Do women have to have c-sections if they are giving birth to multiples?

No: In this day of modern obstetrics most women opt to have cesarean section for twins and mulitple gestation. If this is a twin pregnancy, term, with the first twin head first and normal sized babies then vaginal delivery is a good option. You should discuss your options with your caregiver as each pregnancy is different and circumstances change. Multiples greater than two usually require cesarean.

Please discuss with : Your doc, if you have twins most doctors will do a csection, if they are both head first and not too large and the second one does not change positions then some docs will let you labor, if you have triplets then you have to have a csection, and if you have twins or triples that pregnancy and delivery should only be managed by a board certified obgyn doctor - not a midwife.