Twin VBAC- need info

[Katielady]

(cross-posted in birth professionals)

Hi all,

I'm a birth doula and a colleague of mine has a client who is seeking a vaginal birth for her twins. Her first birth was a cesarean. The client has been working with a hospital-based midwifery group and is starting to wonder whether they will truly support this as a vaginal birth. They've said they handle about one twin vaginal birth a year- not one twin VBAC, one twin vaginal birth. Is that typical? It sounds low to me, especially given the rising rate of twin pregnancies.

What questions should the client ask her providers?

Do most hospital-based midwives support twin vaginal birth? twin VBAC?

Do you think she may be better off with an OB who has lots of experience with vaginal twin birth than with midwives who are more used to singletons?

Any resources that would be helpful for her?

Thanks! :)

[AlexisT]

The hospital handles one twin vaginal birth a year, or the midwives? If the latter, that sounds about right given average practice volume and the rate of risk-out for twins. The fact that they handle ANY twin vaginal births is encouraging; many hospital based midwives cannot take twins. I's not even a question of whether they support it in the abstract; their conditions of practice forbid it. Many women don't even consider a midwife for a twin pregnancy. Twin VBACs are rare. This is partly statistics--the number of women who are pregnant with twins, a candidate for vaginal birth, AND a candidate for VBAC in general isn't huge--but more due to OBs being anti-VBAC with multiple pregnancies.

The rate of multiples has been rising, but AIUI, that's largely due to infertility treatment, and that adds a lot of wrinkles.

She may be better off with an OB who is known to be a proponent of twin vaginal birth, but this would very much depend on the doctors available.