Twins and Spinning Babies
"I am expecting twins, can I use the same Spinning Babies techniques for my pregnancy and labor?"

Yes, use the Three Principles of Spinning Babies while pregnant with multiples.
If you can, start early. Otherwise, start today! Many women, especially if beginning late in pregnancy, will need to also use professional help to balance uterine ligaments. This is done with myofascial release and chiropractic adjustments to correct any misalignments of the pelvis. Misaligned pelvic joints pull the uterus off center and can, at times, effect fetal position.  Women with loose ligaments may need to wear a pregnancy belt, beginning in midpregnancy (or as soon as you learn about pregnancy belts).

You will want to ask your doctor or midwife if there is any medical reason not to do an activity in pregnancy that you see on this site.

The first Principle of Spinning Babies is to Balance the womb.

Balancing the womb means to help the womb be more symmetrical by releasing tension, twists or torsion in the uterine ligaments. These are supporting “ropes” that can get tight and spasm. Most women do not feel discomfort, others feel the jabbing spasms, especially about 15 to 20 weeks of pregnancy.

The second Principle of Spinning Babies is Gravity.

Working with Gravity in a twin pregnancy.

Maternal Positioning

Understanding and Teaching Optimal Foetal Positioning author, midwife Jean Sutton, recommends keeping your belly lower than your spine (or equal) when standing, knees lower than your hips.
Let your belly be a hammock. Wash your kitchen floor, etc., on your hands and knees with kneepads on. Crawl around to pick up after your child, etc. or just to crawl. Leave off squatting and duck walking, but do dip your knees a bit to strengthen your thighs. Gravity works 24/7.

Gravity works best when the womb is in an ideal position and tone it self, and the pelvis bones, too, especially the sacrum.
When time is of the essence, for example, you are 32-34 weeks or more, you need to attend to your pelvis and ligaments with professional help.

Relaxation of the abdomen and pelvis will help baby A to flip head down.  Relaxation for this purpose means relaxing the involuntary muscles, including the muscle fibers within the uterine ligaments, such as the broad ligament.
We don’t know how the twins are going to effect each other with movement. I don’t have much collective wisdom gained on this issue, so I'm going to tell you what seems to be likely. Think of say, multiple sized marbles filling a jar. You want to get one more in, so you jiggle the jar a little bit. The marbles shift some. You add water and jiggle, now the marbles accommodate each other more easily. Let's think now about the babies.

Two babies may be lined up like two little compact ovals or they may be curled near each other, likely with one or two layers of amniotic sac membrane between them. Sometimes the inside of the womb is pear shaped, sometimes heart shaped. A heart shaped uterus may have a variable amount of septum separating the right and left sides of the womb, more or less. Either way, relaxation methods listed here at Spinning Babies relax the involuntary muscles and ligaments. This is your first task.
The first thing to do when you have a friend to help is have your abdomen jiggled while you relax completely.  This jiggling or sifting is called manteada in the Yucatan from where it is as important to prenatal care as taking a blood pressure is in our country.  See the Techniques section and then click on Rebozo for sifting techniques.

After sifting with the rebozo, do a forward leaning inversion.

Myofascial Releases

Myofascial work on your sacrum can return a folded or twisted sacrum to its ideal angle and release the twist it would cause in the lower uterine segment. A symmetrical, or balanced, womb will allow the baby to turn and face the mothers right hip or back more easily. Myofascial body work is a gentle body work. Your partner can learn to “release your sacrum” after car rides, etc.  In a car, your sacrum is tilted back and liable to wrinkle a bit, like a rug irritating baby’s nose (so to speak). The main problem is that the twist in the sacrum distorts the womb and the baby has a more difficult time lining up with the pelvis and cervix during the birth. This makes the birth longer.

Diaphragmatic Release is a technique of myofascial workers, craniosacral therapists and Chiropractors (some) which amazingly helps the tissues relax around the womb. It effectively releases the round ligaments which can be so tight they hold a baby’s forehead in front.
The diaphragmatic release will accomplish emotional release as well. The whole person approach resolves deep tension quickly.

Homeopathy

Homeopathic Pulsatilla, 30 C, is an over the counter dose available at natural food stores and online. Don’t touch the remedy and only place in a clean, taste-free mouth. Avoid mint, menthol, tea-tree oil and coffee during the days you are taking homeopathics.

Generally, the directions are to take Pulsatilla 30 C once a day for three days, then take a day off and try a does of Pulsatilla 200 C one time.
 If that doesn’t work, or you don’t want to risk it not working, seek a professional homeopath.

Chiropractic

Chiropractic adjustments can help the various soft and bony structures of the body relating to the womb. (Seen here, at right) One well known release is called the Webster maneuver. It is the same as for helping to flip a breech baby. It works well for a posterior. And can be used safely for twin pregnancies.

Overview of Maternal Positioning for Twin Pregnancy

Once you balance the womb and supporting ligaments, more room will be available within the womb, the sides will be softer and more flexible. A single baby will be able to sort herself out with gravity and movement. If the twin babies themselves aren’t blocking each other, then they, too, will move into place. 
 

Techniques to use in a twin pregnancy

In order:
   
1.    Jiggling (Manteada, Chunging, sifting...) This can be done by your partner or friend.
2.    Inversion—Reasonable for every twin-carrying mother in the first two trimesters. But inversion may not be for every twin mother in the third trimester. Each woman is different and has different tolerance for being upside down. See the video in Techniques/Inversion. How many and how long? One a day for 30-seconds each, or several in a day for 3-4 days and then occasionally once babies are head down.

3.    Maternal positioning follows each relaxation technique. Arrange pillows to Rest Smart.  Hips higher than knees, belly lower or equal to spine 24/7  Mind your posture always.
4.   Movement - swimming belly down and doing head stands in deep water (for those who feel safe doing so) are good ways to use the counter pressure of water to help the babies into position.

 
   See warnings in the article on Inversion in the Techniques section of this website.

Deep Relaxation of involuntary muscles is assisted by professional techniques/bodywork:
5.    After 36 weeks, avoid squatting and other things to engage baby until baby turns to face your right hip or is definitely LOA. Once labor is underway, especially as baby gets to "0" or +1 station," then

see if squatting is helpful for any fetal position.

Labor helps the posterior baby into position:
6.    Uterine contractions help rotation, so use posture and movements in early labor.
   

Ask your nurse or doctor, “Is there anything about my situation that I should avoid getting upside down?” If your bag of waters is not overly full there probably won't be a problem, but it is best to ask.

Balance the mother and the baby will turn.

Another arrangement of Spinning Babies techniques could be:

    * Inversion (leaning forward as shown on the videos on SpinningBabies.com) ; and
    * Sacral release,
    * Abdominal release (both Myofascial) and
    * Chiropractic adjustments of the pelvis, and neck, regularly.
    * Moxibustion at 33 weeks or later, particularly 2x a day for 20 minutes each on the outer (and upper) little toe nail (bladder 67) for the weeks 34-35 of gestation
    * Acupuncture with only the very well experienced with pregnant women. I’d feel comfortable with student or new acupuncturists myself, but I want to save you time and money. Be efficient and see the best. Find a community acupuncturist to reduce costs and get several appointments in for the cost of one visit to a “regular” acupuncturist.

Relax involuntary muscles and relax the broad ligament with
Rebozo sifting (manteado) as well as the

Abdominal (diaphragmatic) release.
Maya Massage. Once the flow is returned full force to the womb the babies may even grow more symmetrically.
Use a pelvic floor release in late pregnancy or any time in labor  when Baby A is entering the pelvis in a difficult position, labor is not progressing in spite of strong contractions or serious back labor.

Doing only maternal positioning isn't likely, by itself, to help a breech twin turn at 32 weeks or later, especially after 35 weeks gestation. This is a subjective claim, however, success depends on many factors!

 Here are the links for more information to make sense of these instructions:

http://spinningbabies.com/techniques/in-pregnancy/what-to-do-first

http://spinningbabies.com/techniques/in-pregnancy/3-principles-in-pregnancy

http://spinningbabies.com/techniques/bodywork-and-professional-help

http://spinningbabies.com/techniques/in-pregnancy/will-my-labor-be-hard

       If baby engages in OP or ROT position, disengage baby by Inversion (Trendleberg) for 30-40 minutes and try again. Do not use inverted positioning if first baby is NOT engaged, unless jammed at the brim. Read about chin tucking in Baby Positions.
Repeat preceding steps. So, if you can, before inverting, sift with the Rebozo, have a sacral release or abdominal (diaphragmatic) release if you have a friend to help you. If not, go ahead with the inversion. Repeating the inversions daily eventually gives you a pelvic adjustment and releases spasms in the cervical ligaments, allowing the lower uterine segment to become symmetrial!

      Always talk to your babies. Have your partner talk to the first baby directly by putting a tube (paper towel roll or clean vacuum hose) to the lower right side of your belly and talking heart to heart to get baby’s attention. This will encourage your baby to look to the sound and get his/her head in an LOT position, the ideal start position.
The most important thing is love.

To watch a slide show on a twin HBAC (home birth after cesarean) click here: http://www.carolinabirthandbaby.com/unlikelyjoy/2008/06/my-twin-hbac-homebirth-vbac-journey/

"My Doctor wants to induce me at 37 (38) weeks."

Using the late Dr. Tom Brewer’s diet on http://www.blueribbonbaby.org/ twin moms are going full term with healthy 7-8 pound babies. It never hurts to eat green leafy veggies, plenty of lean protein and a gallon of water a day, with salt to satisfy your taste in your food.

35-38 week-old twins will nurse almost hourly each, with a 2-3 hour break while sleeping; while 40 week twins may go 2 hours more often, and 3 and sometimes 4 hours when sleeping.
Babies born early are at higher risk for health problems and death in the first year of life. If we can prevent premature birth we can reduce risk. Why work hard to keep the babies in the womb and then induce, or even surgically remove them, before 40 weeks? Where is the evidence of safety with that plan?

Some attitude

March of Dimes is giving obstetrics the dickens for causing an epidemic of premature babies when they are induced or sectioned before they are due.  Some twins may need to be born early for specific reasons, such as a significant twin-to-twin transfer, but that is the exception, not the routine.

Ask your doctor if the induction is “just in case,” or do you have a specific risk for continuing to go to term? An aggressive doctor or midwife might say, “You have a live baby today, I can’t guarantee that tomorrow!” (I’ve heard this a number of times!) Its one thing if one baby is slowing down and/or the heart rate is not variable or one baby isn’t growing, but the argument that your womb will get too big to work properly is bonkers. Eat well and get your iron up.

Full term is full term, twins or singletons. Placentas and wombs aren’t time bombs, but beautifully designed organs for safe gestation.

Feed your placenta so it is healthy enough to do the work for nine months. Don’t smoke or eat junk, and unless you have a preexisting liver ailment or other unusual situation your placenta should be happy to continue to nourish your babes. Discuss any decisions you make with your doctor and midwife. 

Pay attention to a good pregnancy diet for twins:

    * Eating 6 servings of quality protein (lean proteins, not a lot of peanut butter). Eat 100 to 150 grams of protein each day you are able to get it and keep it down;
    * 3-4 quarts of water a day, including up to a quart of Red Raspberry Leaf Tea (make sure you are drinking non-caffeinated tea and its not flavored black tea! Try and get the leaf bulk rather than bagged.);
    * Leafy green vegetables, like raw spinach, Spring Mix salads, broccoli and cooked kale with lemon, eat a green leafy every day;
    * A yellow fruit or veggie a couple times a week or more; and
    * Whole grains, not white breads. Brown rice or quinoa grain makes a lovely addition and are good for digestion, nutrition and energy levels.
    * Add Omega oils, such as Nordic Naturals cod liver oil in a capsule or oil. Eat happy fats such as avocados or a tablespoon of butter, not margarine, each day.
    * Salt to taste, which means, to me, a bit of salt on your food.

Transverse twins?

Read about helping transverse babies get head down.

Breech twins?

Breech twin birth can be nearly as safe as head down twins if you have a couple of skilled attendants who know not to pull on the breech and know how to rotate stuck arms out and how to bring the nape of the neck into view before helping the head out. The first twin opens the way for the second twin. Contrary to most talk, the danger of a twin birth is usually in the attendant, not the birth process itself. You need both, a breech baby that fits and an attendant that doesn't accidentally cause damage due to ignorance or wrong practice techniques. The main thing is the baby is in a “tube-shape” and your birth attendant really knows what they should not do. Read about breech and avoid a manual version (a doctor or midwife manipulates the baby around through the abdomen.