Why You Can Totally Deliver Twins Vaginally
The other day I sat at the nurses' station at the hospital where I work as a labor and delivery nurse, chatting away to one of our doctors.
She mentioned a recent patient of hers, a mother who had given birth to twins. Expecting her to say something about the usual 48-72 hour stay following a c-section, I was surprised when she instead referenced the shorter stay that is common with vaginal deliveries.
“Wait, do you mean she had the twins vaginally?” I interrupted her.
“Oh yeah,” she said, waving me off with a slight flip of her hand, as if giving birth to twins vaginally was an everyday occurrence. Which, apparently, it is.
Call me crazy, but I just had this notion in my head that twins = automatic c-section. It's just far too risky to trust nature to the messy business of a twin delivery, right?
Well, as with most things, sometimes, mother nature really does know best.
According to the American College of Obstetricians and Gynecologists, vaginal delivery for twins is perfectly safe.The ACOG states, “Twins usually can be born vaginally if they both are in the head-down position. A vaginal birth also may be possible when the lower twin is in the head-down position but the higher twin is not.”
And the decision for type of delivery should not be based solely on doctor's preference. A 2011 literature review of the current studies found that not only is there not any evidence supporting c-section over vaginal delivery for term twins, but the evidence actually suggest that planned vaginal delivery is better for term twins.
Which is, of course, where most of the disagreement about twin deliveries remains–the issue of term vs. preterm babies. Because many twin pregnancies tend to have more complications (advanced maternal age, placenta issues, twin to twin transfusion syndrome, or other issues), many twin babies are born prematurely either on their own or by their provider's hand. In fact, 50% of twins deliver prematurely, making the issue of vaginal delivery a little more complicated.
With our cultural fears about how much that can go wrong in childbirth alone, let alone giving birth to two babies, it really is no wonder that the ACOG has given healthcare providers a lot of leeway in deciding for themselves what mode of delivery is best for twins. Some doctors continue to prefer vaginal delivery for uncomplicated pregnancies with twins who are full-term and in the best position, while others prefer to avoid any risky business and go straight to the c-section room.
But the bottom line is that you – as a patient – do have a voice and a right in deciding on the delivery of your babies. So if you find out you are expecting double the baby fun, don't assume you will automatically need a c-section. Explore your rights as a mother and decide, with your healthcare provider, what is best for all of you.
Did you have twins? How did you deliver them?