Twin Birth Index
Compiled by LLM
Photo supplied by Patti
Ramos Photography. All rights reserved.
Following are stories, quotes and articles that
speak of the safety of twin vaginal birth. Please
email Leilah
if you have a birth story to share.
Click to go to the desired section of the page:
First, from Elizabeth Noble
Excerpt from "Having Twins…and more"
In this incredible book excerpt, many natural
twin and supertwin births are discussed; including
the home VBAC of triplets! This also includes
good reasons not to circumcise twin boys.
Twin Birth Stories
 Twin
Homebirth Lorrie, mother of twins and midwifery
student, attends a beautiful twin homebirth that
brings healing from her own interventionist birth.
The twins were born very early, but are doing
very well, despite a touch of jaundice (treatable
at home, with the right doctor).
The
Births of Amy Noelle and Nicole Faith Patricia,
a registered nurse, gives birth at home to twin
girls; the first girl being born into water. Patricia
had been planning to go to the hospital, but things
happened too fast to transfer. This links to Patti's
other stories on BirthLove, including her first
homebirth story (her second child) and her third
child's breech birth story. Many lovely photos
are included.
A Bittersweet
Twin Tale A mother gives victorious twin birth
in the hospital- despite being induced with Cytotec.
Epilogue
Lorrie adds more of the story, as well as talks
about all she has learned since this pregnany-
and how she's applying her knowledge to her new
pregnancy.
Natural Twin Birth: "So what's so abnormal
about it?!"
"We recently had a client that wanted
a hospital birth with her twins. The first one
was cephalic [head presenting] and the other
breech. They were non identical. They were her
2nd pregnancy.
"She birthed the first one on all fours...
then after hour and a half (their hospital policy)
they started wanting us to put up the synt [induction
drip].... we refused on behalf of our client,
and used skin to skin contact and breastfeeding.
She birthed the second one (not in lithotomy
[flat on her back] which was what the doctor
wanted, but on all fours, her choice) two hours
later. She had no episiotomy and a physiological
third stage [no shot of oxytocin to make the
placentae be born].
"We were clued up, and for all their interventions
we were ready with what our client wanted. She
had no continuous monitoring at all, just intermittent.
Our client wanted to greet the first twin before
she was rushed into having the second one. Next
time she swears she'd have them at home.
"Incidentally, each time they gave us
their medical opinion we declined, they documented,
and everyone was happy. I am far from convinced
of this twins automatically high risk thing...
isn't this the same argument as PROM [premature
rupture of membranes- waters "breaking"
before birth]? if mother nature gives us twins
what's abnormal about it??????"
-Eleanor Peck, Independent Midwife
www.independentmidwives.co.uk
Becoming
a Grandfather John Robbins' grandchildren
were intended to be born at home in the water;
but when his daughter-in-law Michele's waters
broke two and a half months early, she was forced
to give birth in a high tech hospital. What followed
was a profound lesson for the whole family in
love, dedication and humility. Note that "Kangaroo
Care" did wonders for the boys, who had a
50% chance of being born with hemophilia.
The
Birth of Rose and Amelia Andrea, a New Zealand
mother of ten, shares her twins' hospital birth
story- two great big, full term baby girls. Note
that her midwife shines in this (and the OB doesn't).
My
Twins' Hospital Birth Holly is a student midwife
who had her other children at home, but decided
on a hospital birth with her twins due to her
extremely fast births. She is passionate about
women demanding and creating the births they need
to give.
Twin
Birth to Remember A midwife talks about a
twin birth where the doctor did a full breech
extraction with the second baby. Would the birth
have been the same at home? She's not sure, but
glad the mother was in the hospital.
Birth
Story of Saige and Claire Kerri gave birth
to full term babies, naturally, at a Canadian
hospital with an OB and midwives attending. This
includes how well Kerri stood up for herself to
avoid interventions, and a bit about her beautiful
breastfeeding relationship. Includes photos.
No
Birth... Just Pain Christina's OB
broke her water (without notification or permission);
likely as a result one of her twin's hands descended.
What followed was a deeply traumatic cesarean
that she feels intensifying grief over at five
weeks postpartum.
My
Many Blessings Melissa's first twin was born
at home unassisted; her second with a midwife
attending. This includes full detail of the birth
(amazing!), and much afterwards, as Melissa recalls
her early days of life as the mother of twins.
Andrew
and Ian Rosevear's Birth Story This twin birth
happened naturally in the hospital. Note that
links to photos, resources, and more are included
at the end.
Janice's
Twin Homebirth Written by the midwife, this
story describes the gentle homebirth of markedly
different babies.
Elainie's
Twin Homebirth Story A first-time mother gives
birth to twins at home at 42 weeks gestation,
while attended by a midwife. Includes photos.
The Lonely,
Sad Pain of Her Cesarean "I had a c-section
3 months ago for my twin girls, and I felt and
still feel completely alone regarding the pain,
physical and emotional, I went through."
Wild
Women Like Us This empowering story includes
mention of Alison's twin homebirth.
from Birth
Story of Saige and Claire
VBAC Twin Birth
Question:
"Can I stll have a homebirth after cesarean
if I'm carrying twins?" Cindy
answers this question with a story of a friend
whose birth she attended: the first baby came
out with ease; the second baby, who was lying
transverse (across the top of the uterus), could
actually be seen to turn in a miraculous descent
before being born with ease.
VBAC Twin Homebirth
"Would like to share with you all normal
births I attended early this morning as third
midwife. It was Paula's third pregnancy. History
1st pregnancy elective cesarean for a breech
presentation. 2nd Pregnancy happy home VBAC.
This pregnancy dizygotic twins, the sadly usual,
and to me daft, medical advice.
"Paula engaged the services of Independent
Midwives and planned a home birth. I asssisted
two colleagues and we had very normal, quite
quick, and relatively easy labour and birth
of twins at home. Twin 1 was born headfirst
with Paula kneeling, Twin 2 was coming head
first but as he was rather slow to descend Paula
used an improvised birth stool to have gravity
aid descent, and then pushed him out on the
stool. As is not uncommon he needed a little
help with bag and mask to get his breathing
going, but we had anticipated this and bag mask
and heated pad were ready and waiting. Normal
spontaneous third stage. I am unclear whether
a Twin VBAC at home is 'normal' but it certainly
seemed so to me this morning." -Mary
Cronk
Advice
to a VBAC Mom who is Pregnant with Twins How
to have a full term pregnancy, and help with self-doubt
by Gretchen Humphries.
Excerpt
from "Having Twins…and more"
This includes the home VBAC story of triplets!
Vaginal
Birth with Twins after Previous Cesarean Section
This page contains many references that show that
vaginal birth is a very safe option for women
finding themselves carrying twins after previous
cesareans.
from Elainie's
Twin Homebirth Story
Articles and Quotes about
Twin Birth
My
Guidelines for Care of a Woman Expecting Twins
by UK Independent Midwife Mary Cronk.
Included: ways to help ensure a healthy outcome
in pregnancy and birth, signs that indicate medical
help may be needed, and the story of a twin home
birth that Mary attended (a woman with elevated
blood pressure having her first babies).
Woman
Delivers Twins in Parking Lot The mother
says at the end of it all- "We would have
been better off staying at home."
Should twins be induced at 38 weeks?
"The literature supports inducing twins
at 38 weeks because the supposed gain of leaving
the twins in there longer is offset by the increasing
inability of the placenta to sufficiently nourish
the babies. IN THEORY, I suppose this
could be justified, but I have also collaboratively
managed a set of twins with him last year, and
we were able to negotiate leaving the twins
in utero unless they showed signs of decreasing
viability - i.e. non-reactive NST's or greatly
reduced AFI, etc. They did not do that,
of course, as the mom was well-nourished and
she went into the hospital at 40 weeks, after
two days of black and blue tincture, at C/4cms/-1
and I caught the first vertex twin and the perinatologist
skidded in the door for the second vertex one.
"Boys were 7 pounds and 6 pounds 5 ounces
and went home the following day. The hospital
staff was in awe- no interventions other than
a hep lock, in the LDR room, on her side, intact
perineum, etc. All the bells and whistles
of a home birth but with two attendants, since
twins are out of the FLorida Licensed Midwife
protocols. Parents were ecstatic and it
earned us major brownie points with the hospital
and that doc has become one of my staunchest
supporters.
"Personally, I believe that a well-nourished
mom will grow two babies just the same as she
would a singleton, and I was not at all concerned
about her approaching term, but we had to prove
that to the perinatologist. He was convinced
and has initiated that protocol for many of
his twins, as long as there are no other risk
factors. Many of them now go to term,
and spontaneous labor...."
Vicki Taylor, L.M., C.P.M.
Mama's Cradle
Pensacola, FL
Comment by Independent Midwife Mary Cronk:
"There is no advantage in inducing twins
at 38 weeks. In fact there are all the problems
associated with artificially starting and driving
labours. The five sets of twins we helped be
born in the last year all went to 40+ weeks.
Most women, once they are at peace with their
care and carers, labour when they and their
babies are ready."
From the book "Having Twins" by Elizabeth
Noble:
"Interestingly, in a survey of the records
of the Chicago Maternity Center from 1901 to
1933 presented at a 1988 Nortwestern University
conference, the perinatal mortality rate was
about the same as today. All of those multiples
were delivered at home, deliverd by midwives,
nurses and medical students to a population
consisteding mainly of immigrants living under
adverse socioeconomic conditions....All the
high-tech intervention and enormous expense
that surround the delivery of supertwins today
have not significantly improved outcome."
Note that this book features modern-day twin
homebirth stories.
Interlocking heads in twin birth?
One midwife says-
"I was taught that breech, vertex (in
that order) twins was a dangerous combination
to deliver vaginally because the heads may interlock
as the breech twin comes out."
Another midwife comments-
"I just look up the odds of locked twins-
breech to vertex [head down]- wondering just
'how dangerous' it is... or how likely it is
to occur. Yes, it is dangerous. Yes, it can
be a disaster. Yet it is almost IMPOSSIBLE for
full term twins to lock!
Do you want to know the odds the textbooks
give to this danger? Some books say interlocking
breeches are 'excedingly rare', 'very rare',
or 'very rare indeed', but Williams Obstetrics
gets specific. Williams says, to quote:
"Locking of twins is said to occur about
once in 90,000 deliveries, which would be
approximately once in 1,000 twin births."
I did not mistype this- the odds are 'one out
of one thousand twin births'. So, I'm thinking
to myself 'hmmmm. I just wonder how many thousands
of cesareans have been done because of the fear
of a 1/1000 chance of locked twins?'"
A doctor replies to the second midwife-
"I believe it is rarer than what you say.
I have always said that it is more like 1 per
10,000 twins. Perhaps it is 1/1000 in the case
where the first twin is breech and the second
is vertex, which is much less common than the
other way around.
There is no question that interventionists
have used the euphemism of 'locked' to do much
mischief, as if their interventions are 'safe'."
-Bob Doughton MD
From aother midwife about interlocking heads:
"I have often wondered about 'locked'
twins as described in the textbooks. Looking
at the diagrams and texts, it seems to me that
the various authors have done a cut and paste
job for the past sixty years. I think it is
a potential problem, possibly more likely in
the higher parities with the associated poor
abdominal musculature compounded by the poor
nutrition of sixty plus years ago. While one
should always keep these things in mind, I have
personally never seen or heard of a case, and
I have been around a long time." -Mary
Cronk
Studies about Twin
Birth
Folic Acid Could Raise Odds of Having
Twins- Study
LONDON (Reuters)- Women taking folic
acid during pregnancy to prevent spina bifida
and other birth defects could be increasing
their odds of having twins, a magazine said
on Wednesday.
Researchers at the Tornblad Institute in Lund,
Sweden, have discovered that Swedish women who
took the vitamin supplement in the late 1990s
had twins nearly twice as often as the general
population. Bengt Kallen, who led the research
team, said more studies are needed to confirm
his results, but for some women the case for
taking folic acid may not be so clear cut. "I
think one should consider the pros and cons-
especially in areas like Sweden with a low rate
of spina bifida," he told the New Scientist
magazine.
Medical studies have shown that folic acid
taken during pregnancy or before a women conceives
helps to prevent a variety of birth defects.
New Scientist said the link between the vitamin
and multiple births still needs to be proved
because the higher rate of twin births could
be due to unseen confounding factors. "No
one is suggesting that would-be mothers should
stop taking folic acid. In many countries, even
if the link is confirmed, the vitamin's benefit
will still outweigh its disadvantages,"
the magazine said in an editorial. "The
implications of the Swedish findings need swift
investigation," it added.
Reuters Jul 25 2001 2:52PM
Vaginal
vs. Cesarean Birth of Triplets Research
shows that triplets born vaginally have better
outcomes, largely due to vaginal birth's protective
influence against respiratory distress syndrome
(RDS).
When the second twin is breech
Intrapartum management of nonvertex second-born
twins: A critical analysis.
Am J Obstet Gynecol 2001 Nov;185(5):1204-8
Winn HN, Cimino J, Powers J, Roberts M, Holcomb
W, Artal R, Amon E.
Department of Obstetrics, Gynecology and Women's
Health, Division of Maternal-Fetal Medicine,
St Louis University/St Mary's Health Center,
and the St Louis University School of Public
Health.
OBJECTIVE: Our purpose was to assess the impact
of the mode of delivery-vaginal delivery versus
cesarean section-on the perinatal outcomes of
the second-born breech twins.Study Design: This
study was a retrospective analysis of second-born
breech twins with a gestational age of >/=24
weeks at the onset of labor. The patients are
divided into three groups: cesarean section
without labor (group I), cesarean section after
labor (group II), and vaginal breech delivery
(group III).
RESULTS: There were 141 patients: 40 in group
I, 66 in group II, and 35 in group III. There
was no birth injury or neonatal death. Group
II had one fetus with grade II intraventricular
hemorrhage. There was no significant difference
among the groups with regard to gestational
age, birth weight, hyaline membrane disease,
Apgar scores at 1 and 5 minutes, and cord blood
gas indices, except venous pH in infants with
birth weights <1500 g.
CONCLUSIONS: Vaginal delivery of breech second-born
twins, with gestational ages of at least 24
weeks, especially those with birth weights of
>/=1500 g, appears to be a safe alternative
to cesarean section.
PMID: 11717658 [PubMed - in process]
For more about breech birth, go here.
For more about VBAC birth, go here.
Links to Twins' Webpages
9
signs and symptoms of twin pregnancy -some
ways to tell, by a midwife.
The
Twin Miracles by Robin Elise Weiss at About.com.
This is her twin homebirth story, with photos-
a must-view resource.
For a homepage on twin pregnancy and birth, go
to So...You're
having twins? by Gretchen Humphries.
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