How to Create a Birth Plan for Twins or Multiples

Your Essential Guide to a Smoother, More Confident Delivery

Welcoming twins—or more—into the world is an extraordinary journey filled with excitement, preparation, and important choices. One of the most empowering steps you can take during a multiple pregnancy is to create a detailed birth plan.

In this guide, we’ll walk you through how to craft a birth plan tailored specifically for twins or multiples. Whether you’re planning a vaginal delivery, a C-section, or keeping your options open, this post will help you feel informed and ready.

Why You Need a Birth Plan for Multiples

A birth plan is a written outline of your preferences during labor, delivery, and postpartum care. For a twin or multiple pregnancy—where early labor or medical intervention is more likely—having a clear birth plan ensures that your voice is heard, your support system is in place, and your wishes are known even in urgent moments.

According to the American College of Obstetricians and Gynecologists (ACOG), many twin births can happen vaginally if the first baby is head-down, but multiple factors must be considered for each unique case (ACOG, 2023).

What to Include in Your Twin Birth Plan

1. Preferred Delivery Method

Do you want to try for a vaginal birth if both babies are in the right position?
Are you open to a C-section based on medical advice?
Would you prefer an elective C-section for peace of mind?

2. Hospital or Birth Center Preferences

Choose a hospital with a Neonatal Intensive Care Unit (NICU).
Ask whether twin deliveries take place in a labor room or operating room.
Confirm policies about support people during labor and after birth.

3. Pain Relief Options

Would you like an epidural available from the start?
Are you considering a medication-free birth?
Would you like to work with a doula or midwife for added support?

4. Who’s in the Room

Can your partner be present for both vaginal and C-section deliveries?
Would you like someone to document the birth?
Who should stay with the babies if they're taken to the NICU?

5. Post-Birth Preferences

Do you want skin-to-skin contact after delivery?
Do you want to delay cord clamping if possible?
Breastfeeding vs. formula feeding—or a combination of both?

6. Emergency Scenarios

What are your preferences if only one baby can be delivered vaginally?
Who should stay with you and who should stay with the babies if they need special care?

When Should You Make a Birth Plan?

For twin pregnancies, it's best to have your plan ready by 28 to 30 weeks. This gives your healthcare provider enough time to review it with you and prepare for any complications or early deliveries, which are more common with multiples.

✨ Twins are usually born around 36–37 weeks, so early preparation is key.

Common Questions About Twin Birth Plans

Q: Can I deliver twins vaginally?

A: Yes, depending on your babies’ positions and your doctor’s evaluation. If Baby A is head-down, a vaginal delivery is often possible.

Q: Do I need to plan for a NICU stay?

A: While not always required, twins are more likely to need NICU care due to prematurity. Choose a facility that has NICU services and include this in your plan.

Q: Can I have a say in what happens if there's an emergency?

A: Absolutely. Your birth plan should outline your preferences in case of emergencies, such as which partner accompanies which baby and who advocates for your care.

Final Tips for a Confident Twin Delivery

Be flexible. Things may change quickly with multiples. A birth plan helps you prepare, but staying open to adjustments is essential.
Discuss early with your doctor. Go over your plan with your OB, especially regarding delivery method, NICU logistics, and postpartum care.
Keep it clear and concise. Use bullet points, prioritize what matters most, and bring a printed copy to your birth setting.

Ready to Meet Your Multiples?

Creating a birth plan for twins or multiples gives you clarity, confidence, and peace of mind. It helps ensure your team supports your wishes—and helps you feel empowered every step of the way.