How to Create a Birth Plan for Twins

The day you give birth to your twins will be one of the most important of your life. Creating a birth plan ahead of time helps you decide how you want your labor and delivery to be, and lets others know your wishes. So when the big day arrives, you can focus on what's most important -- bringing your new babies into the world.

When you're expecting twins, it's common for them to make an early appearance. Almost 50% of twins arrive before 37 weeks. For this reason, it's helpful to have your birth plan ready well in advance of your due date.

What Is a Birth Plan?

A birth plan is an outline of your preferences during your labor and delivery. For example, it might include who you want with you during labor, whether you want pain meds, or if you want the lights dimmed. You can include anything you think will make your labor and birth more comfortable for you.

Keep in mind, though, that a birth plan is not set in stone because you cannot predict everything that may occur that day -- especially when you're having twins. You or your doctors may need to make changes to the plan once your labor begins. So it's important to try to stay flexible if something unexpected happens.

What Should I Include in a Birth Plan?

Although it's tempting to include many details in a birth plan, try to keep it short so it's easy for everyone to read.

Here are some items your birth plan might cover:

The basics: List your name, your doctor's name and contact information, where you plan to give birth, and who you’re planning to have there with you.

Atmosphere: Think about what will help you feel most comfortable. Would you like the lights dimmed? Would you like a support person to take photos or video of your labor or birth?

Labor preferences: Include any preferences you have for your labor. For example, do you want to walk around freely? Do you want to use a birthing stool, ball, or chair? Would you like to take a warm shower or bath?


Pain meds: Pain management during labor is an important consideration. You may not plan to have an epidural, but you could change your mind during labor. Or you may know that you definitely want to have an epidural if possible. As you're defining your birth plan, ask your doctor about your options for pain relief as well as any questions you have about them. These could include breathing or massage.

Delivery preferences: There are many options to consider for your twins’ birth. If you're planning on a vaginal birth, would you prefer not to have an episiotomy unless it’s medically necessary? Do you want a mirror to watch your babies being born? Would you like your partner to cut the umbilical cords?

When you’re having twins, you’re more likely to need a C-section. Even if it’s not your preference, it’s a good idea to include information about this procedure in your birth plan. For example, would you like your partner with you in the delivery room, if possible?

Feeding and Care: Once your twins are born, you’ll need to think about their feeding and care. For example, do you want to breastfeed right after delivery? Or are you thinking about bottle feeding or combining bottle feeding with breastfeeding? Would you like your twins in the room with you at all times, or would you prefer they stay in the nursery sometimes? Is it OK for the medical staff to offer your babies a pacifier or formula? If one of your twins is a boy, would you like him circumcised at the hospital? (Sugar water may be used at time of circumcision.)

Who Should Review the Birth Plan?

Review your birth plan with your partner and anyone else who will be with you in the delivery room, such as a labor coach or doula. Then ask your doctor to take a look at your birth plan, too. The hospital or your doctor may have their own delivery policies for multiple births. Reviewing your birth plan ahead of time gives you time to help resolve any potential conflicts.


Who Needs a Copy of My Birth Plan?

Once your birth plan is set, give a copy to your doctor to keep with your medical records, and take another copy to the hospital or birth center. You'll also want to give copies of your birth plan to anyone who will be with you during labor. It's a good idea to bring a few copies with you to the hospital or birth center when you go into labor, too. Another doctor may wind up delivering your twins if your regular doctor isn't available.

It is not necessary to have a birth plan as all of these preferences can be made while in the hospital, but it is certainly important to think about all the options and discuss them with your partner and doctor.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on June 25, 2018



American College of Obstetricians and Gynecologists: "Early Preterm Birth", Your Pregnancy and Childbirth: Month to Month, 2010.

Cleveland Clinic: "Creating a Birth Plan"

March of Dimes: "Your birth plan"

Nemours Foundation: "Preparing for Multiple Births" and "Birth Plans"

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