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Giving Birth to Twins: Twin Labor and Delivery Questions Answered

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Giving birth to twins was something I was terrified of when I first found out I was expecting twins. I had no idea what to expect, and the internet wasn’t exactly my friend! What complications could arise? What is considered full term? How possible is giving birth to twins naturally?

My search results were either not very comforting stories from other twin mom blogs, OR were way too impersonal.

I wanted to combine the best of those worlds in this post. My own personal experience, as well as the answers to the biggest questions about twin labor and delivery!

Giving Birth to Twins

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Frequently Asked Questions About Giving Birth to Twins

If you’re currently pregnant with twins, you’re probably still in shock. Most people that are trying to get pregnant aren’t trying to conceive twins!

You’re also probably wondering how on earth you’re going to survive (don’t worry I have a great blog post with tips to get you through your twin pregnancy).

You’re ALSO probably wondering a million things about twin labor and delivery. What is giving birth to twins like? What complications do you need to be aware of during a twin delivery?

I’m here with all of the answers to your questions about giving birth to twins… plus several questions you probably don’t even know you have!

What is Considered Full Term for Twins?

You don’t have to make it until your due date to be considered full term with twins. Twin pregnancies are considered to be full term at 37 weeks.

If your twins are born on or after 37 weeks gestation, they are not considered early.

Are Twins Born Prematurely?

Not ALL twins are born early; however, the odds are higher for a premature twin birth than a singleton birth.

The March of Dimes states that close to 60% of twin pregnancies are premature (prior to 37 weeks).

More than half of twin births are premature. That is pretty crazy to think about.

Do All Twin Pregnancies Result In Bed Rest?

Ugh, well, mine did! I was on hospitalized bed rest for 2 weeks before going into labor (I’ve got some great tips so be sure to click on the post if you end up on bed rest!

It is not extremely rare for twin moms to end up on bedrest, but it is not a given. I know a lot of twin moms, and I would say about under 50% of them ended up on some sort of bed rest during their twin pregnancy.

It is not a given, by any means.

Buuuut. Definitely prepare for it. It never hurts to be prepared!

When are Twins Usually Delivered?

The average twin pregnancy lasts 35 weeks. Twin moms that have their babies by 35 weeks either go into labor spontaneously, or have to be induced because of increased health risks.

Related — What to Pack In Your Hospital Bags for Twin Birth

What Complications Can Occur in Twin Births?

Twin pregnancies are considered to be high-risk pregnancies. Since there are two babies, there are more chances that things don’t go according to plan.

Possible Complications of a Multiple Birth

  • Premature birth: this is the most common complication of a twin delivery and one that I experienced.
  • PPROM: Preterm premature rupture of membranes is when your water breaks before 37 weeks in your twin pregnancy. It is usually treated with hospitalized bed rest and very close monitoring.
  • Gestational Diabetes: Twin pregnancies have an increased risk for gestational diabetes. If you have two placentas, your body can build up resistance to insulin.
  • TTTS: Twin to twin transfusion syndrome is a RARE but SERIOUS condition that can occur in identical twin pregnancies. It is when blood flow between the placentas becomes uneven and one baby is receiving more than the other.
  • Pre-eclampsia: Pre-eclampsia happens twice as frequently with twin pregancies.
  • Placenta Abruption: This is when the placenta becomes separated from the uterine wall and is more likely to happen during a twin pregnancy.

Related Post –> My Biggest Fears During my Twin Pregnancy

Is it Possible to Have a Vaginal Delivery With Twins?


It is possible to have a vaginal birth with twins.

While the odds are slightly higher for a cesarean section, it absolutely DOES NOT have to be that way.

I have met many people who simply assume that because I had twins I wasn’t able to have a vaginal birth.

During the intake for my new OBGYN, the nurse actually put in her notes that I had a c-section without asking me.

When she asked if I’d had any surgeries other than a c-section, and I corrected her, she even said “Oh, I assumed that since you had twins you’d had a cesarian!”

It is possible to have a vaginal birth with twins. My identical twin girls are living proof of that!

black and white picture of identical twin newborn girls sleeping. They are wearing headbands and wrapped in blankets.

You can read my twin birth story <– in this post!

Whether or not you’re able to have a vaginal birth with twins depends mainly on the positions of the babies in your womb.

Vertex/vertex: This position is when both babies are head down. Barring any other health complications, you should be able to try for a vaginal birth.

Vertex/breech: This is when the first twin, baby A is head down and the second twin, baby B is feet down. You should still be able to try for a vaginal birth, but some doctors won’t be comfortable doing so.

This was the position that my twins were in. According to my doctor, it was perfectly safe to attempt a vaginal birth (I had a prior vaginal birth with a singleton).

What happened in my situation, is once baby A was born, my doctor used pressure to manually flip baby B into the vertex position for delivery.

Breech extraction is also possible for baby B. This is when the second baby won’t flip and the doctor pulls the baby out by their feet.

Breech/vertex and breech/breech: If baby B or both babies are feet down, a vaginal birth is unlikely.

With a twin vaginal birth, you run the risk of having an emergency C-section for the second twin. Once the first baby comes out, there is no telling what the second baby will do.

With all of the newfound space, it is possible for them to flip around and have the umbilical cord wrap around their neck, or go into distress.

If either of these things happen you will need to have a C-section for the second twin. I can’t imagine anything worse than having to recover from both a vaginal birth and a cesarean section.

You can read more about the safety of a vaginal twin birth in this post!

Read –> How to Prepare for Twins on a Budget

giving birth to twins

Do All Twins End up in the NICU?

Not all twins end up in the NICU. It depends on their birth weight, ability to regulate temperature, breathe on their own, and feed (learning to suck, swallow, breathe is a skill that premature babies need to master).

There is an increased chance of your twins needing NICU time simply because there is a higher chance of twins being born prematurely.

My twins were born 8-weeks early, and were in the NICU for about 3 weeks.

Twins that are born full term, at healthy birth weights have a very good chance of skipping the NICU life.

Does Giving Birth to Twins Hurt More?

This honestly depends on so many things… your pain tolerance, whether or not you have an epidural or any other drugs, the size of the babies.

I birthed a 9 pound singleton effortlessly. Seriously, it was so easy and painless because my epidural was just perfect.

For my twin delivery, they came so fasted that my epidural didn’t have time to start working.

So for me? It hurt a freaking ton more to give birth to twins, even though their combined weight was over a pound less than my firstborn.

I also think it’s fair to say that even if it doesn’t hurt more, it hurts for longer.

I distinctly remember the relief after delivering baby A… and then immediately feeling the contractions and pressure again as my body prepared to deliver baby B and thinking “there is NO WAY I can do that all over again!”

Other posts you want to read…

Preparing For Twins On a Budget: Are you wondering how to prepare for twins financially? Preparing for twins on a budget is daunting but doable. #preparingfortwinsonabudget #preparingfortwins #expectingtwins #newborntwins #twinpregnancy #budget #registryguide #registryonabudget

8 Essentials for Twin Pregnancy Discomfort #twinpregnancy #expectingtwins #pregnancy #morningsickness

Is Giving Birth to Twins Harder?


It is just hard.

Giving birth to twins? It all depends on your experience.

I know there are mamas out there who had extremely difficult deliveries with single babies. Harder than my twin delivery. For sure.

I am not by any means at all trying to negate anyone’s birth experience.

But if I were to generalize… yes… it is harder to give birth to twins. It is twice as much work, twice as much pain, double the pushing… and then the placentas… don’t get me started.

But rest assured that no matter how hard or easy your twin labor and delivery is, the results are two amazing babies and it is so worth all of the pain!

giving birth to twins

What About Giving Birth to Twins Naturally?

Many people wonder if it is possible to have a natural birth with twins.

A natural birth is a birth without an epidural or any pain medication.

There are doctors that advise against having a natural birth with twins because if you need an emergency cesarean delivery, there might not be time to get an epidural. Having a c-section without any anesthia sounds like jsut about the worst thing in the world to me!

But it is totally possible to deliver twins naturally. I know people who have pushed out two babies with no drugs.

I advise listening to your doctor… but also do your own research.

If your doctor isn’t comfortable with the birth that you want, then get a second opinion. There are many extenuating circumstances with pregnancies, and with a twin pregnancy, there are twice as many risks.

Things You Won’t Think to Ask But Need to Know About Twin Labor and Delivery

You Will Probably Deliver on an Operating Table

It is common practice for most hospitals to have twin moms deliver in the operating room. I’ve heard many twin moms complaining about this, but I was completely fine with it.

Is it as comfortable as delivering in a delivery room? No. However, it is safer.

There are so many things that can happen between the birth of baby A and baby B. Once baby A comes out, there’s suddenly an influx of space for baby B.

This could cause all kinds of problems that result in an emergency C-section. I’d personally rather be right where I need to be in case of emergency, than have to be rushed down the hall to another room.

In the majority of cases, baby B comes out perfectly fine after baby A.

But on the off chance that there’s a problem? You’re in the operating room, ready to go!

Infant twins in white shirts with blue eyes.

You Might Not Know if They’re Identical or Fraternal

We didn’t know if our girls were identical or fraternal until we did a DNA test when they were over a year old.

If you have one placenta, they are definitely identical.

If you have two placentas and they are different sexes, they are definitely fraternal.

If you have two placentas and they are the same sex, the only way to tell if they are identical or fraternal is by doing a zygosity DNA test.

Click here to read about our experience doing a zygosity DNA test and more facts on identical versus fraternal twins!

Black and white picture of newborn twin girls wrapped in blankets in identical poses.

Both Babies are Born Before the Placenta(s)

Yes, that’s right! Even if you have two placentas, you will deliver BOTH BABIES first… and THEN the placenta(s).

Newborn twin babies sleeping under a blanket.

Constant Fetal Monitoring is Common Practice for Twin Labor and Delivery

This is definitely something to be prepared for. They will likely recommend having constant fetal monitoring for both babies.

Fetal monitoring will limit your ability to get up and move around. If this is an important part of your birth plan, be sure to talk to your doctor about it prior to giving birth.

You Will Freak Out on the Ride Home

On the ride home from the hospital, you will likely be thinking…. “Did they seriously let us leave with TWO babies?! We aren’t ready for this! We need help!”

Don’t worry. Deep breaths. Many parents have raised twins before you, and you will do just fine.

New twin parents holding newborn twins sitting on their bed after getting home from the hospital after giving birth to twins.

You Might Not Be Able to Tell Them Apart (Even if they’re fraternal!)

Our twins were identical girls, so of course, we mixed them up on occasion (heck, they are 3 and we STILL do!)

I always thought it was simply because, well, they are identical. However, I’ve spoken with other twin parents who have mixed their twins up… even if they are boy/girl twins!

Now, obviously with a diaper off, it’s easy to tell them apart, but fully clothed? Babies can all look similar even if they aren’t identical!

You Might Bond More With One Twin

You might feel a closer connection with one twin. Don’t let this bring on twin mom guilt; it’s very normal.

It doesn’t mean you love or care about your other twin ANY less.

P.S. Make sure you’re following me on social media to keep up with our family and all the twin cuteness! I am on Instagram, Facebook, and Pinterest!

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