Q&A: What do I need to know to prepare for a vaginal birth with triplets?

Congratulations! Getting deep into the third trimester with triplets is quite an accomplishment! You are about to start on a difficult but amazing journey.

Vaginal birth of triplets typically isn't advised. It is quite difficult to follow the condition of all the babies during labor and birth. Plus it is unusual that they are all coming down in a safe way to be born vaginally.

While it isn't standard practice, some physicians will help their patients have a vaginal birth with triplets if everything is lined up properly—the babies are in good positions, they are each in their own amniotic sac, and their heartbeats are easy to monitor (and to differentiate from one another). Emergency Cesarean must be easily available in case of a problem during the birth, and the mom must be prepared that the second and third babies may require birth by "breech extraction" meaning that the doctor reaches inside and brings the baby down by its feet to hurry delivery along.

Triplets can be difficult to check on during labor—can we be sure we are hearing the heartbeats of three different babies and are they all OK? To me, birth at home is for healthy low-risk-desiring moms who are having singletons at term, with an experienced well trained home birth midwife and resources for hospital transfer if necessary. Triplets should never be born at home. I personally don't think twins should be born at home either, though, so we already may differ in our priorities and acceptance of risk.

Talk to your doctor about your desire to give birth vaginally, and be sure you get enough information to have a realistic picture of all the possibilities for how things may go. Good luck to you! And congratulations, congratulations, congratulations!