[name]Hi[/name].
Im expecting twins late november early december.
Im genuinely curious from those who have experienced it, is delivery much different with twins?
I have of course asked this of my obgyn but i actually would like to hear from more first hand point of view.
Thank you 
I haven’t had the singleton experience, but I imagine it is a bit different! Once the first baby was out I didn’t have much time to meet him before I had to work on getting his brother out too! In fact, as soon as twin 1 was out it was the job of one of the midwives to grab my stomach (literally!) to keep twin 2 from moving out of position. They then had to do an ultrasound to be sure he was still properly oriented to continue with the normal delivery. My boys were born 20 minutes apart.
Another thing that I imagine was different was the number of people in the room. I delivered in [name]Sweden[/name] where it is the norm for midwives to do the deliveries, but in the case of twins, I had a midwife for each baby, one for me, a pediatrician and an obgyn too! Plus nurses and even an intern (it was a teaching hospital).
Good luck with your delivery!
I have assisted with the delivery of a few sets twins and triplets, does that count?
For starters, twins automatically equal a high-risk delivery. [name]Both[/name] twins have to be in a vertex (head-down) position to attempt vaginal delivery. It is an unacceptably high risk to breech-deliver twins, or to attempt an external version (flip) of Twin B once Twin A is delivered. Secondly, many twins, even fraternal ones, eventually end up sharing the same placenta. After the birth of Twin A, the placenta can start to detach from the uterus-- as is normal. Except Twin B still needs that placenta to be attached in order to live, otherwise he will be starved of oxygen. Therefore both twins must be continuously monitored during labor to make sure no signs of distress occur in either baby. Thirdly, twins can get wrapped in each other’s umbilical cords if they’re monoamniotic, or they can smoosh each other’s umbilical cords if they’re diamniotic. Again, you must continuously monitor both babies throughout the entire labor to make sure there’s no unwanted interference with each other.
Not to open the entire natural childbirth / homebirth / birthing center/ whatever can of worms-- really, really don’t want to open it-- but anything you might have read advocating for no epidurals, no continuous fetal monitoring, etc doesn’t apply to twins. As I hope I clearly stated above, they have unique complications that just don’t apply to singletons-- particularly the problems re: interfering with each other’s oxygen supply via cord compression or early placental detachment. You need to be mentally and physically ready to have a c-section at any point in your labor due to these very real concerns. If you don’t want an epidural, you must accept the fact that you will be administered general anesthesia for a c-section and will therefore be unconscious for the birth, if that’s the way things go.
Lastly, as you know, twins are born early, on average, and they’re smaller than singletons. A pediatrician will be present for the birth and, depending on how early you deliver them, they might need a NICU tune-up afterwards based on their lung maturity, or lack thereof. Since each baby is, on average, smaller, often the birth itself (if they’re vertex and no problems manifest) is a bit easier, so that’s cheering news!
Lastly, for twins who share a placenta (which again can be fraternal twins as well as identical twins) there is a small but very serious risk of something called twin-to-twin transfusion syndrome. I recommend reading a bit about it since you will be closely monitored for it at the end of your pregnancy if your twins are monochorionic, and if it comes up it will dramatically change everything.
Zaelia’s experience was a bit like mine, but I had a home birth with my twins.
[name]Blade[/name]'s advice/knowledge is a very comprehensive and normal medical view of a twin labor and delivery. The only thing I’m confused about is the placenta thing. It is true that most twins placentas fuse together (even fraternals who had separate ones in the beginning - our first set of twins had this happen - they are fraternals and this set is most likely also due to our history, but we can’t be 100% sure yet since they are same gender and could have split early). It was my understanding that fusing together was just a literal fusing (sticking?) together - not a sharing of blood supplies or blood vessels. When my girls placentas were viewed as fused together they never worried about a risk of twin-twin transfusion.
What type of birth do you want? Were you just looking for some information about what L&D will be like (they often deliver twins in the operating room in case one flips or they need to switch to an emergency C-section), some potential complications and considerations, and procedural items? If so, I think [name]Blade[/name] did an excellent job at explaining that. Pretty much what your OB will tell you I’m sure.
It’s a little late in the game to explore a birth center or home birth type experience for your twin delivery since you are due so soon, but I do want you to know that the potential complications and considerations for twins are real… but they aren’t definites or even factors in many cases.
For example, you should know at this point if your twins are in one sac/sharing one placenta. If they are not, that eliminates some of those risks right off the bat. Are they both head down? Well that’s great and as long as A stays head down, they CAN do a breech delivery of B (A has “cleared the way” so to speak). Talk to your OB about his or her plans for delivery in that regard. If B moves to breech after A is delivered, would they make you have a C-section? Could you attempt a 2nd vaginal birth? I’d be prepared with your preferences about that topic before you find out the doctor’s preference. Educate yourself on the risks/benefits and you should be allowed to have your own preferences when its something within reason.
My twins were born at home with a midwife at 37.5 weeks. They were over 14 pounds combined and completely healthy. [name]Both[/name] were head down for many weeks- I had many ultrasounds during the pregnancy. I was seeing an OB AND the midwife who ultimately delivered them the entire pregnancy (paid for the midwife out of pocked cause insurance would not covery both obviously). They were 45 minutes apart. We did external fetal monitoring on B after A’s delivery and applied some pressure to encourage B to stay head down (which she did) during the wait. We were prepared/open to B being breech if that happened though. We also had a plan in place for transport to the hospital at any point during the labor/delivery and I knew that would mean I would need general anesthesia if a C-section was warranted. My husband is a physician and he wasn’t immediately (we’re talking 1st trimester here) comfortable with the idea or plan AT ALL… but I shared my research and after speaking to the midwife a few times and praying together about it all, he changed his mind and completely supported me with this decision.
[name]Just[/name] to add something that wasn’t clear in my original comment, twin 2 was breech in my case. My doctors and midwives were not opposed to delivering him vaginally since he was the second baby. They explained it to me that the concern about delivering breech is that since the head is the biggest part, you could get the entire baby out except the head only to discover that there isn’t room for the head which obviously would be a very serious situation. Since the first baby was head down they were not worried because if he had the room to come out, it was pretty sure his, smaller brother would too. They grabbed him to be sure he didn’t change position to become transverse (as least I think that is what they call it) which would have required a c-section.
I delivered them in a normal labor and delivery room, not in an OR. While my birth plan had been to have a walking epidural at the strong encouragement of my doctors (since it was twins), once I got there I really didn’t want one since it would have required me to remain lying down for an extended period of time which was terribly uncomfortable. I did use nitrous oxide though.
@zaelia-- exactly. If Twin B is smaller than Twin A some OBs feel comfortable trialing a vaginal breech birth for #2. As she said, the worry is that even in a frank breech position the head is still the biggest part of the baby. In a normal vextex birth, if the head is too big to exit the pelvis you still have an option to safely deliver the baby-- csection, since the baby is still in the womb. In a breech, the body is out of the womb entirely so a csection won’t accomplish anything; the head alone remains inside and is stuck. You have essentially no options to get the baby out, except to push the baby back up into the uterus and then attempt a csection. This is called the Zavanelli Maneuver and it is not very successful; most babies either die or are profoundly neurologically damaged as a result.
I not only work in the medical field but also have delivered twins vaginally. I am an ER physician, however, and only have a limited amount of training in obstetrics.
My first daughter was delivered vaginally through a natural water birth. It was beautiful and everything I had ever dreamed of. Only my husband and midwife were in the room with me during the birth.
I delivered my twins vaginally in [name]September[/name]. They shared two separate placentas, as they were fraternal (boy and girl). Although we did not know the genders going in to labor. I was aware that there was a very high chance that I would have to go to have a c-section but since I work closely with the OB/GYN, I was very firm about my wishes to deliver vaginally. I did not get my natural water birth as I did with my first child, but did not use any epidurals or pain management.
At one point, we almost ended up having a C-section because one of the baby’s heart rates dropped for what felt like an hour but really was only a 1-2 minute period. They manually shifted him slightly in my abdomen and his heart rate went back to normal again. I was given the go ahead to begin delivering vaginally.
We had many more people in the room with this birth–an OG/BYN, a resident, several nurses and PA’s or NP’s. As a previous poster stated, I did not get much time with my daughter before she was taken away so I could deliver my son. The birth process was also much more laborious (no pun intended) as after the first one, I felt a giant relief, despite still having contractions. I felt the urge to stop but knew I could not. My children were delivered on a bed and not in a pool as with the first child.
My twins were born somewhat premature (3 weeks). My daughter was born 6 pounds 5 ounces and my son was only 4 pounds 11 ounces. My daughter was able to go home with us the next day but my son had to stay in the hospital for 4 days on oxygen. He was the one whose heart rate had dropped prior to the birth. It was very hard but this can happen even with singletons.
I’d have to say that honestly delivering twins vaginally was the most difficult thing I have ever done in my life and I pray to God that I do not become pregnant with multiples in my next pregnancy because I don’t think I’d have the guts to go through with it again(once again, no pun intended); I’d opt for the C-section. I don’t regret my decision but I don’t know if I could do it again.
I am, however, glad that I was so adamant about having a vaginal birth (if possible) because I do plan on having another 1 or 2 in the future and after a C-section, uterine scar tissue tearing is common and many other complications can arise secondary to having a C-section.
I wish you the best in your decision.