Natural delivery of twins

The decision depends on how the twins are positioned, their growth and wellbeing, the placenta, your health, and the experience and facilities of the maternity unit. A head-down first twin may make vaginal birth a reasonable option for some people; the position of the second twin can still affect the plan. Your team may explain why a planned caesarean is safer in your circumstances.

Twin labour commonly involves close assessment of both babies, sometimes with continuous monitoring. The team prepares for changes after the first baby is born, because the second baby may need a different approach.

Attend scheduled appointments and scans so growth, fluid, placental position, and each baby's presentation can be reviewed. A Growth Scan can help your team assess development, although it does not predict every event during labour. Make a plan for pain relief, the place of birth, monitoring, and what would lead to caesarean birth. Ask who will be present and how the babies will be checked after delivery.

Call your maternity unit urgently for bleeding, leaking fluid, painful regular contractions, reduced movement from either baby, severe headache, visual changes, or sudden swelling. Seek emergency help for heavy bleeding, collapse, severe breathlessness, or severe continuous abdominal pain. Follow any personalised instructions from your maternity team, since twin pregnancies may have a lower threshold for assessment.

Ask: Which twin is closest to the cervix? Are both babies growing well? What monitoring will I need? Is vaginal birth suitable for me? When would you recommend Caesarean Section? What happens if the second baby changes position after the first birth?