Lakes District Hospital midwife Sue Wood said 10 sets of twins had been born or were due in the Wakatipu basin this year.
"I've been working here for 10 years and normally we have one or two twins a year out of about 300 births.
It's very sporadic, so to have 10 in one year is remarkable," she said.
Lakes District Hospital had no neonatal facilities so premature babies had to go to Dunedin if born before 32 weeks, she said.
It also had no obstetric service or facilities for Caesarean births, so all mothers expecting twins had to go to Invercargill or Dunedin to give birth, because of the higher risk of complications and risk of twins being premature.
"It is a challenge for us because we are a remote rural hospital with an urban population," she said.
It was also challenging for the parents because 80% did not have family in the district.
Families of twins with toddlers under 5 were entitled to 240 hours' subsidised child care a year, she said.
Mothers and babies returned to Lakes District Hospital for care until the babies were 6 weeks old, at which time care transferred to Plunket nurses.
"We look after antenatal and postnatal breast-feeding support so there will be a lot of work involved in so many sets of twins all at once.
"We have had to refer some mothers to independent midwives to share the load," Ms Wood said.
Independent midwife Wendy Wilkins said it was the highest number of twins in one year since she began working in Queenstown 10 years ago.
"It's an unusual number.
There are three midwives working at the hospital and three of us are independent so we are spreading them around so we have about two each because there is quite a lot of work involved.
"They are more likely to come early or have problems, particularly identical twins who only have one placenta," she said.
She had looked after one set who were born in Christchurch in March.
That mother had to live in Christchurch from 32 weeks because of risk of complications.
Mrs Wilkins also had another set of twins on the way next month, to Jude Nickolls, of Arrowtown.
Mrs Nickolls said she and her husband, Mark, were "very excited" at the prospect of her twins.
"They are due in September but I am having a C-section in two weeks because 38 weeks is considered full term for twins.
"They run out of room after that. I'm going to have them in Dunedin because I have family there," she said.
She was relieved that so many other Wakatipu women were also having twins so a support network could be formed.
"These will be my first children so I know it's going to be hard.
"Short term, it will be a lot of work but, long term, I think it will be cool having twins because they can play together and grow up together," she said.
An Arrowtown mother with 2-year-old twins was setting up a support group for mothers with twins, she said.
Queenstown Plunket committee president Belinda Ricketts said the Southland Multiple Birth Society would be holding a twin group for new mothers and babies.
"They have set up twin groups in the past when necessary.
"The area fluctuates - sometimes we have quite a few twins and then it drops down," she said.
