Twin Home Birth study just released!

This study follows 100 sets of twins attended at home by an obstetrician, the first publication looking exclusively at twin home birth.

• link to the published study

  
  

• link to the birthing instincts podcast with Dr. Stu

High Vaginal Birth Success Rates for Twin Pregnancies in Community Settings: A New Study's Insights

Twin pregnancies are often categorized as high-risk, leading to frequent cesarean deliveries in hospital settings. However, a recent study of 100 twin pregnancies planning community births has revealed promising outcomes that challenge the conventional approach to twin birth. The study, which analyzed outcomes over a 12-year period, shows that when attended by a skilled obstetrician with extensive experience in twin births, community births can offer high rates of vaginal deliveries with minimal maternal or neonatal complications.

Key Findings from the Study:

• Vaginal Birth Success: A striking 91.3% of women who went into labor under the care of a community practitioner had vaginal births. Interestingly, vaginal birth rates did not vary significantly based on chorionicity (whether the twins shared a placenta) or whether it was a woman’s first birth (primiparous) or a subsequent pregnancy (multiparous).

• Low Cesarean Rate: Despite the common assumption that twins require cesarean sections, the cesarean rate in this study was relatively low—only 8.7%. This highlights the potential for vaginal birth even for twin pregnancies, especially when the care provider is skilled and experienced.

• Safety and Outcomes: No serious neonatal morbidity was recorded for babies born in the community setting. There was only one postpartum transport to the hospital for the mother, and one baby required post-delivery care. The study also noted that all babies were born at or near full term, with an average gestational age of 39 weeks.

• Transfers in Labor: A total of 8 women (11.6%) required transfer to a hospital during labor, with 6 of these transfers resulting in cesarean births. However, this was a relatively small proportion, demonstrating that the majority of twin pregnancies in this study were managed successfully in a community setting.

Implications for Women's Choices

This study presents compelling evidence for women considering a twin birth in a community setting. As many hospitals continue to limit access to vaginal twin births due to concerns about safety or medical protocol, a skilled, experienced community practitioner may offer a viable alternative—particularly for women wishing to avoid a cesarean section. In areas where hospital options for vaginal twin births are restricted, community-based birth may be a key solution for women who prioritize a low-intervention birth experience.

Furthermore, the study suggests that proper selection of candidates, including consideration of factors like chorionicity and gestational age, along with adherence to specific care protocols, plays a crucial role in ensuring positive outcomes. Training practitioners in the unique skills required for vaginal twin and breech births is highlighted as an essential step toward improving access to safe and successful community twin births.

Conclusion

As cesarean section rates for twins remain high, this study provides a valuable insight into the potential for successful twin births outside of hospital settings. With skilled practitioners, well-defined protocols, and careful patient selection, community twin births can yield excellent outcomes, offering women more choices when it comes to the mode of delivery for their twins.