“Twin birth, at its heart, is not much different than a single birth – first one baby comes, then the other. With trust, preparation, and skilled care, the physiological process unfolds naturally, one beautiful step at a time.”

– Khadijah Cisse, Midwife

Where I Offer Twin Birth Support

Massachusetts: Twin homebirth with me directly—this is fully within my scope of practice.
New Hampshire: Twin homebirth may be possible when attended with my CNM preceptor and colleague, based on her availability.
Maine: Homebirth with twins is not permitted for midwives. However, some Maine hospitals support vaginal twin birth. I’m happy to provide consultation and help you explore your options.
Nationwide: I offer virtual support for mothers planning a freebirth with twins.

Have questions about your specific situation? Contact me to discuss your options.

The Evidence: Twin Homebirth Is a Valid Choice

In 2024, a groundbreaking study was published co-authored by Dr. Stuart Fischbein and Dr. Rixa Freeze. This study followed 100 sets of twins attended at home by an obstetrician. It was the first publication looking exclusively at twin home birth.

The results were remarkable: 91.3% of women gave birth vaginally. Compare that to the national average of just 25.2% for twin pregnancies. This study shows what is possible when mothers are supported in physiological birth.

To read the study: bit.ly/twinhomebirth

For more information, contact admin@birthinginstincts.com or call 805-455-8618. Learn more at Birthing Instincts and Breech Without Borders.

Is Twin Homebirth Safe?

Q: Is it safe to have twins at home?
A: Yes, twins can be safely born at home under the right circumstances. With support from a skilled midwife or obstetrician, twin pregnancies can be managed safely at home. This applies when there are no complications and the pregnancy is progressing normally.

Careful screening, close monitoring, and thorough planning are essential. The health of both babies and the mother matters. Access to emergency medical care is also a key factor.

Q: What makes a twin birth at home safe?
A: Several factors contribute to safety:

Experienced Birth Team: You need a midwife experienced in twin pregnancies and deliveries. This includes handling breech or other uncommon presentations.

Low-Risk Pregnancy: The pregnancy should be free of complications. This means no preeclampsia, gestational diabetes, or fetal growth restrictions. Both babies should be healthy.

Proper Screening: Regular ultrasounds and monitoring of fetal heart tones are crucial. Any abnormalities need to be identified so both babies are in a safe position for birth.

Clear Backup Plan: A detailed plan for hospital transfer is necessary. You should have access to nearby medical care if needed.

Mother’s Health: You should be in good health with no contraindications to vaginal birth.

Breech Twins: What You Need to Know

Q: How do breech presentations affect twin home births?
A: It’s common for at least one twin to be breech. In fact, 50% of the time, at least one twin will present breech. This is not necessarily a reason to avoid a home birth!

Breech twin births can be safely managed at home with a skilled midwife. Here’s what matters:

Skilled Practitioner: Your midwife must be experienced in delivering breech twins. Vaginal breech delivery requires skill and preparation.

First Twin Head-Down: Ideally, the first twin is head-down. This presents fewer challenges during labor. At times, both babies may present breech. This scenario may be considered based on your individual factors and prior birthing history.

Monitoring and Planning: Close monitoring is necessary. We assess fetal heart tones and ensure the second twin remains in a safe position. We also prepare for hospital transfer if complications arise.

Q: What if one or both twins are breech?
A: Breech presentations are common in twin pregnancies—as often as 50% of the time. This is especially true with the second twin. If one or both twins are breech, you need a birth team experienced in breech delivery.

The position of the first twin is especially important. If the first twin is head-down, the second twin can often be delivered breech without issue. If the second twin is breech, your midwife will manage the delivery or facilitate a hospital transfer if needed.

Q: Can I still have a vaginal twin birth at home if one baby is breech?
A: Yes! A vaginal twin birth at home can be an option if one baby is breech. Certain conditions must be met, and requirements vary based on provider experience and licensing. An experienced midwife may assist with delivering the breech twin or recommend repositioning techniques. If complications arise, you may need to transfer to a hospital.

Key Considerations for Twin Homebirth

Q: What are the key considerations for twin births at home?
A: These factors are important:

Positioning of the Babies: The first twin should ideally be head-down. If the second twin is breech or in another position, your midwife must have the skills to manage this.

Gestational Age: Twin births at home are typically safest after 37 weeks. At this point, the babies are more likely to be fully developed.

Spontaneous Labor: A home birth is safer when labor begins spontaneously. Medical interventions may be necessary if labor is induced.

No Major Complications: Both babies should be healthy. There should be no significant medical concerns for the mother.

Twin Type Matters: Mono/di twins should be carefully monitored for Twin-to-Twin Transfusion Syndrome (TTTS). Mono/mono twins are not good candidates for home delivery. They share a single amniotic sac, which creates substantially higher risks.

Understanding the Risks

Q: What are the risks of a twin home birth?
A: The risks are similar to any homebirth, with some additional considerations due to twins.

There is a risk of prematurity. There’s also potential for TTTS with mono/di twins. Mono/mono twins should not birth at home. There is also a higher risk of bleeding for the mother.

In homebirth, midwives come equipped to manage most excessive bleeding scenarios. However, distance to the hospital should be considered. Very rarely, excessive bleeding cannot be easily controlled. Mothers with a healthy medical history are not immune from rare circumstances. However, they are still generally good candidates for homebirth according to recent research.

Freebirth with Twins

Q: Can I have a freebirth with twins?
A: It is always a mother’s God-given right to birth free. There are some scenarios I would not recommend. But it is always a mother’s right to make that decision free from judgment.

All around the world, women still birth twins alone or with support from only family and friends. I personally have three friends who birthed twins alone. One friend birthed triplets intentionally unassisted. All had good outcomes. Some of those babies were also born breech, as is often the case.

I have supported many mothers virtually worldwide as they birthed twins or breech babies alone successfully. It was their risk to take, regardless of any perceived or statistical risk.

It is my belief and experience that mothers birthing intentionally unassisted always have the best interest of their babies in mind. The cultural mindset is not always behind them, unfortunately. But I am. Contact me if you’re considering this path.