Delivering twins question - EMTLife.com - The #1 Online Forum for EMS-Related Discussion

b2dragun · 01-07-2010, 09:12 PM

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

juxtin1987 · 01-08-2010, 12:37 AM

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.

Jeffrey_169 · 01-09-2010, 06:27 AM

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.

CountryEMT-bGurl · 01-13-2010, 11:47 AM

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.
HTH

medic417 · 02-12-2010, 07:06 PM

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

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.

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

dmc2007 · 02-12-2010, 08:37 PM

Quote:

Originally Posted by medic417

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

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.

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

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?

medic417 · 02-12-2010, 09:01 PM

Quote:

Originally Posted by dmc2007

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?

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.

Fbarba123 · 04-05-2010, 03:02 AM

off topic... but I'm a TWIN!

akflightmedic · 04-05-2010, 06:48 AM

Quote:

Originally Posted by Fbarba123

off topic... but I'm a TWIN!

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!

eveningsky339 · 04-05-2010, 11:01 AM

I'm a fraternal triplet. No joke.

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

01-08-2010, 12:37 AM	#2
juxtin1987 Forum Crew Member Join Date: Nov 2009 Location: Turlock CA Posts: 70 Training: EMT-Basic	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. __________________ A truly wise man never plays leapfrog with a unicorn. Blood is thicker than water, and much tastier. Only in death does duty end. Last edited by juxtin1987; 01-08-2010 at 12:40 AM.

01-09-2010, 06:27 AM	#3
Jeffrey_169 Forum Lieutenant Join Date: Apr 2008 Location: Amarillo, TX Posts: 175 Training: EMT-Paramedic	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. __________________ "The fate of the wounded rests in the hand of the one who applies the first bandage" Nicholas Senn, MD If stupidity reigns, and stupid hurts, is it a wonder why the government is broke. "If we fail to instruct our children in justice, religion, and liberty, we will be condemning them to a world without virtue, a life in the twilight of a civilization where the great truths have been forgotten.", President Ronald Reagan

04-05-2010, 03:02 AM	#8
Fbarba123 Forum Lieutenant Join Date: Oct 2009 Posts: 141 Training: EMT-Basic	off topic... but I'm a TWIN! __________________ Diesel is my favorite treatment method

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01-07-2010, 09:12 PM	#1
b2dragun Forum Crew Member Join Date: Jan 2010 Posts: 99 Training: EMT-Paramedic	Delivering twins question 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

01-13-2010, 11:47 AM	#4
CountryEMT-bGurl Forum Lieutenant Join Date: Sep 2009 Location: Missouri Posts: 176 Training: EMT-Basic	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. HTH

04-05-2010, 11:01 AM	#10
eveningsky339 Forum Lieutenant Join Date: Sep 2009 Posts: 123 Training: CNA, EMT-B	I'm a fraternal triplet. No joke. Sadly, my C-Section delivery was uneventful, therefore I can offer no pointers.