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Do Multiples Equal Cesarean?
A Guide to Vaginal Twin Births By Neilia Sherman
The interval between the birth of twins is usually less than an hour. Dr. Hill says that there is no required time in which the delivery has to occur because the second twin is monitored very closely. In her book, Having Twins: A Parent's Guide to Pregnancy, Birth and Early Childhood (Mariner Books, 1991), author Elizabeth Nobel points out that putting the first twin to the breast immediately can stimulate contractions which will aid in the birth of the second twin. She attributes the high incidence of C-sections for twin births to the fact that medical schools teach doctors to do surgical interventions rather than training them to do breech births.
"Unfortunately, the extra difficulty in breech deliveries and the skill required to are reasons enough for many obstetricians to opt for a Cesarean," she says. She also explains that the generally smaller size of twins should make a breech birth easier than it normally is.
It is possible for the position of the second twin to change after the first is born. An internal version (moving the baby internally) can be done if the second twin is transverse. Doctors also sometimes try external version to avoid a breech delivery.
There are occasionally instances where one baby is born vaginally but the second is born by C-section. Dr. Hill says this is not unusual and happens in cases where there is a prolapsed cord or an abruption, resulting in the need for a prompt delivery of twin No. 2.
Marge Williams, of Edison, N.J., saw a team of doctors who specialize in high-risk births throughout her pregnancy. She believes that a twin pregnancy is high risk and should be handled by specialists. "A doctor who is used to delivering twins is going to be far less likely to do an automatic 'C-section' to avoid complications," she says. She was able to deliver vaginally the first twin was head down and the second one turned head down after the first was born.
