If you are having triplets or more multiple births, your doctor will perform a scheduled cesarean delivery. If you are having twins, your doctor will discuss with you options for delivery.
In a vaginal birth of twins, there are two separate pushing stages. After the first baby is born, there is a waiting period that generally lasts severa; minutes (but every birth is different). During this time your doctor will continue to monitor the second baby's position and heartbeat. If the baby was breech before, there is a good chance the baby will turn during the wait. If not, your doctor may decide to turn the baby internally or externally or deliver the baby breech (bottom- or feet-first).
Vaginal/cesarean section combination
In rare cases, one twin may be delivered vaginally and the second twin by cesarean section. This is needed if a medical emergency occurs after the first baby is born. This could be a cord prolapse, in which the umbilical cord comes out before the baby, or a placenta abruption, in which the placenta separates too early from the uterus, or if the baby's heartbeat does not tolerate labor. If your doctor detects a life-threatening condition with the second baby, he or she will perform a cesarean section to deliver the baby quickly.
Talk to your doctor before labor about your options for anesthesia. If you plan to deliver twins vaginally with no anesthesia, your doctor may suggest you receive an epidural even if no medication is placed inside the tubing. This will prevent the need for general anesthesia should you require a last-minute cesarian section.
Having twins or higher-order multiples (such as triplets or quintuplets) puts you at higher risk for delivering the babies prematurely. If your babies are born prematurely, they may be taken to a warming table for examination right away. This may delay your chance to hold your babies for the first time. Although this may be upsetting, remind yourself that your babies are getting medical care to protect their health. One or more of your babies may be taken to the neonatal intensive care unit (NICU) for special care. These units are filled with technology that may seem intimidating.
The staff there will do everything they can to ease your fears, answer your questions, and give you time with your baby. If you had planned to breastfeed, it is still possible. Your baby may be so early that the sucking reflex is not developed, so you can pump your breast milk to be fed to your baby through a tube or a bottle. If you go home, you can pump your breast milk to leave at the hospital for your baby's bottle feedings. If you want to breastfeed and your baby is able to suck, you will need to visit the NICU for feedings.
Leaving the hospital
If your babies are born prematurely, one or more may need to stay at the hospital while you go home. This can be very upsetting. Remind yourself that your baby is receiving needed health care and will join you at home as soon as possible.