How Late in the Pregnancy Can Twins Change Positions?

Joe Rawlinson by Joe Rawlinson - March 21, 2024

The position of each twin in the womb becomes crucial at birth as their position can determine the type of delivery your medical team is comfortable handling (c-section vs. vaginal birth). If you’re hoping for a natural twin birth and not a c-section, you’ll be monitoring the position of the twins during the pregnancy and wonder: how late in the pregnancy can twins change positions?

Twins Constantly Move During Pregnancy

It is essential to understand that twins can change positions throughout pregnancy, including during labor. While most babies will settle into a fixed position by the 32nd to 36th weeks of gestation, twins have been known to flip and rotate even beyond this point.

All babies move around during a pregnancy so this isn’t unique to twins. However, twin pregnancies have their unique dynamics because in addition to each baby moving, their interactions with each other can impact positioning.

Typically, babies settle into a head-down position by the final trimester in preparation for birth. However, in twin pregnancies, one or both babies may not adopt this optimal position, leading to potential challenges with the birthing process.

The Mayo Clinic reminds us that “vaginal delivery is often possible if the first baby is in a head-down position. If not, a C-section might be recommended”.

One or more of your twins will be in “breech presentation” when the baby’s buttocks or feet are positioned to exit the birth canal first, instead of the head.

(RELATED: Still expecting twins? Will you be having two boys, two girls, or boy/girl twins? Answer these quick questions to see what several old wives’ tales claim you’ll be having….)

The likelihood of twins changing positions later in pregnancy is influenced by various factors, including the amount of available space in the uterus, the position of the placenta, and the babies’ individual movements.

Additionally, certain maternal activities, such as specific exercises or positions, may encourage babies to change positions.

Make Plans with Your Doctor

During the twin pregnancy, you should maintain open communication with your healthcare providers regarding your twins’ fetal positioning.

Regular prenatal check-ups and ultrasounds allow obstetricians to monitor the babies’ positions and address any concerns you may have. A cesarean delivery may be recommended if one or both babies remain in a breech or unfavorable position close to the due date.

With our twins, we had planned for a c-section birth from the beginning but it turned out that our twins’ fetal positions would have forced that to happen anyway. One of our twin girls was positioned transverse (meaning she was laying sideways) and that would have prevented a vaginal birth. Thus our girls were born via c-section at 36 weeks.

Can You Make Twins Change Positions?

You may have heard of external cephalic version (ECV) where the doctor tries to manually turn the baby into a better birth position late in the pregnancy. However, according to the American College of Obstetricians and Gynecologists, ECV is not recommended for twins or higher order multiples.

(RELATED: Still looking for the right twin gear? See my Twin Baby Gear Essentials.)

Be Flexible with Twin Birth Plans

Twins can change positions throughout pregnancy, with some babies even flipping or rotating late into the third trimester. While most babies settle into a head-down position by the final weeks, twins may exhibit more variability in their positioning.

This means you need to be flexible with your birth plans. Ultimately, you want a healthy pair of babies with minimal complications. So be prepared to change your plans if the babies aren’t cooperating before birth.

Low Battery Twins Shirt

Further Reading

Dad's Guide to Raising Twins book
Don't forget to pick up a copy of the definitive guide to raising twins. "Dad's Guide to Raising Twins" was written for fathers of twins to help guide you through the first several years with twins. Click here to learn more about the book and get your copy.

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