Updated 03 October 2013

Most twins can be born without a C-section

Expecting twins? Most can be born without a C-section, sparing surgery.


Expecting twins? You probably don't need to schedule a Caesarean section. Most moms can safely give birth without surgery, a major study finds.

It's the latest research to question the need for C-sections, which are done in one-third of all births in the United States and three-fourths of those involving twins. Studies increasingly are challenging long-held beliefs about caesareans, such as that women who had one need to deliver future babies the same way.

Doctors are now reconsidering C-sections for twin births, which are on the rise because of infertility treatments. Twins have more risk for birth complications and some studies suggest C-sections lower that risk, but this had not been put to a rigorous test.

Dr Jon Barrett of Sunnybrook Health Sciences Centre in Toronto, led a study in 25 countries of 2 800 women pregnant with twins. All of the first of the twins to be delivered were in good position for birth (most doctors still recommend a C-section if the first twin is in feet-first or breech position).

Half of the moms were scheduled to have C-sections and the rest vaginal births. About 40% of the latter group wound up having C-sections and 10% of those scheduled to have Caesareans ended up giving birth vaginally.

About 2% of newborns died or had a serious problem, but the manner of birth made no difference and nor did it affect the rate of complications in moms.

Results of the study were published in the New England Journal of Medicine.

Dr Michael Greene of Massachusetts General Hospital said: "These results do not indicate that all sets of twins should be delivered vaginally, but that planning to do so is a reasonable choice if the doctor is experienced in twin births and knows when a C-section becomes necessary."



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