Twins, Triplets, and More: Adapting Your Childbirth Class for Multiples

As a childbirth educator, if a family expecting multiples walks into your class, would you feel ready? Most classes focus on singleton pregnancies, but 3.12% of live births are twins (31.2 per 1,000), and 0.08% are triplets (78.9 per 100,000). With multiples becoming more common, it’s likely you’ll encounter these parents in your classes. If you’re not yet equipped to support them, don’t worry—we’ve got you covered.
 
Here, we’ll look at the different options for integrating information about expecting multiples in your childbirth education classes, including how to approach the material and what to include.

How Should Your Class Differ If It Includes Parents Expecting Multiples?

How much time to dedicate to educating your clients about multiples depends on how many parents of multiples sign up for your classes, what your clients’ needs are, and your personal teaching style. There are several different ways you can incorporate information for parents expecting multiples.

• First, you can integrate this info into each topic you are covering. So, if you have a section about managing pregnancy challenges, you can add in a few pointers for challenges specific to parents expecting multiples. The same goes for other topics, such as childbirth, feeding and postpartum.
• Alternatively, you can spend one section of your classes addressing all the information that parents of multiples might need, all at once. This is especially helpful if you have several people in your classes who are expecting multiples.
  
• Finally, some childbirth educators even end up dedicating a whole class series to expecting multiples. This is a great idea if you have some specific expertise in expecting multiples, such as if you are a parent of multiples yourself or if you have specialized training in this topic. You might choose to do this if there is a strong demand for this type of class in your community.
  

What to Include in Your Curriculum

Childbirth is childbirth, and babies are babies, whether you're expecting singletons or multiples. But there are several aspects of expecting multiples that are different from expecting singletons. It can be overwhelming to figure out what to cover, especially if you are low on time. To that end, we’ve compiled a list of essential topics to cover if you want to include information about expecting multiples in your classes.

Pregnancy

• More frequent visits to your healthcare provider for monitoring
  
• Increased caloric and nutritional needs and recommended weight gain
  
• Greater risk for gestational diabetes and gestational hypertension and how to decrease this risk with lifestyle choices, frequent provider visits, and nutrition counseling
  
• Strategies for managing increased discomfort, such as back pain, swelling or fatigue

Childbirth Risks

• Importance of monitoring for signs of premature birth, which you are at higher risk for when expecting multiples
  
• Options for childbirth, which may include vaginal birth or Cesarean birth, depending on your medical status, positioning of the babies and health needs
  
• Creation of flexible birth plans, including plans for induction, combined vaginal/cesarean birth or unplanned cesarean
• What to expect and how to cope if your babies end up spending time in the NICU
  

Nutrition Needs

• Answering frequently asked questions like, “How can you feed two babies at once?”
  
• How to tandem breastfeed
  
• Nutrition needs for breastfeeding moms of multiples
  
• Bottle-feeding techniques for multiples
  
• The essentials of getting partners and other helpers involved with feeding
  
• Managing overnight feedings with multiples
  

Preparation for Postpartum

• Managing sleep disruptions with multiples
  
• Discussing the importance of emotional support
  
• Seeking mental health support and how parents of multiples are at higher risk of postpartum depression
  
• What baby gear is actually needed for multiples, and what can be skipped
  

Support and Encouragement

• Asking for help, and how this is non-negotiable if you are expecting multiples
  
• The importance of connecting with other parents of multiples and the vital need to find a community or tribe for support
  

Making It Stick

As with any other aspect of childbirth education, you want to be sure that all the information you cover about expecting multiples comes alive and has staying power.
 
People learn best when they can interact with the material. When it comes to expecting multiples, hearing from real parents is gold. If possible, sharing the stories of parents of multiples with your classes—through video or even live interviews—can be wonderful.
 
Finally, having extra babies means a need for extra support. You want to arm your clients with resources specific to expecting multiples, such as the contact info for local support groups, healthcare providers who are well-versed in multiples, and reliable, evidenced-based books and online resources. Here are some popular options:

Multiples of America

The Holistic Guide to Twin Pregnancy

When You're Expecting Twins, Triplets, or Quads

Breastfeeding Twins and Triplet

Wendy Wisner, Freelance Writer and Lactation Consultant (IBCLC)

Sources

Egsgaard S, Bliddal M, Lund LC, Vigod SN, Munk-Olsen T. Risk and timing of postpartum depression in parents of twins compared to parents of singletons. Acta Psychiatr Scand. 2025; 151(2): 163-172. doi:10.1111/acps.13766
 
Multiple Births. CDC. 2024.
 
Roman A, Ramirez A, Fox NS. Prevention of preterm birth in twin pregnancies. Am J Obstet Gynecol MFM. 2022 Mar;4(2S):100551. doi: 10.1016/j.ajogmf.2021.100551

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