And delivery presents some interesting challenges. For one, the position of each twin matters a lot: One may come head first, which is ideal for a vaginal birth, but the other may be in a feet-first or butt-first ( breech ) position. "Depending on the position of the first baby, the mom may elect to have a C-section," Dr. Ramos says. Or, if the first baby is head down and the second one is breech, some OBs may opt to try to turn the second baby around or just wait and see what happens when the second baby comes. Sometimes the second baby turns on its own after the first has been delivered because it has some extra room to move. But in other cases, the first baby is delivered vaginally and the second via C-section.