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<p>(cross-posted in birth professionals)</p>
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<p>Hi all,</p>
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<p>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.</p>
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<p>What questions should the client ask her providers?</p>
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<p>Do most hospital-based midwives support twin vaginal birth? twin VBAC?</p>
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<p>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?</p>
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<p>Any resources that would be helpful for her?</p>
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<p>Thanks! :)</p>
 

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