When is caesarean section recommended for twin and multiple pregnancy?

The birth plan depends on the number of babies, their positions, growth, placental arrangement, fluid levels and your health. If the first twin is not head-down, caesarean birth is commonly discussed. Other reasons may include significant growth concerns, complications affecting a baby, or a pregnancy where vaginal birth would be difficult to monitor safely.

When the first baby is head-down, some people may be offered planned vaginal birth after an individual assessment. The second baby can change position after the first is born, so the team prepares for more than one possible birth method and keeps continuous monitoring available.

Attend recommended scans and appointments so growth, positions and placentas can be reviewed. Ask where delivery will take place, which specialists will be present, and what happens if labour starts early. Pack your records and discuss pain relief, feeding plans and recovery support before the planned date.

Call your maternity unit urgently for contractions, leaking fluid, vaginal bleeding, severe abdominal pain, severe headache, visual changes or reduced movement from either baby. With multiple pregnancy, use the personalised instructions your team has given you about when to attend.

Which baby is presenting first? How do the placentas and growth measurements affect my options? What would change the plan to caesarean? If labour begins at home, when should I leave for hospital?