Thanks for the detailed information. I delivered at AAMC and my providers were happy to try vaginal, but not breech for Baby B. Most times Baby B moves and I didn't want to have to deal with a vaginal and C-section recovery so we went with a scheduled C-section. Neither of them were head down, so it worked out.

Update for anyone else who finds the thread:

I've met with OBs at INOVA Annandale and also OBs at Virginia Hospital Center's Physician Group. Both were open to vaginal birth--and it is recommended by ACOG as well, so most providers shouldn't push you to an automatic C-section (unless, of course, there's a medical indication for it). That said, as a PP pointed out, an important question is whether the OB is conformable with a breech extraction for the second twin. Baby B can shift after Baby A is birthed, so even if both are head-down as labor begins, Baby B may enjoy all that new-found room in the uterus and switch positions. Sometimes the baby can be turned back to head-down position, other times a vaginal breech extraction may be required. Baring extra complications, a breech extraction of Baby B is safe, but not all OBs will be comfortable or experienced with the procedure. So depending on the OB, if Baby B is in breech as labor begins, that might mean they recommend a C-section; other providers will be comfortable with vaginal delivery of a head-down Baby A and a breech extraction of Baby B.

Based on the handful of OBs I've chatted with and the recommendations of several others, including our doula, our OB will be Dr. Owen at VHC. Dr. Rohn at VHC was also recommended to us. GW OBs and midwives were also recommended by a number of folks, including our pre-twin midwife, but they are still not taking new patients.

And it shouldn't need to be said, but of course complications can happen, before or during labor, and a C-section may be recommended for the health of mom, babies, or both. However, without those complications or health concerns, vaginal birth is safer for mom and has better outcomes for babies (even ACOG agrees with that), so I don't see harm asking around to find providers who will not push for surgical birth outside of medical indications for it. Asking these questions or looking for providers with a certain skillset doesn't make someone unable to adapt to changing circumstances in their pregnancy or labor. <3

Look for a doctor who does breech vaginal births.

Agree with PPs about complications coming up and changing plans. Has happened to me. On the other hand, I've had complications from C sections too. Try not to get too mentally wedded to a vaginal birth.

OP here; thanks for all the responses. Unfortunately, GW isn't accepting new patients on the midwife or OB side currently; seems like they've lost a number of providers recently and are trying to rehire. I'll look into the other recommendations; thanks!

MedStar does them all of the time.

Reiter Hill will consider vaginal delivery for twins if both are head down. Dr. Engel in particular.

I know that Dr Susan Hurson delivered twins vaginally a few (maybe 10?) years ago. She was super excited about it as it’s so rare. You could call her office and see if she can recommend a doctor who might be willing to consider it. Obviously, it will depends on a lot of factors. I woke or worry so much about vaginal vs getting them to 34+ weeks with all of your healthy.

Midwives of Medstar.

Also GW! They were very supportive of my preference for vaginal, but ultimately my body didn’t cooperate (placenta previa).

Twins at GW. Amazing doctors that delivered by kiddos. I had a hemorrhage, which twins are at risk for, and felt extremely greatful for the care provided.

Foxhall OB/GYN encouraged me to have a vaginal birth, but I wanted a c-section.

Ended up having an emergency c-section two weeks earlier than my delivery date.

But the doctors there were encouraging vaginal birth. I was not interested, as I did not want to push one out, only for the other to need to be born via a c-section and end up doing it both ways.

Anonymous wrote:Anyone at GWU Medical Faculty Associates. I delivered twins with them in 2017. I had a slightly different experience in that in retrospect, I feel I should have just had a scheduled c-section. Everything went fine but they were very, very open to me trying to just deliver vaginally. They induced me at 36 weeks (I had cholestasis of pregnancy, otherwise would have been induced at 38 weeks), labored for 3 days to no avail, and then started developing pre-e on the third day, so they decided on a c-section. They definitely do NOT push you to do a c-section even with twins.

+1. I had a VBAC with twins at GW in 2019. I had assumed I wouldn’t be a candidate for one because it was twins but the OB brought it up at one of my early appointments. I can’t recall the OB because I saw a few but it might have been Lesko? My water broke and I labored for over 24 hours before they even brought up a C section (and then they checked and I was far enough along to push).

Anyone at GWU Medical Faculty Associates. I delivered twins with them in 2017. I had a slightly different experience in that in retrospect, I feel I should have just had a scheduled c-section. Everything went fine but they were very, very open to me trying to just deliver vaginally. They induced me at 36 weeks (I had cholestasis of pregnancy, otherwise would have been induced at 38 weeks), labored for 3 days to no avail, and then started developing pre-e on the third day, so they decided on a c-section. They definitely do NOT push you to do a c-section even with twins.

At one point, Dr. Tchabo was one of the only providers willing to attempt a vaginal delivery with twins. I'm not sure where he stands now, as my youngest was born almost a decade ago.

Looking for any recommendations moms of twins may have for providers that are open to vaginal birth. There are of course any number of circumstances in which cesarean may be the safer option when time for L&D actually comes, but I’m hoping to find someone who won’t immediately push me there as soon as they hear the word “twins “ at my first prenatal appointment.