I've got nothing for you that's not anecdotal, I know a few people who have very successfully birthed twins at home and one who had a perfect twin UC. I have heard of bad outcomes (vary degrees of "bad") on the internet, but never known anyone with a bad outcome personally. I have not been able at any point to find research, pointing either way, I felt comfortable with because it just hasn't been done.
As for what **I** would do:
- I would plan to HB.
- If I couldn't find a MW who would attend me in my state, I would look in another state close to me.
- If I couldn't find anyone who would attend at home, but would attend in hospital for a vaginal birth, I would look into their actual rates and find out if they were ACTUALLY supportive of a vag birth.
- I would UC before I went to the hospital for a c/s if I couldn't find a MW who would attend me and couldn't go vaginally in hospital.
HOWEVER, I would also invite WAY more testing, ultrasounds, etc into my prenatal plan and I would sincerely work to make sure that I was doing everything in my power to birth as safely as possible. If a test or ultrasound showed something that made things "less than perfect" for HB...depending upon what it was, I would proceed or schedule the c/s. There are some things they could find that I would be OK with at home and there are some things that I would NEVER ever risk.
For the record, I'm a 28 year old in good health, never had a pregnancy or birth related complication and easily handled two natural childbirths with no help from anyone. Those things all factor in for me. If I started to have blood pressure problems or even if I was just getting gut feelings like maybe things were turning fishy, I would try really hard to let go of feeling "Steadfast" and would open myself to the possibility of selective sectioning. I don't worry about positioning, or even things like cord prolapse or rupturing. In my mind, those are actually lower end risks and for things like positioning, there are ways -very old and tested ways- to safely welcome babies in all manner and position. Prolapse just isn't a big enough risk for me...again, there are ways to try and avoid that and the risk, in my mind, is less "spooky" to me than the risks associated with c/s.
BUT when you start talking TTT, mono/di cord questions etc etc....or any indication that there is a problem with one or both babies that MAY require immediate care...well, then I start feeling spooked. I think twin pregnancy is pretty normal. I think the chances of things going wrong are still fairly small. But I do feel there are subtly elevated risks. I am normally a WAY minimalist when it comes to prenatal care...but with twins, I would insist on closer monitoring of the pregnancy, would want more ultrasounds, etc and would be much less attached to my homebirth plans.
Sorry that's so much. Look, I'm a fierce homebirther. I stand by homebirth completely. I stand by UC completely. I stand by HB and UC for women even in situations that I wouldn't HB or UC. I believe in birth choice. I can only think, off the top of my head, of a few pretty rare circumstances under which I would sign up for a c/s selectively. But they exist....and I think that knowing they exist and preparing for both ways (or any number of other options) is important.
It's interesting to me, to re-read this post and realize that after my DDs birth or even after my DSs birth...I wouldn't be writing a post like this. My post would have been absolutely ragingly 100% pro-homebirth. But you know, I've been blessed with two completely perfect births, two completely perfect outcomes and two completely perfect, healthy kids. And those facts lead me to feel MORE cautious about birth. Over the last three years, I've had these amazing births, fallen in love with these two amazing kids and have come to realize where my priorities lie. This life I've built is so precious and seeing them growing so fast and perfect in front of my eyes has made me realize that I don't want to take this for granted for even a moment.
If my first pregnancy or even my second, had been a twin pregnancy, I would have fearlessly charged forward with a planned homebirth...with or without a MW and wouldn't have been fearful about something going wrong. If I were to find out that this pregnancy was twins, I would be much more committed to very thorough prenatal monitoring and would do whatever I had to, to feel comfortable that I was going into my birth, wherever it ended up happening, with open eyes and good information.