A vaginal birth is possible -- maybe
The stars need to align when it comes down to the babies' presentation -- meaning which part of the baby is lying over the cervix. Baby A is referred to as the baby presenting first, or as some moms of twins say, the baby closest to the exit. Baby B is the baby presenting higher in the uterus (the younger baby who will be born second). It's fairly common for one or both babies to not be vertex -- meaning their heads aren't presenting over the cervix, and they are breech (usually foot or butt first), or transverse (shoulder/back first.)
OB/GYN Dr. Roseline Dauphin-Baptiste explains, "Vaginal deliveries which are anticipated to be without complications are the only ones that are done today and only if both twins are in head down positions or if at least the first is head down."
Why C-sections are more common for twin births
In addition to the issue of presentation Dauphin-Baptiste explains, "Twins are usually born prematurely because a mom with twins is likely to go into labor before full term," Dauphin-Baptiste says, "They are smaller than singleton babies and there could be other problems present, so premature twins do better if they are delivered by C-section. When a baby is premature their head is bigger than their body and if a premature, breech baby were allowed to go through the birth canal, his body could deliver but his head which is larger might get stuck high up in the uterus which would be devastating."
Find support and know your options for labor and birth
There are no guarantees you'll have a vaginal birth, but having a good support team can help. If your baby -- or babies -- are breech, talk to your doctor or midwife about ways to try and turn them into the head down position. You may also want to work with a doula who will be there with you every step of the way during labor and can support you and your partner regardless of the eventual mode of delivery.
Sue F. credits her support team with giving birth to her twins vaginally. "My acupuncturist did moxibustion (Chinese medicine that involves warming acupressure points by the tor) to help Baby A turn," she says. "And my husband, midwives and doula believed in me."