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Expert Q&A

	By David L. Fay, M.D. Family Physician Associate Director, Waukesha Family Practice Residency Program

I'm wondering what the current statistics are for vaginal vs. Cesarean delivery of twins. I've found a ton of information, oddly enough nothing that is current with today's medical advances. Also, are some doctors more likely to perform a Cesarean than others, and how would I go about finding out if my doctor is prone to Cesarean deliveries for twins?

Right now, about half of twin deliveries are done by C-section. While there are many proponents of this mode of delivery, no large-scale trials have conclusively shown benefit to either mode of delivery (vaginal or C-section).

It is universally accepted that vertex-vertex twins (both head down) are reasonable candidates for vaginal delivery, although a small (and controversial) British trial in 2002 revealed a higher incidence of the second twin dying during a vaginal delivery. Vertex-breech and breech-breech twins are usually delivered via C-section. You should speak to your physician about their philosophy well in advance of the delivery date.

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