medic417 The Truth Provider

    Wow that's helpful "I would not want to deliver them prehospital".:rolleyes:

    No one wants to deliver any baby in the field. The problem is when baby wants out baby comes out. Holding moms knees shut, leaving moms panties on, tying a knot in a sheet, placing knot over vagina and tying sheet on does not work. :wacko:

    So now you know that babies come when they want you need to know what to expect, what to do, and be ready.
  6. dmc2007

    dmc2007 Member

    Middlesex, MA
    So if the first child is delivered in the field due to either maternal urge to push or crowning, do you transport before the second child or deliver him/her in the field as well?
  7. medic417

    medic417 The Truth Provider

    That is patient dependant. Some twins come within minutes some wait. If signs of imminent delivery are there you deliver the second if not you sit and watch the vagina while your partner drives to the hospital. Pull over and deliver the next one if it starts to come.
  8. Fbarba123

    Fbarba123 New Member

    EMS Training:
    off topic... but I'm a TWIN!
  9. akflightmedic

    akflightmedic Well-Known Member

    So tell us...were you first out, or did you share placentas, did you wait to exit after first placenta passed??? We all wanna know! :)
  10. eveningsky339

    eveningsky339 New Member

    I'm a fraternal triplet. No joke. :ph34r:

    Sadly, my C-Section delivery was uneventful, therefore I can offer no pointers.
  11. Fbarba123

    Fbarba123 New Member

    EMS Training:
    I was the first one out, and me and my brother are identical twins. Meaning one egg was fertilized then split.

    I'm lucky to be born first I think, because this way, I technically have a little brother by 2 minutes!

    I've had so much fun tricking people with him

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