Is it too late?
These sleepy twins pictured below were breech at 40 weeks and then, with one Forward-leaning Inversion flipped head down in time for a stress-free vaginal birth.
Spinning Babies® gentle techniques work for twins, too!
Balancing the womb means to help the womb be more symmetrical by releasing tension, twists or torsion in the uterine ligaments. These are the supporting “ropes” that can get tight and spasm. Most women do not feel discomfort from the spasm. While others feel jabbing pain or just discomfort.
Balance Means “Make Room For Babies”!
Balance is achieved with pregnancy activities, such as the activities on this website. Professional bodywork also helps overcome torsion or tensions from accidents and I suggest myofascial release and chiropractic adjustments to correct any misalignments of the pelvis. Misaligned pelvic joints pull the uterus off-center and can, at times, affect the fetal position. Women with loose ligaments may need to wear a pregnancy belt, beginning in mid-pregnancy (or as soon as you learn about pregnancy belts). The alignment of the uterus with the aligned pelvis will help baby A to flip head down.
Should I have a cesarean?
Having a cesarean is a personal decision with your self, your care providers, and your babies!
If you are facing a cesarean because one or both twins are breech (bottom first) or one or both are sideways, you may like to try the activities listed above and below. They may help.
Turning depends on why a baby is breech. If it is because there is a twist in your lower uterine segment, then these “balancing activities” may work very well. Here and there, there are still Obstetricians and trained midwives (homebirth in the US) who are specially trained in breech birth skills. If you find one that is comfortable with breech, you may still be supported in a plan for a vaginal birth even if the first twin is breech. Second twins often do well with a vaginal breech birth– the gate is wide open! Choose a doctor with skills to support this common twin birth scenario. If you have to travel for your birth, remember how you birth sets how you will live.
While not all intended natural labors continue with a vaginal birth (some have cesareans because the baby or babies aren’t lined up to come into the pelvis or because of mother or baby health reasons). So many women could have empowering twin births. Personally, I find twin births to nutritionally well fed and healthy women go quite amazing! More important than how babies are born is how babies are grown. You may have to find good advice yourself about diet and rest during a twin pregnancy. Here’s a good start: Midwife Mary Cronk of the UK gives Guidelines for Twin Pregnancy. If you are well nourished and healthy and stay healthy through good nutrition for your needs, you are likely to go full term.
Eat about 6 protein servings a day, including an egg unless sensitive; with 3 quarts of water; salt-to-taste; dark greens daily and other fresh veggies; one Vitamin C source such as fruit or hibiscus tea; and a couple of servings of whole grains, not so much bread as whole cooked grains such as slow-cooked oatmeal, brown rice, quinoa, bulgar, buckwheat groats (high in iron). Tom Brewer recommended a baked potato with its skin (wash it well before baking and avoid the green ones!). I’d add to make one quart of the water a pregnancy tea of bulk sourced Red Raspberry Leaf Tea (1 part) and Alfalfa (1/4 part). Other additions in the tea can attend to other needs, such as 1 part Nettles for iron. Steep 5-15 minutes and drink hot or warm.
Other Techniques for Twin Pregnancy Fetal Positioning
Fascia-centered bodywork may include Craniosacral, Dynamic Body Balancing, or Fasciatherapie Methode Danis Bois. A standing sacral release sets the lightest pressure (no, lighter!) on your sacrum and abdomen and begins “unwinding” the thickened areas of the fascia. The sacrum may return to its ideal angle and release the twist it would cause in the lower uterine segment.
Asymmetrical, or balanced, the womb will allow the baby to turn and face the mother’s right hip or back more easily. Side-lying Release is the Queen of Balance. More than side-lying, you are addressing 30 or more muscles that affect pelvic alignment and comfort. See the instructions, it’s tricky! The Standing Release is from Dynamic Body Balancing. Your partner can learn to “release your sacrum” after car rides, etc. In a car, your sacrum is tilted back and liable to wrinkle a bit, like a rug irritating baby’s nose (so to speak). The main problem is that the twist in the sacrum distorts the womb and the baby has a more difficult time lining up with the pelvis and cervix during the birth. This makes birth longer. See Spinning Babies®; Parent Class Video Download for how to do it. Diaphragmatic Release is a technique of myofascial workers, craniosacral therapists, and Chiropractors (some) which amazingly helps the tissues relax around the womb. It effectively releases the round ligaments which can be so tight they hold a baby’s forehead in front. The diaphragmatic release, also called Abdominal Release, will accomplish emotional release as well. The whole-person approach resolves deep tension quickly. Protect the body balance you have just enhanced with Rest Smart positioning while you sit or lie down: https://spinningbabies.com/learn-more/techniques/rest-smart/
Chiropractic adjustments can help the various soft and bony structures of the body relating to the womb. One well-known release is called the Webster maneuver. It is the same as for helping to flip a breech baby. It works well for a posterior. And can be used safely for twin pregnancies. Here is a lovely case study on helping breech twins flip head down spontaneously after Webster’s Maneuver on the Chiropractic Journal of Pediatric, Maternal & Family Health: Resolution of a Twin Breech Presentation with the Application of Webster and Diversified Chiropractic Technique, by Danita Thomas Heagy, D.C
Overview of Maternal Positioning for Twin Pregnancy
Once you balance the womb and supporting ligaments, more room will be available within the womb, the sides will be softer and more flexible. A single baby will be able to sort herself out with gravity and movement. If the twin babies themselves aren’t blocking each other, then they, too, will move into place. Techniques to use in a twin pregnancy In order:
- Jiggling (Manteada, Chunging, sifting…) This can be done by your partner or friend.
- Forward-leaning Inversion—Reasonable for every twin-carrying mother in the first two trimesters. But inversion may not be for every twin mother in the third trimester. Each woman is different and has a different tolerance for being upside down. How many and how long? Once a day for 30-seconds each with head down twins. Breech? Keep scrolling down!
- Maternal positioning is more effective following the balancing techniques. Gravity follows balance. Arrange pillows to Rest Smart. Hips higher than knees, belly lower or equal to spine 24/7 Mind your posture always. Doing only maternal positioning isn’t likely, by itself, to help a breech twin turn at 32 weeks or later gestation. This is a subjective claim, however, success depends on many factors!
- Movement – gentle swimming belly down may be a good way to use the counter pressure of water to help the babies to the position.
- After 36 weeks, avoid squatting and other things to engage baby until the baby turns to face your right hip or is definitely LOA. Once labor is underway, especially as the baby gets to “0” or +1 station,” then see if squatting is helpful for any fetal position.
- Uterine contractions help the first head down baby rotate from posterior to anterior (if necessary), so use Balance, Gravity and Movement in early labor, especially. You can consider a Forward-leaning Inversion. After the birth of the first twin, you might put the baby to breast, skin-to-skin, and let your body relax. Contractions will resume. If a baby isn’t coming into the pelvis, standing and lunging to the side of your body that the baby’s presenting part (the head if a baby is head down) will bring the baby into your pelvis with a couple of contractions. Stay standing if the baby slips back up. Someone should be at your feet, ready to catch!!
Enjoy your amazing body! Enjoy your full family! I’m a grandmother of triplets and there is 3 times the love!!
Are the twins still breech? Is one still breech?
Avoid a manual version
In what’s called an External Cephalic Version (ECV) a doctor or midwife manipulates the baby around through the abdomen to a head down position. It’s not considered safe to do with twins. Add balance and the babies will follow. At least if they can navigate past one another. Gravity pulls, so if there is room for the heavy head of the baby to settle towards the bottom of the womb it will. The second baby lying cross ways or breech is not uncommon and may not be nature’s issue. If the space is available and then gravity follows the birth of the first baby (stand up), the second baby usually turns head down.
Can I have a vaginal breech twin birth?
Breech twin birth can be nearly as safe as head down twins if you have a 2-4 skilled attendants. Whether twins or singletons, every breech baby deserves a provider who knows how to rotate stuck arms out and how to bring the nape of the neck into view before helping the head out. The first twin opens the way for the second twin. So if only the second twin is breech, then many doctors and some midwives who do twins will have the skills to support a vaginal birth (if not their peer support). Read about breech vaginal birth elsewhere on this website.
There are still skilled doctors and midwives accepting parents late in pregnancy to help avoid a cesarean if vaginal birth is a healthy possibility for those parents. Most doctors today lack skills for natural breech births and that includes twin breech births. It is considered medically safe for the regularly skilled doctor to pull out the second twin vaginally. Fewer let the second twin be born spontaneously, and the safety in spontaneous 2nd twin depends on how the second twin is doing. Monitoring is called for, and most 2nd twins do quite well but some don’t like to be left behind and Mama’s loving push and some need a gentle hand to guide them out along with that push. Many parents don’t know of this challenge to their birth plan until the babies are within a month or weeks of birth. The time to bring better balance into the body to encourage head down babies in early in pregnancy. The second trimester is a key time for body balancing. Still, some women can help their babies be head down later in a twin pregnancy. Continue the balance techniques (without the breech tilt, which is not in this category of techniques) until birth. An email
…She really wants a vaginal birth. She is with a very good OB now, but he is not comfortable doing Baby A as a vaginal breech. There are other options she is pursuing. I just wondered if doing techniques such as the ones you describe or for example, the Webster’s Technique or moxibustion would be safe seeing as how it’s twins….
My answer was something like this: I can answer with my opinion.
Non-invasive techniques such as the two you mention seem compatible with multiples as well as singletons. More importantly, let’s acknowledge the woman with a breechling who desires a natural birth or VBAC and has a doctor who doesn’t/or can’t support her desires. She desires her original birth plan strongly. She realizes her doctor isn’t on board with that but he/she is so good in other ways, and the relationship is already established. Change seems more alarming than continuing with the original doctor, even if the cesarean plan is causing distress. Trying to get twins to flip, which does happen, becomes the only way to keep the established relationship with the doctor and continue the hope for a natural birth. The chances of natural birth are diminished with this approach. Changing providers may lead to an empowering vaginal breech birth. Meanwhile, I’d suggest self care or professional myofascial body balancing and pelvic alignment. a craniosacral therapist and a Chiropractor certified in Websters make a good team approach. Moxibustion and Acupuncture have some success as well. I think more is better than one modality. We don’t know which a particular body might respond to, but time is of the essence and flipping is less likely without increased balance of the soft tissues and pelvic joints.
All pregnant mothers benefit from increased body balance, even pregnant mothers of twins
Always talk to your babies. Have your partner talk to the first baby directly by putting a tube (paper towel roll or clean vacuum hose) to the lower right side of your belly and talking heart to heart to get baby’s attention. This will encourage your baby to look to the sound and get his/her head in an LOT position, the ideal start position. The most important thing is love.
“My Doctor wants to induce me at 37 (38) weeks.”
Using the late Dr. Tom Brewer’s diet twin moms are going full term with healthy 7-8 pound babies. It never hurts to eat green leafy veggies, plenty of lean protein and a gallon of water a day, with salt to satisfy your taste in your food. 35-38 week-old twins will nurse almost hourly each, with a 2-3 hour break while sleeping; while 40 week twins may go 2 hours more often, and 3 and sometimes 4 hours when sleeping. Babies born early are at higher risk for health problems and death in the first year of life. If we can prevent premature birth we can reduce risk. Why work hard to keep the babies in the womb and then induce, or even surgically remove them, before 40 weeks? Where is the evidence of safety with that plan?
March of Dimes is giving obstetrics the dickens for causing an epidemic of premature babies when they are induced or sectioned before they are due. Some twins may need to be born early for specific health-related reasons, such as a significant twin-to-twin transfer, but that is the exception, not the routine. Ask your doctor if the induction is “just in case,” or do you have a specific risk for continuing to go to term? It’s one thing if one baby is slowing down and/or the heart rate is not variable or one baby isn’t growing, but the argument that your womb will get too big to work properly is bonkers. Eat well and get your iron and protein intake up. Full term is full term, twins or singletons. Placentas and wombs aren’t time bombs, but beautifully designed organs for safe gestation. Feed your placenta so it is healthy enough to do the work for nine months. Don’t smoke or eat junk. Every day counts. Discuss any decisions you make with your doctor and midwife.