If you’ve been seeing a midwife  during your early prenatal care and found out  that you’re carrying twins, you may want to take a look at your plans. Some certified nurse midwives will continue while most  will not.

Even a young healthy person carrying multiples is considered high risk. Carrying multiples increases your risk of premature delivery and other complications.This means that you have to see an  an obstetrician or perinatologist (an obstetrician who specializes in high-risk pregnancies). However your midwife may be able to stay involved in your care and even deliver your babies.

Some midwives who work in the hospitals have collaborative agreements with obstetricians who support and consult on midwife-managed twin pregnancies. However other hospitals have guidelines that do not allow midwives to  care for women carrying multiples or deliver them.

If your midwife delivers exclusively at a birthing center , she  will not be able to continue your prenatal care because multiple  pregnancy is considered too high risk for birth centers delivery.

If you see both a midwife and an obstetrician or perinatologist, the three of you will need to discuss how the collaboration will work. Assuming you do not develop any complications, your midwife may deliver your baby as long as they’re both in the optimal head-down position and your labor goes smoothly. The delivery will take place in the hospital  with an  obstetrician in attendance, as well as the rest of the medical team that would typically be present for twins. When a complication such as if the second twin is not head-down, the obstetrician  will take over immediately.