Giving Birth To Twins: What To Expect During Delivery?

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It’s double the joy when you are pregnant with twins. But the number of questions and concerns you have about the delivery could also be more in this case.

Is vaginal delivery a good idea? Will it be more painful in the case of twin pregnancy? How long will it take to give birth to twins? Will a c-section be less painful in the case of twins?

These are a few of the many thoughts that could leave you overwhelmed about giving birth to twins. Worry not. In this MomJunction post, we provide a guide to delivering twins, and also answer a few commonly asked questions about it.

Should You Go For A Planned Delivery With Twins?

Yes. It is good to discuss with the doctor and plan the delivery way before the due date. The doctor may recommend either a vaginal delivery or a c-section depending on your health and the baby’s overall development. A planned birth could prevent certain complications in the case of a difficult twin pregnancy.

Do You Need To Plan A Twin Delivery In A Hospital?

Yes, it is always safe to deliver your babies in a hospital that offers round-the-clock medical care. Regular monitoring of the babies is essential at the time of delivery to let the doctor plan the ideal method of delivery. Regular monitoring will also enable the doctor to check for any complications and suggest the right remedial measures in time.

What Is Full Term For Twins?

Usually, 36 to 37 weeks (gestation age) is considered the full term for a twin pregnancy. However, it might differ from one pregnancy to another based on the health condition of the babies and the mother, any complications and risks, and maternal age, among other factors (1).

[ Read: How To Conceive Twins ]

What Are Your Twin Delivery Options?

Vaginal delivery and a cesarean section are the two delivery options even in the case of twins. The doctor may suggest either of the two based on the overall health of the mom and the babies.

  1. Normal or vaginal delivery: According to a study, planned vaginal twin births are as safe as planned cesarean births (2). Your doctor will monitor you and the babies regularly. If there are no adverse health conditions and both the babies are in a head-down position, then both the babies can be delivered vaginally. Otherwise, the doctor will recommend c-section.
  1. Cesarean delivery: C-section delivery of twins is based on a lot of factors such as the position of the twins, health risks, the position of the placenta, and more. If you prefer a c-section to vaginal delivery, even though it is not necessary, talk to your doctor about it.

After understanding both the options, the final decision rests in the hands of the mother.

It is good to consult your doctor beforehand and clear your doubts about the delivery procedure.

In What Situations Is A Twin Vaginal Birth Possible?

Usually, normal or vaginal delivery is preferred if all the factors are favorable to it unless the mother opts for a c-section. Vaginal delivery is more viable:

  • If both the babies are in head down or a vertex-vertex position. However, it is uncommon for both the babies to settle in this position.
  • When the mother is healthy and has no health complications.

What’s Vaginal Twin Birth Like?

Every delivery experience is unique, whether it is singletons, twins, or multiple births. Talking to the doctor and planning a twin vaginal delivery way before the due date will prepare you mentally and physically for the procedure. Here are a few aspects of vaginal twin birth at the hospital.

  1. There will be a set of doctors, along with trained medical staff, in the hospital with you. The labor room might have two fetal monitors (among other equipment) to track the babies’ health.
  1. You may be given an epidural before the delivery for pain relief (3).
  1. Once the first baby is delivered, there will be an approximate time interval of 15 to 30 minutes for the second child’s birth (4).
  1. The labor could be longer or shorter, depending on the medical condition of the twins and mother.

In certain situations, the doctors would recommend against a vaginal delivery for twin pregnancies.

[ Read: Complications Associated With Twin Pregnancy ]

In What Situations Is A Twin Vaginal Delivery Ruled Out?

Factors that rule out the chances of vaginal delivery for twins include:

  1. Position of the babies: If the babies are in transverse or other abnormal positions, then a c-section delivery is recommended. In between 34 and 36 gestational weeks, if the babies are in the breech/breech, breech/vertex, or vertex-breech positions, then cesarean is performed (5) (6).
  1. Perinatal outcome: If the risks of perinatal outcomes such as neonatal morbidity and perinatal mortality are high, then cesarean birth for the twins is considered safer than vaginal delivery, especially after 36 weeks of gestation (7).
  1. Complications: High risks in pregnancy with twins are usually associated with preeclampsia, gestational hypertension, intrahepatic cholestasis (liver disorder), and gestational diabetes. These may increase the chances and risks of cesarean delivery (8).
  1. Growth retardation: This is ten times more common in twin pregnancies. If the doctor suspects this risk, they are likely to recommend cesarean delivery (9).
  1. Others: C-section delivery is also recommended when the twins share one placenta, you are diagnosed with placenta previa, labor is progressing slowly, prolapse of the umbilical cord, one baby or both babies are distressed, or if your previous pregnancy was complicated (10).

In some rare cases, where vaginal delivery for both babies and c-section birth of both is not possible, there could be a possibility of delivering one twin vaginally and the other by a c-section.

Most women get anxious about c-section, but can you avoid it? Continue reading to know more.

Is It Possible To Avoid A Cesarean For Twin Delivery?

Vaginal delivery is often the preferred birth method. However, if it is ruled out due to certain conditions, then a cesarean birth is recommended. Avoiding it even after the doctor recommends it could increase pregnancy risks.

[ Read: Symptoms Of Twin Pregnancy ]

Talk to your doctor about the delivery options, the care you should take to increase the chance of vaginal delivery, and the pros and cons of elective c-section. Find out about the procedures and voice out your concerns and get the doctor to address them to make an informed choice.

Did you have a twin pregnancy? How was your experience? Do share your experiences with us in the comment section below.


1. Carrying Twins Brings Risks – An Argument For Birth At 37 Weeks; American Council On Science And Health (2016)
2. Barrett JF et al.; A randomized trial of planned cesarean or vaginal delivery for twin pregnancy; The New England Journal of Medicine (2013)
3. Giving birth to twins or more: Your pregnancy and baby guide; NHS (2016)
4. W. F. Rayburn, J. P. Lavin, M. Miodovnik, and M. W. Varner; Multiple gestation: time interval between delivery of the first and second twins; Obstetrics and gynecology (1984)
5. Complications of Multiple Pregnancy; University of Rochester Medical Center
6. P. Olofsson and H. Rydhstrom; Twin delivery: How should the second twin be delivered?; American Journal of Obstetrics and Gynecology (1985)
7. Y. Dong et al.; Is Cesarean Delivery Preferable in twin pregnancies at >=36 Weeks Gestation?; (2016)
8. M. Jonsson; Induction of twin pregnancy and the risk of caesarean delivery: a cohort study; BMC Pregnancy & Childbirth (2015)
9. R. C. Vandenbosche and J. T. Kirchner; Intrauterine Growth Retardation; American Academy of Family Physicians (1998)
10. Giving birth to twins; pregnancy birth & baby


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