14. Are all higher order multiples delivered by c-section?

Almost all deliveries of triplets or more are cesarean sections. A scheduled C-Section ensures that the Labor & Delivery and NICU are adequately staffed for the births of higher order multiples; however an emergency C-Section may be necessary as one of more babies experience fetal distress or the mother develops high blood pressure.

The MOST Medical Birth Survey shows these percentages for each type of delivery:


Delivery Type
C-section 93.8% 94.5% 90.3%
Combo (vaginal & c-section) 1.5% 2.1% 3.9%
Vaginal 3.6% 2.9% 5.8%
Unknown 1.1% 0.5% --


Staff members generally present during a c-section for higher-order multiples:

  • One anesthesiologist
  • One delivery nurse
  • One or more surgeons (OB/GYN, or perinatologist)
  • Surgical nurse for each surgeon
  • Neonatalogist for each baby
  • Neonatal Nurse for each baby
  • Respiratory Therapist for each baby

Risk associated with a vaginal birth for mothers of multiples include excessive bleeding and damage to the pelvic floor (uterus, bladder, rectum) due to the manipulation that would be needed if all babies are not in the vertex (head down) position.

Risks associated with a vaginal birth for the babies in a multiple pregnancy include:

  • Difficulty adequately monitoring all babies during active labor.
  • Difficultly determining which baby is in distress.
  • An increased risk of stillbirth.

With either delivery, the delivery room will be crowded. During a c-section the actual birth of the babies usually takes no more than 5 minutes, but the stitching of the incision will take about 45 minutes. Depending on the individual needs of each newborn, the parents may be able to hold or touch their babies, but some babies are very premature and are immediately taken to the NICU.




For more information about higher order multiple birth deliveries, visit the MOST Supertwins Statistics page.

Also see MOST's book Expecting Multiples: A Comprehensive Guide for additional information on the delivery of higher-order multiples.

About Childbirth Classes for Multiples

Birth Plan for Multiples (Word format)

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Copyright MOST 2005      Updated 1/18/10