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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 versus 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 50 percent of twin deliveries are done by Cesarean 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.

One should speak to one's physician about that physician's philosophy well in advance of the delivery date.

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