Month: July 2026

What Should I Put In My Birth Plan?

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A birth plan is your way of expressing your preferences and priorities for the sort of birth you would like. By writing down what you want to happen, and what you’d ideally hope to avoid, you can communicate your thoughts and wishes to me and the team who will care for you and help you deliver your baby.

Table of Contents

Why do I need a plan?

Like most pregnancy healthcare professionals, I ask expectant mums to produce a birth plan. Not because I don’t know what to do, or because I will ever do anything other than what is best for mum and baby, it’s simply because I want to actively involve the mother in the decision-making process. A plan isn’t compulsory, so you can go with the flow if you prefer - but if you have specific views about what you want, or don’t want, during labour, it really helps if the people looking after you know what these things are.

What is it all about?

When it comes to birth, there’s an awful lot to consider. This is something I work through with every mother I care for - together we will prepare and perfect your plan. I’ll go into more detail later, but here’s a handy checklist, to help you cover the most important questions.

 

Birth plan checklist:

  • Who do I want as my birth partner?
  • Where do I want to deliver my baby?
  • How do I want to deliver my baby?
  • What pain relief would I prefer?
  • Do I want my baby delivered straight onto my body or cleaned and wrapped first?
  • If my labour doesn’t progress, what intervention would I prefer?
  • Am I happy for drugs to be used to speed up my labour?
  • What would I prefer if my labour has to be induced?
  • What are my feelings about instrumental deliveries?
  • What are my feelings about Caesarean sections?
  • What do I think about episiotomies?
  • Do I want an injection to be given to speed up the delivery of the placenta in the third stage?
  • Do I want my baby to be given an injection of vitamin K after the birth to prevent bleeding problems?
  • How am I planning to feed my baby?

I’m now going to emphasise something I say to every mother I care for: it’s important to remember that a birth plan is a guide and not a guarantee. What everyone wants most is a healthy baby and a healthy mum. If something happens to threaten either you or your baby, plans will have to be changed. I think it is helpful to think of this as revising your birth plan, even if you have to do it quickly.

"I did have a loose birth plan, but it was the opposite of what happened. I was keen for a vaginal birth and not a Caesarean but was happy to have interventions if necessary for the safety of the baby."
— Andrea, London

You need to trust the person attending your delivery - and that trust is exactly what our appointments together are for. If circumstances change on the day, you need to know I'm doing the right thing for you and your baby. It’s also important to have a partner with you, whom you trust completely and who can understand what’s going on when you may be in pain and under stress. That person has to be prepared to help change the birth plan in your place, if necessary.

"We discussed our wishes for the birth with our midwife in advance. I wanted a calm natural birth with as few drugs as possible and prepared for birth using a hypnobirthing CD. In the end, I ended up being induced five days before the due date due to poor fetal growth."
— Laurie, London

Researching your birth plan

When you’re putting together your birth plan, it’s important to find out as much about your birth options as possible. By gathering information from a variety of different sources, you can start to compose a picture of the sort of birth you would like to experience.

 

Ask the experts

At your antenatal appointments with me, we'll have plenty of time to talk through your options. I know that antenatal appointments can sometimes be hectic and a little overwhelming, so if you have specific questions, it can help to write them down so your mind doesn’t go blank at the critical moment.

 

Get out and about

Wherever you're considering giving birth, visiting in person helps you get a feel for the environment and ethos. Mothers under my care deliver at The Portland Hospital, and I always suggest arranging a tour with your partner before the big day - it takes a lot of the unknown out of labour when you already know where you'll be walking in.

 

Online knowledge

There’s a huge amount of information available online, some is fantastic and some is frankly dangerous and it can be difficult to tell the safe from the suspect - you are more than welcome to bring anything you find to your appointments with me, I'm always happy to help.

 

Been there, done that

Personal experiences and recommendations can be incredibly useful, and can really help you picture and understand the whole incredible process of childbirth. Chat to friends and family members who have been through birth or have played an active role in supporting a partner as they can tell you about the pros and cons of the choices they made. Many of the women I care for have come to me after a recommendation from a friend whose baby I delivered.

 

Lessons and learning

Sign up for antenatal classes. They’re a great opportunity to meet new people, exchange tips and learn about the nitty-gritty of labour. Talk to me about any groups running in your area.

"My ‘plan’ was to have as natural a birth as possible. I like ‘plans’, I like to feel in control. After researching other people’s birthing stories and discussing the topic openly with family and friends I felt prepared. I had booked the birthing pool at the hospital and was determined that everything would go as envisaged. I was that expectant mother with her hospital bag prepared by my front door weeks before my due date.
I woke on the 14th April at my usual time of approximately 8am. I felt terrible pains and at 37 weeks I excitedly rang my sister who, along with my husband, was to be my birthing partner. Once at the hospital I was pleased that I had involved her as she proved to be a fantastic support.
I soon regretted that I had opted against the pain relief offered. By the time I realised I wanted to suppress the pain, which had become almost unbearable, it was too late. I was offered the water birth pool but I couldn’t imagine anything worse; I wanted my baby out!"
— Hayley, Blackpool

Team talk

You, your birth partner and I are a team, so chat to your partner about the type of labour and birth you would like, how they envisage their role and any worries they may have. As you’re researching, scribble down any ideas that catch your eye as well as anything that doesn’t appeal. Don’t worry about crafting the perfect plan straight away. At the beginning it’s more about collecting, sorting and collating the mountain of available information. You can edit and tidy things up later on.

Questions to consider

1. Where do I want to give birth?

You have a choice about where to have your baby. When considering this question, you should think about your health, your medical history, your pregnancy so far and the options available to you - midwife-led units, hospital, home or a private unit are all possibilities. For the mothers I care for, delivery is at The Portland Hospital, and we'll talk through whether that's the right fit for you and your pregnancy at your first appointment. Wherever you're leaning, I'd encourage you to visit the potential places so you can weigh up the good and bad bits and come to the right decision for you and your baby.

 

2. Who do I want as my birth partner?

Most women like to have someone to support them during labour and childbirth. Many choose the father of the child, but that’s not the only option. Anyone who gives you confidence can help. Friends, relatives or professionals like doulas (women whose job is to support another woman during the late stages of pregnancy, through childbirth and into the early days of motherhood) are all valid alternatives, or you may want to go it alone. It’s about choosing what makes you most relaxed and comfortable.

 

3. Is there any special equipment I would like to try?

Birthing balls, beanbags, floor mats, birthing pools, TENS machines, soft music and aromatherapy oils can be used to help make the birthing process more personal and more bearable. Think about what you would like to try, and check whether it’s available in the place you’re planning to give birth. If not, make sure you buy or hire the equipment early so it’s ready and waiting on the big day.

 

4. Do I have any particular preferences for the birth?

Some hospital or birthing units have special facilities available. These can include birthing pools, dedicated labour/ delivery/recovery/postnatal rooms where you can stay in the same room throughout your stay and postnatal amenity side rooms that you can book for an overnight stay. We can talk through options available at The Portland Hospital during our appointments together.

 

5. How would I prefer to be monitored?

Every baby is monitored throughout labour to make sure they are healthy and well. There are different ways of checking the baby’s heartbeat to make sure there are no signs of distress. If everything is progressing well, the heart-beat may be checked every quarter of an hour or so with a Doppler device, or continually by a belt strapped around your waist. You can express a preference between these two options. However, problems, an epidural, a drip to strengthen contractions or any sign that your baby may be struggling can mean that continuous monitoring of your baby’s heart using a clip attached to their scalp is necessary. In childbirth, safety should be the first consideration.

 

6. Would I like to move during labour?

Actively moving and participating in the process of labour can help labour progress, increase your feeling of control and boost confidence. However, it may make you a little tired, and sometimes moving around is not possible with standard epidurals.

 

7. Positions for labour and birth

The positions you adopt in labour can make a big difference to how it progresses. So experiment with positions like kneeling on all fours or leaning over a beanbag and think about what might work for you. Standing, sitting, squatting, lying, kneeling, doggy position or standing up, you can choose as many positions as you want and change whenever you feel the need.

 

8. What pain relief would I prefer?

In my experience, many women seem to adopt the ‘suck it and see model’ for pain relief and come into the delivery room with an open mind. You may prefer to try some of the less invasive methods of pain relief, like TENS, relaxation exercises and gas and air in the early stages, and then progress onto something stronger, such as an epidural, as and when you need it. Some women feel strongly about avoiding injectable medications, like pethidine, because they want to avoid that out of control and woozy feeling, while others love it. The choice is yours. List any you would consider and make a note of any strong preferences.

 

9. If my labour doesn’t progress, what intervention would I prefer?

Sometimes labour doesn’t progress as planned and needs a helping hand. This is called augmentation of labour. Your body has its own contraction hormone called oxytocin. If your contractions start to fade, or if they need a boost, you can be given an artificial version of oxytocin called Syntocinon, or your waters could be broken to speed things along. Consider whether you would be happy to have this, or whether you would ideally prefer to wait and see what happens.

 

10. What are my feelings about instrumental delivery?

Very few women plan to have an assisted delivery, but sometimes things go wrong and babies need a little extra help into the world. You can say whether you have particular feelings about ventouse over forceps delivery and whether you would like a planned episiotomy to prevent tearing. You can also express whether you would like your partner to remain in the room if you need an assisted delivery. If you express a preference, I will try to follow your wishes if possible. However, it is important to try to be adaptable to ensure the safe delivery of your baby. If you are worried, chat through your concerns with me.

 

11. How do I feel about Caesarean sections?

A Caesarean section is an operation where an I make a small cut in your abdomen and womb and deliver your baby through it. It can be performed as a planned operation or in an emergency. If it is carried out under epidural or spinal anaesthetic, you will be awake for the operation and your partner can stay with you.

 

12. How do I feel about an episiotomy?

An episiotomy is a small cut made in the perineum during birth. It is done to avoid more extensive tearing, especially involving the structures surrounding the back passage. It may also be performed to help make the delivery of your baby a little easier, especially if you have an assisted delivery or a breech birth.

 

13. Do I have any preferences about clamping and cutting the cord?

If you’d like your partner to cut the cord or you’d prefer to delay the clamping of the cord, detail it in your plan. If everything goes well, I'll make sure this happens wherever possible.

 

14. Do I want an injection to be given to speed up the delivery of the placenta in the third stage?

Most hospitals and birth centres recommend an actively managed third stage of labour using an injection of a synthetic version of oxytocin. Research shows that this decreases the risk of losing lots of blood after the birth. However, you can choose to have a natural third stage, if you would prefer less intervention.

 

15. Do I want my baby delivered straight onto my body, or cleaned and wrapped first?

In the past, babies were often washed, wiped and returned to the mum as a neat little bundle wrapped in a blanket. You may prefer this, as newborn babies can be a little mucky. However, you may prefer immediate skin-to-skin contact to help with bonding and establishing breastfeeding.

 

16. Do I want my baby to be given an injection of vitamin K after the birth to prevent bleeding problems?

Babies have low levels of vitamin K at birth. For a small number of babies this can put them in danger of life-threatening haemorrhage. Because of this risk, it is recommended that all babies receive vitamin K after birth to protect them. The most effective way of giving this is by a single injection into the muscle of your baby’s leg immediately after birth. An alternative is oral vitamin K, three doses are needed if your baby is breastfed. Two are given in the first week followed by a top-up when they are one-month old. Bottle-fed babies only need two doses of vitamin K during their first week of life. The problem with this is that often doses can be missed in the chaos of the early weeks, which could put your baby at risk. You don’t have to consent to the vitamin K injection - talk to me about your choice.

 

17. How am I planning to feed my baby?

Whether you’re going to breast or formula feed, it’s important to let me and the midwifery team know your plans so they can help you get things started after the birth.

 

18. Do I have any special requirements for the birth?

Everyone has different needs and demands during birth. Whether English is not your first language, you have special educational needs, you follow a specific diet or you have religious customs you’d like observed, this is the place to detail your individual needs. It will help me help you to achieve a happy and healthy birth experience.

"I had a great birth plan! Lots of careful thought and preparation in the months leading up to the birth. I had candles, oils, yoga balls and numerous different music playlists at the ready. I had my first contraction as I walked through the door of the hospital and was howling within seconds. The midwife asked, ‘Have you thought about pain relief?’ I growled, ‘Give me an epidural!’ And do you know what? It was the best thing. As soon as it was administered I completely relaxed and actually began to enjoy the whole experience. No doubt it was still intense but I was completely coherent and with it when my little man was born. I could still feel the contractions, move my legs and had the urge to push, nor did it slow the labour down! Listen to your body!"
— Sarah, Larne

A plan is easier with someone beside you

If there's one thing to take from this chapter, it's that you don't have to figure any of this out alone. Working through your birth plan is one of the first things we do together when you join my care so if you're expecting, or planning to be, get in touch with my secretary, Colette, to arrange an appointment. I'd love to help you prepare for the day you meet your baby.

Frequently Asked Questions

No. A birth plan isn't compulsory, and you can simply go with the flow if you prefer. But if you have specific views about what you want, or don't want, during labour, writing them down really helps the people looking after you know what those things are. I ask every expectant mum I care for to produce one, not because I don't know what to do, but because I want to actively involve you in the decision-making process.

A birth plan is a guide, not a guarantee. What everyone wants most is a healthy baby and a healthy mum, and if something happens to threaten either, plans will have to change. I find it helpful to think of this as revising your birth plan rather than abandoning it - even if it has to be done quickly. That's also why it's important to trust the team attending your delivery, and to have a birth partner who understands your wishes and can help revise the plan on your behalf if you're in pain or under stress.

The key questions cover where you want to give birth, who you want as your birth partner, your preferred pain relief, your feelings about interventions such as induction, instrumental delivery, Caesarean section and episiotomy, preferences around cord clamping, delivery of the placenta, the vitamin K injection, immediate skin-to-skin contact, how you plan to feed your baby, and any special requirements - whether dietary, religious, language-related or otherwise.

Most women like to have someone supporting them during labour, and many choose the father of the child - but that's not the only option. Anyone who gives you confidence can help: friends, relatives, or a professional such as a doula. You may also prefer to go it alone. It's about choosing whatever makes you most relaxed and comfortable.

Gather information from a variety of sources: ask at your antenatal appointments (writing questions down beforehand helps), visit the hospital where you're considering giving birth, talk to friends and family who've been through it, and sign up for antenatal classes. There's plenty of information online too - some fantastic, some frankly dangerous - so bring anything you find to your next appointment and we can separate the safe from the suspect together.

This post is adapted from Dr Duncan's new book, Anything Pregnancy. If you've enjoyed reading it, the full book is available to purchase on Amazon.

What Can I Do To Prevent Stretch Marks?

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The changing body shape, rapidly expanding bump and the hormones raging around conspire to ensure that loads of women get stretch marks during pregnancy. They seem to appear overnight; you may feel a little itchy, your skin can look thin and the next minute you’re covered in red stripes.

When your skin is stretched harder and faster than it can deal with, your tissues can tear, leaving a little linear wound and the purple or red streak of a stretch mark. They classically appear across the lower abdomen but can also affect your breasts, thighs and back.

They look red, angry and frankly alarming at the beginning, but with time they will fade to fine silvery lines that are barely noticeable.

 

Why me?

Stretch marks or striae gravidarum to use their scientific name, are common. In fact, by the end of pregnancy most women are affected. You’re more likely to get them if they run in your family, so ask your mum if she was affected. They’re also more common in darker skins, in people who gain lots of weight during pregnancy or if you’re having a multiple birth.

The trouble is, once you’ve got them, there’s little that can be done to blitz them. Although they shrink and fade with time, they don’t disappear. Laser treatment or resurfacing treatments are used to help fade the colour and improve the appearance, but the elastin in the skin remains damaged and the wound is still there. Prevention is better than cure, but what can you do?

 

Nourish your skin

Avoid excess rapid weight gain by maintaining a healthy balanced diet and make sure you get plenty of zinc, vitamin C and vitamin E to keep your skin healthy.

Keep your skin supple:

"I got terrible stretch marks in puberty. They’re all over my boobs, my thighs, my bum and even my calves. I’ve kind of learned to live with them, but I was paranoid about getting them in pregnancy too—it seemed like my tummy and my face were the only places without the damned things!
I was OBSESSIVE. Seriously, I rubbed oils in religiously twice a day. Some were expensive but actually, with a body oil a little goes a long way so it didn’t break the bank. Anyway, I didn’t get any new ones at all. I don’t know if it was the oils, but I do know that my skin is prone to them and that something made a difference."
—Elizabeth, Wetherby

Some early studies suggested that ANY cream regularly massaged into the abdomen, thighs and breasts could help to prevent stretch marks appearing. The extra moisture and the process of massage may help the skin to stretch and adapt to your changing shape. More recent research shows that anointing your bump in cocoa butter or olive oil doesn’t seem to make a blind bit of difference when it comes to stretch marks. However, regular moisturising will help make your skin soft, supple and smooth - so it’s worth a try. There’s no need to invest in pricey products; choose something that you like the smell and texture of and that doesn’t irritate your skin. Try to make moisturising your bump and breasts part of your morning and evening routine.

Follow the evidence: I’ve been through the research on stretchmark treatments and I’m not going to lie, it’s a little disappointing. However, the British Journal of Dermatology reported that there was some suggestion that certain lotions and potions may help prevent them appearing, so look out for these ingredients:

Centella (gotu kola or Indian pennywort) and vitamin E: Creams containing this herbal remedy together with vitamin E, appeared to protect women who developed stretch marks in puberty from getting more during pregnancy. Gotu kola is an active herb and should not be taken orally during pregnancy. Its safety topically is less clear, so it’s sensible to chat to me about it at your next appointment before you start using it.

One mum, who was also a complementary therapist told me that she found vitamin E cream helped her stretch marks fade quicker, so it may offer some benefit.

Bitter almond oil: Massage with this oil may prevent stretch marks appearing or reduce their severity.

Hyaluronic acid: The evidence for this working is a little weak, but hey, that’s better than nothing.

 

After they’ve appeared

At the moment, there’s no proven way of totally getting rid of stretch marks, and lots of mums find they can really affect their body image and sense of self-worth after the birth. While you’re waiting for them to fade, if your skin is pale, a good fake tan can even out your skin colour, camouflage the stripes and boost your confidence. Pulsed dye laser therapy can be used in private clinics to fade discolouration and make the marks less conspicuous. I was also interested to read about a new treatment developed by a team from the University of Manchester harnessing the calming properties of green tea. You don’t drink it or bathe in it. Instead, it’s formulated into a lotion, which has recently been launched. It is designed to tackle the marks as they appear and research is still in the early days, so watch this space.

 

Your body is doing something remarkable

Stretch marks are one small part of a much bigger story - and if any of it is worrying you, from how your skin is changing to how you're feeling about your changing shape, you don't have to keep it to yourself. If you'd like to talk it through, get in touch with my secretary, Colette, to arrange an appointment, you don't have to be on a package with me for a one-off appointment, and no question is too small.

Frequently Asked Questions

There's no guaranteed way, I'm afraid - the research on prevention is honestly a little disappointing. Recent studies show that rubbing cocoa butter or olive oil into your bump doesn't make a measurable difference. That said, avoiding rapid excess weight gain through a healthy balanced diet helps, as does getting plenty of zinc, vitamin C and vitamin E to keep your skin healthy. And while regular moisturising isn't proven to prevent stretch marks, it will keep your skin soft and supple - so it's worth making it part of your morning and evening routine. There's no need for pricey products; choose something you like the smell and texture of that doesn't irritate your skin.

Mostly, it comes down to factors outside your control. Stretch marks - striae gravidarum, to use their scientific name - affect most women by the end of pregnancy. You're more likely to get them if they run in your family (ask your mum if she was affected), if you have darker skin, if you've gained a lot of weight during pregnancy, or if you're expecting twins or more. They happen when your skin is stretched harder and faster than it can cope with, so the tissue tears slightly, leaving that red or purple streak.

They won't disappear completely, but they will fade - those red, angry-looking stripes shrink over time into fine silvery lines that are barely noticeable. There's currently no proven way to remove them entirely, because the elastin in the skin remains damaged. If they're affecting your confidence in the meantime, a good fake tan can camouflage the marks on paler skin, and pulsed dye laser therapy at private clinics can fade the discolouration. There's also a newly launched green tea-based lotion, developed by researchers at the University of Manchester, designed to tackle marks as they appear - the research is early, but it's one to watch.

This post is adapted from Dr Duncan's new book, Anything Pregnancy. If you've enjoyed reading it, the full book is available to purchase on Amazon.

Dr Duncan’s Guide To Twin Pregnancy

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They say that having twins is ‘double the trouble and twice the joy'. It’s completely understandable that known risks associated with a twin pregnancy can cause some anxiety, however, with the right support and guidance from a highly-experienced obstetrician with specialist interests in maternal and fetal medicine, you can stay healthy, protect your growing babies, and be well-prepared for birth and beyond.

 

Is there an increased risk with a twin pregnancy?

Yes, a twin pregnancy is associated with increased risk for both Mum and Babies. The risk of maternal mortality is 2.5 times higher in multiple births than in singleton births, and the chances of an earlier delivery is also significantly higher in a twin pregnancy, which means your babies may need additional support immediately post-birth.

The good news is that we now have more experience of caring for twin pregnancies, due to their higher incidence in light of an increase in average maternal age and associated use of assisted fertility treatments; multiple births now account for 3% of all live births. Choosing an experienced obstetrician who can provide regular monitoring and continuity of care is therefore the very best first step towards a healthy twin pregnancy, a safe delivery, and a great start to new and happy lives together.

 

What are the signs I am having twins?

Women who are pregnant with twins often notice that the line on their positive pregnancy test is darker and more distinct at an earlier stage. This is because levels of the pregnancy hormone hCG (human chorionic gonadotropin) are usually elevated in multiple pregnancies. These higher levels can also be detected on hCG blood tests. Some of the effects of this may be that you feel particularly tired and drained, and suffer badly with morning sickness. A bigger than average bump may also be a clue that there could be more than one baby developing inside your womb. In truth, not all women with a twin pregnancy will have the same response to the hormonal changes, and you may have none of these signs despite being pregnant with twins. The one way to know for sure if you’re pregnant with twins is with your first ultrasound scan, at around 6/7 weeks, when two tiny heartbeats may be visible.

 

Types of twins

You should be carefully scanned by a fetal medicine specialist between 11 and 14 weeks so the ‘chorionicity’ and the ‘amnionicity’ of your twin pregnancy can be determined. The chorionicity refers to the placenta, and whether you babies have their own (as in a dichorionic twin pregnancy) or are sharing a placenta (as in a monochorionic twin pregnancy). The amnionicity refers to the amniotic sac, and describes whether your babies are in their own sacs (diamniotic) or share a sac (monoamniotic).

If your babies each have their own placenta and own amniotic sac, then you have a DCDA twin pregnancy, a dichorionic diamniotic twin pregnancy.

If your babies are sharing one placenta with two sacs, then you have an MCDA twin pregnancy – a monochorionic diamniotic twin pregnancy.

MCMA twins are more rare where the babies share the same sac and the same placenta.

 

Why does twin type matter?

The importance of twin typing goes well beyond whether your two babies are going to look alike. The information helps Dr Duncan to know the risk of complications developing, and this in turn informs the best plan for managing your pregnancy, based on evidence and experience. MCDA twin pregnancies are more complicated than DCDA and tend to have increased risk of transfusion between twins, growth restriction, and congenital abnormalities, and need extra care and closer monitoring throughout pregnancy.

 

Fraternal (dizygotic) twins

Fraternal or non-identical twins are the most common type of multifetal pregnancy. It happens when two separate eggs are fertilised by two separate sperm cells (thus creating two separate zygotes, hence dizygotic). This means that fraternal twins are like any other pair of siblings; they may share a birthday, but they do not have exactly the same genetic make-up. They therefore do not look identical and can be different sexes. If you’re wondering how two eggs can be available for fertilisation at the same time, you’re not alone. Many shell-shocked parents have asked precisely the same question. The truth is, there are lots of different reasons. Researchers suggest that some mothers may be genetically prone to releasing lots of eggs instead of just the one, and this type of twin does tend to run in families. It can also be more likely to occur in older mums or with the use of some fertility drugs, such as clomid, which stimulates follicular development.

 

Identical (monozygotic) twins

Identical twins occur when one zygote (one egg having been fertilised by one sperm) splits in two, thus producing two identical embryos.

Monozygotic twins, sharing the same genetic material, are the same sex and generally look exactly the same, or thereabouts. I say thereabouts, because although their DNA is essentially identical, environmental factors can have a significant influence on genes. They can be turned on and off in a phenomenon known as epigenetic modification. Even in identical twins there will be ways of telling the difference, and as someone who has delivered many twins I am intrigued by how two individuals with the same DNA can be so different, both physically and emotionally.

Monozygotic twinning can occur spontaneously after natural conception or after IVF treatment. It is not fully understood why a zygote may divide into two, producing identical twins. The later in pregnancy that this division occurs, the more structures that will be shared. These two ‘blastocysts’ can both implant in the lining of the uterus to form two identical embryos. Even after years of studying, researching and delivering twins, it’s still a process that fills me with awe.

 

Chorionicity

The chorionicity of twins relates to whether they share the same placenta and lining of the fluid sac, and is dependent on precisely when the zygote divides:

  • Dichorionic/diamniotic: These twins divide at the earliest stage and so each twin has their own placenta as well as their own chorion and amniotic sac
  • Monochorionic/diamniotic: The zygote forming these twins, will usually divide between four and eight days after fertilisation. These identical twins share a placenta and chorionic sac but have their own amniotic sac.
  • Monochorionic/monoamniotic: These twins develop from a zygote that splits late, usually between eight and twelve days after conception. The twins will share a placenta, chorionic and amniotic sac. If the division occurs more than twelve days after fertilisation, the twins will share even more and are likely to be conjoined and share body parts.

 

Dr Duncan would be delighted to look after you during your twin pregnancy, please get in touch with the clinic to book your appointment.

Twin Pregnancy FAQs

Twins can be the result of a variety of causes. They can arise naturally due to the release of multiple eggs or multiple ovulations, or the splitting of a single fertilised egg, or by medical intervention via fertility treatments such as IVF, when multiple embryos are placed in the womb. The particular way in which twins are conceived determines the degree of relatedness between them, as well as whether they’re identical or not.

If you’re pregnant with more than one baby, it’s especially important to look after your own health and wellbeing. A balanced diet which includes plenty of fruit, vegetables, fish, lean meat and eggs, pulses, dairy and wholegrains will nourish your body and the babies growing inside you. Exercise will keep you fit and ready for the challenges ahead, and together with quitting alcohol, will ensure you give your babies the best start to life.

You’re more at risk of developing iron deficiency anaemia during a multiple pregnancy. You can boost your body’s iron levels with red meat, fortified cereals and plenty of leafy green vegetables, washed down with a glass of orange juice, as the vitamin C in the juice will help your body absorb the iron in the food.

Yes. A multiple pregnancy can be wonderful, but it can also be utterly exhausting. It is important to be gentle with yourself. Take regular rest, make sure you get enough sleep, and if you’re feeling stressed, you should seek to minimise this before you feel overwhelmed. Having a solid support system in place, including friends, family and medical professionals, is of paramount importance.

Morning sickness and indigestion can be a real problem, and this can often be managed by eating little and often. If however you need additional help, then anti-sickness and/or anti-acid medications can be prescribed.

The size of your bump, the demands of your growing babies, and a hormonal surge can mean that a multiple pregnancy can bring more pronounced problems alongside pregnancy’s usual niggles and gripes:

  • The weight of your babies can press on your pelvic blood vessels, increasing the risk of varicose veins and haemorrhoids. You can stay comfortable by wearing support tights and by putting your legs up when you have a quiet moment. Taking plenty of fluids and fibre will keep you regular and prevent painful constipation.
  • Your expanding bump, together with pregnancy hormones that soften and stretch your ligaments, means you may be plagued by backache or pelvic pain. Whatever problems you may experience though, I urge you not to suffer in silence. Please speak to me and I can refer you to a specialist physiotherapist or chiropractor for treatment and advice.

Antenatal appointments are important in any pregnancy, but they’re especially important if you’re carrying twins. Dr Duncan will want to keep a close eye on you and your babies.

If you have a multiple pregnancy, you are at increased risk of high blood pressure, gestational diabetes and preterm delivery, however with close monitoring, early detection and treatment of any problems as they emerge, we should be able to keep you and your babies as healthy as possible.

We will talk through the risks, signs and symptoms of pre-term labour, and by 32 weeks we will expand this discussion to agree on the timing of birth and the possible mode of delivery. Together we can develop the best birth plan for you and your precious babies.