Twin Homebirths and "requirements"

[turnquia]

I know each midwife is different, I'm more looking for what is most often done. So for those who here who participate in twin homebirths what are your "requirements" to attempt a homebirth.

1) Does position of babies matter? I'm meaning like do you require both vertex? (obviously transverse of first twin is an issue)
2) Does type of twins matter
3) How many midwives and assistants to you generally like present
4) Any special "requirements" for delivery (standing, hands and knees or whatever mom dictates)
5) How far away from hospital do you feel comfortable?
6) Is monitoring during labor increased?
7) Do you bring extra equipment that you wouldn't normally for a singleton?

Just curious, what overall what most midwives do. In my state the midwives vary greatly in experience and requirements and even if they will participate with twins at home.

If you don't do twins at home... why?

[JunipersMom]

For twins alot of midwives will ask that an ultrasound be done to see if each twin is in its own amniotic sac. Once that is established, usually at least one extra set of hands is helpful (if you are using a midwife who has a fully trained or almost fully trained assistant - I would think only one more person)
No extra equipment really - and no extra monitoring or special birth position. But a lotus birth with the first may be difficult depending on the length of the cord etc.. so that may be something the parents may need to compromise on a bit if necessary.

[mwherbs]

I don't have the experience- so don't really want to be a primary attendant -the option is available in the hospital locally too which makes it simpler
also my limited experience with women carrying twins- gave birth preterm- or had other issues like sized differences and one gal who had a couple prenatals and did a UC lost one of the babies and the other ended up hospitalized for a month

[homebirthing]

*This is an answer from my own twin homebirth (and I am also apprenticing to be a midwife with MY midwife)

1) Does position of babies matter? I'm meaning like do you require both vertex?

Mine could both be present breech. But we prefer the first one vertex. Iknew that I could push out two breech babies, so that was why everyone was comfortable with it.

2) Does type of twins matter.
Yes. They both need to be in two different sacs. Di/Di. I have been to a Mo/Di homebirth though and everything was great. So, no mo/mo...too dangerous.

3) How many midwives and assistants to you generally like present.
Three. One for each baby and one for the mother. We have two CPMs and one apprentice.

4) Any special "requirements" for delivery. (standing, hands and knees or whatever mom dictates)
Mostly what mom dictates. If any baby is breech though, hands and knees is usually the best position.

5) How far away from hospital do you feel comfortable?
We happened to be next to a zillion hospitals, but I bet within 30 minutes is probably average.

6) Is monitoring during labor increased?
Maybe it takes a little longer because there are two babies. I didn't notice an increase with mine. One vaginal exam after the birth of baby A to see how Baby B is presenting is normal.

7) Do you bring extra equipment that you wouldn't normally for a singleton?
No. With two midwives, you have double everything anyway!

[Gena 22]

Not a MW, but I did have a twin HB. My midwife's requirements are pretty much identical to Homebirthing's post.

One thing about monitoring. No need for more monitoring, but whoever's checking has to be really careful to make sure they get each baby's heart beat. It's easy to get one heartbeat, and then get the same one again. You'll need to know you got good readings on both babes.

[turnquia]

I wanted to bump this back up Thank you much for the responses given so far!