Childbirth with Twins
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Childbirth with Twins
I am pregnant with twins and am looking for an OB/Gyn who
will fully support my desire to deliver vaginally in the
absence of complications. I like my OB a lot, but feel
she is skittish about natural twin births and I am
concerned that she will push for medical interventions at
the drop of a hat.
We are Blue Cross HMO members, which probably means we'll
be delivering at Alta Bates (despite the inhumane policy
that all twin births take place in an operating room even
if there are no problems).
All the doctors at the East Bay Physicians Med. Group
support natural birth for twins when possible. My twins
were born full term naturally although I had assumed that I
would probably have a c-section just because the risk of
complications is that much greater with twins.
And on your comment about the inhumane practice of giving
birth in an OR instead of some pastel-coated birthing room,
there's actually a good reason for it. For twins they need
double everything - equipment, people, etc. as you never
know what might happen. There's just not the physical space
in a birthing room for all that stuff. You need to focus on
what's important, not on what the room looks like where you
give birth. Seriously...
Twin mom who doesn't care what the room looks like as long as the babies are healthy!
When I was pregnant with my twins it was all so very overwhelming - too much
information and way too much going on while pregnant with my own body.
Though I ended up having a c section because Twin A was breech, I still ended
up with two really wonderful kids. Yes, operating rooms are not romantic and
visually pleasing, but I decided it was not about the birth but the kids' childhood
and being a parent. Like its about the marriage, not really the wedding.
Yes, you will need extra help to recover from a major surgery and it would have
been great not to go through it - and perhaps you will be lucky and more power
to you. The best thing is to join your local twins club now! Twins by the bay I
think is this local one-- cheap stuff and plenty of twin specific advice from
members. My biggest tip - get as much help as you can afford and when people
ask what you want tell them all diapers and fully cooked meals that you can heat
up for you and your husband!
been there and back
Hi, I am currently 31 weeks pregnant with fraternal girl twins
and I am starting to rethink my birth plan. My partner and I have
desired a home birth all along, but were told by the MDs at UCSF
that twins are a high risk pregnancy. We were scared into
deciding to deliver at UCSF b/c they have the best NICU in town,
and god forbid we should need it! That said, I have been given
the details of their expectations about my birth plan, including
desired interventions, and quite honestly, I'm scared. I don't
want to have an epidural, I don't want to have a breech
extraction, I'd like to try to deliver both babies vaginally, but
they are in the typical yin/yang position (one vertex, one
breech). UC doctors have told me their options are breech
extraction or C-section. My questions... can people please tell
me about their twin birthing experiences? Has anybody had these
interventions before? Any advice on how I can be more flexible?
Has anybody delivered twins w/ midwifes at home or in St. Lukes
midwife delievery system? Am I being dumb by even thinking of
delivering in a different way than traditional UC doctors
suggest? THANKS A MILLION!!! I need some calming down. :) -Rina
I am a Doula who works with twins a lot and also has done twin
births at UCSF. I would strongly suggest that you continue to
talk about natural birth for twins at UC. I have attneded several
women there who had natural births. no Epicurals, only IVs in place.
All Twins are born in the OR and all twin deliveries have a
pediactirc team available.
I would also suggest that you look into getting a Doula who has
twin experience and even better if she has it at UC. Patty
lipinska 510-849-1082 or Esther Gallagher at 415 821 4490 are
both great. A Doula can help you navigate the system, keep your
vision of the birth alive, and support you as you become parents.
I do not know if there are any homebirth midwives who are
currently attending twins and even if they were if your are a
canidate. It is a really big picture decision.
I would encourge you to keep looking at all of your options however.
First, congrats! Parenting twins is fabulous. Having twins is
fabulous. Two sets of giggles. Two hugs. Two silly people in
We had our twins at a hospital. I had preterm labor and was an
antepartum patient. They came at 33 weeks and spent 3 weeks in
the NICU. At our hospital (John Muir) all multiples are
delivered in the OR because of risk of having to do a c
section. There are so many variables with twins I'd not want to
take the risk of delivering without lots of help. I was amazed
how many people were in the OR when I delivered -- 2 OBs, 2
pediatricians, 1 anesthesiologist, me, my partner, 2 surgical
nurses, 2 pediatric nurses, one other nurse who seemed to be
orchestrating the whole thing. It was a carefully choreographed
One of my best friends is a NICU nurse at UCSF. I was so
fortunate to know a lot about what she did for a living because
if not, I would have been scared to death when my kids had to
live there for their first three weeks.
I don't know anyone who had twins not in a hospital. And I
belong to a 400 member mother of twins club.
Again, congrats. Your life will never be the same
Mommy of three
Here's my take on things: The doctors know what they are
doing. They have a ton of experience and truly want what is
best for everyone's health. To them, that means minimizing the
chance of any Rbad outcomesS for babies or mom. Will that tend
to make them more interventionist? Absolutely. But if they are
seeing warning signs that the babies may be in distress, they
will feel strongly that they should act to keep the situation
from worsening, even if the statistical risk is small. They
don't want you to be part of that small statistic.
In your case, the risk of trying to deliver vaginally is
actually not small. The risk of trying to deliver at home is
HUGE. Is your midwife trained for this situation? Has she
faced it before? How many times? What were the outcomes? Why
do you feel more comfortable with her helping to make your
medical decisions than the UCSF doctors? I'm even wondering if
there are there any midwives out there who would feel
comfortable taking this situation on.
Remember that making a birth plan is MORE than twice as hard
with twins, because there are more decision points (this is true
regardless of where and with whom you deliver). For example,
what if you deliver the first baby vaginally, with no problems,
but the second baby is breech and/or in distress?
For me, I had hopes for my delivery but very few expectations.
I decided my bottom line was that we all remain as healthy as
possible. If the doctors thought it necessary for me to have a
caesarean to minimize the risk to either baby, I would do it
without hesitation. In the end, I was induced at 39 weeks and
delivered both babies vaginally. BUT the babies were both in a
head-down position all along. If I were in your position, I
would schedule the c-section and just try to look at the
advantages of having that decision already made, and prepare
For the record, my OB thought that one of the main reasons I had
a relatively smooth delivery was my attitude. Deciding early on
that the doctors would do what was right was very freeing, and
allowed me to concentrate more fully on what I had to do
I'm sure you'll get lots of advice on how to manage a home
birth for twins, and I don't want to be a downer, but your post
really struck me.
Our birth experiences are sooo important, but not nearly as
important as delivering healthy children. I lost twins to early
labor and was very sad when I learned my next child was full
breech. I so wanted a natural birth experience after the
hideous medicalized experience of a stillbirth. However, I was
also scared to death to endanger this baby at all. I don't love
that I had a caesarian, and birth stories are such a part of
those first few weeks after your baby is born, and I actually
had people give me condolences for my c-section! But within
five months, when she was smiling and giggling and really
interacting with us, my birth experience ceded so far into the
background, and today I am so grateful to have this happy
healthy toddler in my life that I rarely think about it. The
most important thing, IMO, since birthing is filled with so
many surprises, is to adopt a flexible attitude about it and
keep looking ahead to holding those beautiful healthy babies in
Best of luck in whatever you decide to do, but please keep in
mind that your birth experience is just the beginning of the
most empowering, frustrating, awesome, surprise-filled and
amazing journey you'll ever take
I gave birth to twins 11 years ago-I was lucky enough to deliver
vaginally, which was great. I had them in the hospital, and
while there was more intervention than I wanted, in the end, I
was just so happy to have 2 healthy babies. I really don't
think you should have them at home-there is a high risk of
complication, and you need to be in a hospital in case something
happens. But I highly recommend having a doula or someone
besides your partner (who needs to attend to you) to advocate
for you-could you have a midwife at UCSF? I think it is
important you maintain control of the process. I also had an
epidural, which was a godsend. Before childbirth a lot of
people have a lot of ideas of how they want it to be, but truly
what matters most is that everyone is healthy. If you need an
epidural, it's okay to get one, and if you need a c-section,
it's okay too. In the big picture your health and your babies'
health is what matters most.
I would encourage you to take a deep, deep breath and remember
what is important here. I will say I have never had -- or
really desired -- a home birth. I had three children - the
second and third were unplanned, non-emergency c-section (they
just wouldn't come out vaginally).
I was disappointed with each section. HOWEVER, having three
healthy kids was what was most important. I do know of people
who lost babies in home births that were too complicated and
should have been done at a hospital. The risk of living with
that kind of regret and grief should also factor in to your
decision -- along with the risk of not having the birth you
The birth seems so much more important going forward than
looking back. Looking back, all I really remember is moments in
the hospital with the baby and a life together afterwards.
Don't put too much importance on the birth -- it's only a moment
in a lifetime of moments (assuming you're lucky).
That said, I think you do want to arm yourself with information,
know the facts, argue for what you want within reason. Find out
the reasons for the hospital's and doctor's preferences -- it's
probably to protect themselves against real risks associated
with breech birth. Just because so and so had a breech birth OK
doesn't mean the statistics make it a gamble worth trying. I
don't know what the precise numbers are, myself, but I would
Finding a way to be open about the birth is good practice for
all those ways in which you will have to be open about those two
lovely girls not being exactly the girls you are imagining in
your mind - they will be who they are; the birth will be what it
is. Welcome to the lack of control that is parenting!
Anonymous in this home birthing town
congratulations on becoming a twin mom.
i know many, many twin parents and have never in my life heard
of anyone choosing a home birth for a multiple pregnancy. it is
a high risk pregnancy - just think, you have twice the chance
of having something happen to you or the babies. it is
important to have a quality NICU and all the fetal monitoring
i delivered at cpmc at 37 weeks, vaginally, in the OR, with an
epidural. from what i've heard, cpmc is a bit more ''touchy
feely'' of an experience but you are pretty late in your
pregnancy to be switching doctors (unless you don't like
yours). my pregnancy was awful but my delivery was smooth.
however, i would say about 75% of the women i have met who have
delivered twins have had complications. i'd be safe and stick
give yourself a few more weeks and you will just want them OUT!
in any way possible!
In my view, the absolutely most important thing of all is
delivering healthy babies. To that end, with twins, and twins
in complicated positions in utero, I would toss my prefered
birth plan out the window and head to the hospital, where I'd
expect the safest possible delivery experience. In my birthing
class at Kaiser many years ago, we all diligently wrote up
our ''birthing plans'', picturing the music we'd be listening to,
the things we'd want our partners to say to us, etc. All of
this was made meaningless when I had an emergency C section.
Now I have a happy healthy gorgeous smart twelve year old; we
absolutely made the right choice to be in a hospital where they
could detect the possible complication and bring her safely
into the world in a mere 14 minutes after recognizing the
Better safe than anything else
I had two children in two deliveries (ie singletons), with
the certified nurse-midwife team at Stanford. All the talk
about the mood and warmth of home deliveries aside, this is a
serious medical process and you would be very foolish to do
anything other than deliver at a hospital. If you can have a
certified nurse midwife with you that would be better, I guess,
but if something goes wrong at home you could have a nightmare
on your hands.
I am a midwife who has delivered twins and I will say it is definitely
high risk and you
should only deliver in a hospital. The reasons are too many to get into.
It is very
possible to do a vaginal birth with breech extraction, as long as your OB
pelvis feels fairly adequate. Most midwives in the area don't do twins,
but some groups
that deliver twins might have a midwife working with them and they might
be able to
work as a team. I don't really see the benefit of this though since it is
high risk and
obstetricians are going to have to be involved. Really I think you should
focus on the
health of the babies, and not the idealized birth. Best wishes
Well, I know that you have heard all of the stats and have been scared
that line. I am a mom of twins, and I chose a planned caesarian for my
for several reasons: 1) the odds are quite high that the second twin will
assistance, and I didn't want to have to heal in two places (vaginally for
tummy for the second) 2) I have had several friends who have had a long
ended in c-section, then a second pregnancy with a planned c-section. All
report that a planned section without the hours and hours of labor is
to recover from compared to the reverse.
I can tell you that I thought the c-section was pretty easy to recover
spinal was no big deal at all! The day after delivery, I was quite sore,
managed with pain meds. All in all, I'd do it in a heartbeat. It seemed to
me to be
the safest way to give birth both for me and my babies.
And, take it from me: you are going to do countless things differently
because you are having two at once--this is only the beginning. Feeding,
bathing, traveling--you are going to be amazed at how differently things
have to be
because you are having twins. It will be a much larger challenge--but a
reward as well!
Twin mom too
I would advise against at home birth for twins. I was extremely healthy
when my girls were born, but still had unforeseen problems. My twin A
rested in the
birth canal for a very long time and my twin B was breech. I would trust
She speaks from experience. Good luck and congratulations!
I don't have specific advice for you, but I wanted to recommend
you Google ''Unassisted Twin Homebirth'' - just for a different
perspective from the Western medical one on what is doable with a
twin birth. What you'll find is a website about a couple who
faced the same dilemma as you and also wanted to have a homebirth
for their twins. They had a really hard time finding a midwife
who would do that, and eventually decided to have their babies at
home anyway, but unassisted. The babies went full term - she
delivered at 40 weeks, and the babies ended up weighing around 8
lb each. They have and sell a video of the birth, which my doula
recently showed me (I am 34 weeks pregnant but with a singleton),
and it was absolutely amazing - just the couple and their 2 year
old were there, and the dad was filming the whole time while also
watching the toddler. The woman gave birth on a towel in the
bathroom to both babies, and it was a really beautiful, calm,
completely panic-free birth. The second one was actually a
footling breech, but came out just fine without any medical help
at all, and both babies and the mama were healthy.
Now, I would personally be reluctant to have an unassisted birth,
especially with twins - but the video really changed my
perspective on what's possible in birth in general (so much so
that my husband and I are now considering a homebirth after
planning this whole time to have a hospital birth). You may have
more luck than they did finding a midwife who will deliver twins
Lots of luck with whatever you decide - I wish you the best!
I know that countless other women have had homebirths for twins before,
there are more risks associated with twins, one of them being breech. I am
with many of the midwives in this area and don't know any who would do a
birth at home; many don't have enough experience to do this and it is
''illegal'' per the State of California to perform this, if you are a
Did you already have a homebirth midwife who said she'd do this? If so, I
she's had plenty of experience and that you understand the liability. I
am not saying
you shouldn't do it, because I'm sure many women have had successful
homebirths with twins, but these are just a few things to consider. There
is one or
two OBs who are still willing to deliver a breech baby in hospital (I
think one is at
UCSF or SF General), but I don't know if they'd do it for twins (I don't
see why not).
Your midwife would probably know which OB this is. Good luck to you!
homebirth mom of 2
Well, I had a c-section and an epidural, and after it was all
over, all I could focus on was my new little guy. I understand
that natural childbirth at home is the optimal situation for
you, however, if your doctor recommends a c-section and other
intervention methods, follow her/his advice. At the end of it
all, the health and welfare of your new babies is the ultimate
issue, not the method of childbirth. Even if you went looking
for a second opinion, respect the doctors at UCSF, because
generally they know what they're talking about.
Good luck and trust me, even if you have the c-section, you
will be so happy that you did what was best for your children.
Hi- I had fraternal twins, and baby A was vertex, baby B was breech. My
bloodpressure started to go up as I neared my due date, and i got induced. I had an
epidural, which was fine for me, made me able to think about more things than my
discomfort. The plan was to try to turn baby B after baby A was out. I knew it was a
possibility that I could have one baby vaginally and one by c-section, but as long as
we all ended up healthy that was OK. Baby B didn't want to turn, but was smaller
than baby A and they were able to pull baby B out by the feet!
I was very happy to be at a hospital with a neonatal icu just in case. I was a resident
at the time and a physician now. I would never have been able to get past the guilt if
there had been any complication that hurt my baby that would have been possibly
preventable. I understand why people want to home birth but having worked with
kids with cerebral palsy and other complications, I encourage you to take advantage
of the experience of the hospital. For example, I loved having the lactation
consultant help me get going with twin feeding while still in the hospital. I wish you
great luck on your big adventure! I had postpartum elation!
Happy at the hospital
My advice is to give birth in the hospital. I know that many
births turn out OK at home, but I believe it is too risky. I
had visions for delivering a natural birth (in Alta Bates).
While in labor the baby's heart rate suddenly plummeted and he
was delivered through emergency c-section in 8 minutes. It
seems that when my son suddenly descended into the birth canal,
his head blocked his umbilical cord (or something like that).
Even if we could have learned of the problem during a home
birth, in the time we would have rushed to a hospital, he would
have died or been severely brain damaged. I am so grateful to
the skilled phsyicians & nurses at Alta Bates and that pesky
heartrate monitor that everyone (including me before this
happened!) complains about. Since you are so much more likely
to have complications with twins, I say, be in the hospital.
There is so much you can do to still make it your own
experience while there.
Grateful mother of a healthy son
I have to 2nd the responses about not being worth the risk with
twins to attempt a home birth against the advice of your doctor.
I am pregnant with twins right now, & after the birth of my
first would never consider a home birth. My son was stuck for a
while in the birth canal. My doctor wanted to vacum him out, but
I wanted a natural birth. In the last minutes of pushing the
scapal monitor fell off & no one knew that the cord had also
tightened around his neck. He was completely blue & lifeless
when he came. Nurses rushed to revive him and he only had an
AGAR of 3 at 1 minute. Years later it still causes me pain to
remember the feeling of laying there, not knowing if he was dead
or brain damaged, thinking I should've just let them vacum him
to get him out faster. He was rushed to intensive care and put
under warmers. It was hard not to get to hold him for a couple
of hours, but the advice everyone has given you is true. It's
just a few hours out of an entire lifetime and my bonding with
him was in no way hampered by not getting to hold him
immediately. Later a doula had the audacity to tell me that had
I been allowed to hold him immediately he would've revived on
his own from getting to smell me. Insane advice considering he
couldn't even breathe, let alone smell.
I also appreciate the fetal monitors on at the hospital. Both my
sister and I had the experience where the monitors showed the
babys' heart beats dropping dangerously low (70 beats/minute)
due to the cord around the neck. All it took was rolling over on
our sides to get it back up. If you're at home, you don't get
these monitors. Someone wrote about a video of a woman birthing
alone in the bathroom. That woman was very fortunate that there
was no cord wrapped around the baby's neck, or meconium in the
amniotic fluid, something that even a midwife at home would send
you to the hospital for.
I also have several friends that work at Children's Hospital,
and have heard about cases of newborns that are there because of
a delay in receiving emergency care due to having to rush from a
home birth to the hospital, treatments that would've been
available in seconds had they been born in a hospital.
Go to a hospital with a good NICU.
There is a reason twin births are ''high risk''. Many OBs
(including MFM trained) get stressed with multiple
deliveries. I understand that many people would like to
deliver vaginally, but really, what is important here? the
delivery or 2 healthy babies. (ie is it the wedding or the
marriage). For me, there was no question: 2 healthy babies.
My babes were born 2 months premature, but I had a discussion
with my perinatologist about what I wanted should I make it
to ''term'' and what my options/risks/benefits were if they came
early. Thus, I and my husband were educated and knew what to
expect and were able to make the urgent c-section the best
moment of our lives. My ob team also knew what we would like.
And just because you deliver your babes in a hospital, who says
you will have a c-section? I know plenty of MOMs who delivered
vaginally. Having 2 beautiful babies is a blessing.
anybody recommend a doula or midwife who specializes in delivering twins? We
had a wonderful home birth for our daughter, and although that might not be
possible for the twins I'd still like to make an effort to make their
entry into the
world as natural as possible.
As I'm sure you know, having twins at home may not be possible. You
really can't tell what position they will be in until the ~ 30th or 32nd
week, and if they are in a number of unfavorable positions you will
require help in a hospital. Even if they both position correctly, I'd
personally feel more comfortable in a setting where an OB could step in
in case of problems. Our second child had difficulties in the birth
because her umbilical cord was shorter and it started to pull the
placenta from the uterus wall during birth. This caused her to bleed, a
dropping heart rate, and a need to get her out quickly. Having not only
an OB who was on top of the situation, but also a waiting family
physician who was able to ensure good breathing and everything else once
she was out, was really great for us scared parents. The short
umbilical cord was not something that could have been seen on an
ultrasound. Anyway, I'm not trying to scare you, but if you do plan a
more natural birth setting, I would also plan for several contingencies.
Good luck with the pregnancy and congrats again!
A woman named Patti Sala has been recommended to me from a
woman in my group. She is not a trained doula, but experienced in
helping postpartum families and also does night time care.
Most there now are doulas and charge accordingly. Her rates are lower. Sherry
For person wondering whether a doula is a necessity if no family is
around. I also didn't have family close by but I had twins! For me the doula
was a lifesaver but I also consider myself lucky to be able to have had this
help. I know people with twins that manage without help and many of my
friends with one baby also didn't have family and got through the first
weeks just fine. I'd say a doula is a luxury but absolutely worth it if
you can budget it in. Our doula was a "present." If family back home
ask you what you need have them chip in for the doula. Our doula was Carol
I delivered twins at Alta Bates by C-Section 8 months ago and was surprised to find out
that the recovery was not nearly as bad as I expected. A lot of people I know with vaginal
deliveries had more discomfort and pain afterwards than I did! I was not able to hold either
baby right after delivering, but the doctor did hold each of them up for me to see and talk to
right away, and the anethesiologist took pictures of my husband and I with each of the
babies minutes after they were delivered. Of everything I went through, I think not being
hold them and stay with them right after birth was the hardest emotionally. But, my
husband was with them every minute and brought them to me in the recovery area. It
wasn't until I was in my room that I was able to hold them. I think the most important
piece of advice I can give
you is to walk as soon as you are able and to walk as much as you can. I was so
overwhelmed with trying to deal with two babies that I didn't walk as much as I should
have and as a result ended up with terrible gas pains. No one warned me about that, and
the gas pain was worse than any of the other C-Section related pain. I liked having the
babies room in with us,
but relied on my husband to do all the diaper changing and to bring the babies to me for
nursing. I didn't really experience incision pain with nursing, although I've heard that can
be an issue. That may be because I mainly used the football hold for nursing, so I didn't
have the babies resting on my tummy. Once I got home, I was definitely more active than
what the doctor recommended, but I didn't know how that could be avoided -- we live in two
story house, and I had two babies to tend to. I don't want to be irresponsible for saying this,
but I've always felt that my recovery was quicker, because I was walking around a lot and
going up and
down stairs. (Both things I was told not to do!) Lastly, I would highly recommend getting a
private room and staying at the hospital as long as you can. Good Luck!
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