They may come sideways or oblique, meaning at an angle that is neither breech nor vertex. Or they may come in any combination of the above. When both twins are head first, a vaginal delivery may be attempted and may be accomplished safely. It may be possible for one baby to deliver normally. The second one could require a C-section if it turns, the cord comes out ahead of the baby or the baby is distressed following delivery of the first fetus.
Some doctors believe delivery of two or more babies requires a C-section.
After delivery of two or more babies, doctors pay strict attention to maternal bleeding because of the rapid change in the size of the uterus. It is greatly overdistended with more than one baby. A heavy blood loss could produce anemia and make a blood transfusion or long-term treatment with iron supplementation necessary. Your requirements for calories, protein, vitamins and minerals increase if you carry more than one baby. You'll need to eat about 300 calories a day more per baby than for a normal pregnancy.