I don't think that the NHS maternity service is well set up for twin birth. Of course this might just be my London-centric view. This saddens me because I do think that it ought to be and could be. There appears to be a sad loss of experience in twin vaginal birth amongst midwives, in the same way that there is a lack of midwives with breech vaginal birth experience.
We learn more and more that caesarean birth comes with risks that actually don't always make it safer than vaginal birth. Each family are different, each family should make the choices that are right for them. All the options for twin birth should be explored, there shouldn't be an automatic surgical option. I feel heartened each time I hear about another hospital that has helped facilitate a physiological birth of twins.
Of course we have to bear in mind that things don't always go to plan and that some complications in some particular twin pregnancies will necessitate a caesarean and rule out vaginal birth completely. We have these life saving measures for a reason. But we should take lessons from those midwives and consultants that listen to the mother...
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