You do have choices in the method of delivery. There's normally a lot of hospital policy surrounding twin birth but there's not too much actual research about it so it's mostly based on a better safe than sorry approach.
I'm 39 +3 with my boy/girl twins today. My nearest hospital is a small unit and I have had a bad relationship with them in my last two pregnancies so we moved to the bigger hospital who have a specialist twin clinic and a consultant midwife for normalcy.
We've had absolutely excellent care from then on. I am planning a Midwifery unit delivery as the unit is down the corridor from the consultant unit and have been under the joint care of the consultant obstetrician who does the twin clinic and the consultant midwife for normalcy.
My twins are fraternal and twin1 is head down, twin2 has mostly been head down but is occasionally breech but the hospital is willing to support vaginal breech delivery of the second twin if that's how she ends up after delivery of twin1.
If you want a copy of the plan of care my hospital have made with me I'll be happy to e-mail it to you. My e-mail is c u r i o s i t y . k i l l e d @ h o t m a i l . c o m
I am very geared towards keepng things natural, I don't want a section or induction, I don't want CTG monitoring or a scalp monitor for twin1. Basically I'd like to only be given interventions as and when they become necessary.
I think our hospital's standard practice is similar to most others. Their ideal is to deliver twins around 38 weeks so they will offer induction at this time if you haven't laboured or run into other problems by then. Most hospitals like to monitor both babies with CTG monitors throughout labour and delivery of both. Some hospitals prefer to break your waters and attach a scalp electrode to twin1's head so they can be sure they are measuring both twins with the CTG. Most hospitals prefer to offer epidural anaesthetic or site the line for epidural in case you need a section or in case they need to turn twin 2. Most hospitals would prefer a section for a breech presenting baby but can be comfortable delivering twin2 breech after a vertex birth of twin1. They will offer section for transverse babies. You can normally choose to opt for induction or section if you feel more comfortable with that. If you have vaginal deliveries most hospitals will have a time limit for the amount of time between deliveries of each twin, this can vary between hospitals. Some hospitals like to break the waters of the second twin after twin1 is born to speed up delivery time and some hospitals like to aid delivery of the second twin by putting a hand up inside and puling the baby out (forgotten what this is called and it's normally done if the baby is in a funny position).
You'd be surprised how much choice you can have in how you deliver your babies. I've done a lot of research on the reasons behind the various policies hospitals have. I'm happy to talk to you about it - if I don't imminently deliver mine! lol The one thing I'd warn is that if you have no strong feelings about how you want the birth to be and you are happy to let the doctors be in control then do that because looking at all of these things and making decisions about what you want on each issue can be quite tiring! You can always stipulate that you just want to be informed before decisions are made about your care and leave it up to people to explain things as and when they become necessary.