Fewer than half of all twins are born with both babies presenting in a cephalic (head down) position. In another 40 percent of cases, one twin presents in a cephalic position and the other is in a breech position. Typically, the first twin will be in cephalic presentation and the second will be breech. In such cases, it is sometimes necessary to perform a c-section to deliver the second baby.

Breech births can be dangerous, since the incidence of cord prolapse, when the umbilical cord descends from the uterus before the baby, is more common.

Other cord troubles including compression and “trauma” are also more common in multiple births, and happen most often when the cords of the twins become entangled. Entangled cords is a rare problem, and generally only happens when the babies share the same bag of waters, which is unusual. When babies share the same amniotic sac, cesarean birth is recommended.