Like all labours, labour with multiples is a journey into the unknown. Will it start early? Will it be fast or slow? Will everything go well? Will I have a cesarean? How much will it hurt? It's impossible to know these things ahead of time. Some women with twins give birth without medications at 38 to 40 weeks while others give birth at 30 weeks by cesarean. As with any other labour, it is possible that unexpected events or issues will arise, which will change the plans you made with your caregiver.

Premature Labour

Multiples tend to be born earlier than singletons. Prematurity (being born before 37 weeks) is responsible for many of the problems multiples may have as newborns.

If you are expecting multiples, you may already have been counselled about the risk of premature labour, but how will you know if there is a problem? Use this link to learn more about the signs of premature labour.

Vaginal or Cesarean Birth?

All triplets and quadruplets are born by cesarean. Use this link to learn about cesarean births.

If you are having twins, your caregiver may also talk to you about the increased possibility of a cesarean birth. About 50 percent of women deliver twins by C-section and 50 percent deliver vaginally.

It is difficult to predict what will happen at the delivery of twins. Whether you have a cesarean or vaginal birth depends on many factors including:

• your health
• the babies' health
• the number of babies
• the position of the placenta
• the position of the babies in the uterus

The babies' position is usually the most important deciding factor for how the babies will be born. It is also the most unpredictable, because babies move so often during pregnancy! Twins can settle in many different positions.

If at least the first baby is head down, you have the best chance of having a vaginal birth. Sometimes it is possible to turn the second baby after the first is born. Discuss the delivery with your caregiver during the late stages of your pregnancy.

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