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Evidence Library · Reasons for cesarean

Twins

A cesarean is not automatically safer.

A randomized trial of 5,565 twin pregnancies between 32 and 39 weeks, with the first twin head down, compared planned cesarean with planned vaginal birth. The combined rate of fetal or newborn death or serious newborn problems was 2.2% with planned cesarean and 1.9% with planned vaginal birth. There was no significant difference.

Twins are not by themselves a reason for cesarean when the first twin is head down and experienced clinicians are available. Many hospitals nevertheless schedule all twins for cesarean. You are entitled to ask which applies to you and why.

Where this comes from:
283. Barrett JFR, Hannah ME, Hutton EK, Willan AR, Allen AC, Armson BA, et al. A randomized trial of planned cesarean or vaginal delivery for twin pregnancy. N Engl J Med. 2013;369(14):1295-1305.

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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.