C-section no safer than vaginal birth for delivering twins

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What is the optimal method of delivering twins, C-section or vaginal birth? Though, giving birth via surgery is perceived to be safer, a new study suggests a vaginal delivery is just as safe for a mother and her twin babies.

As the number of multiple births around the world has risen, thanks to the infertility treatments, so has the trend of delivering twins by planned cesarean section.

According to Canadian researchers planned vaginal birth is the correct method to deliver twins in a pregnancy sans complications when the first baby is facing head down. The study found the babies’ outcomes remained the same regardless of whether they were delivered by cesarean section or naturally.

“The study shows that women who are pregnant with twins can achieve the same results for their babies by planning a vaginal birth compared with planning a cesarean section, as long as they have obstetricians who are competent, skilled and safe,” said study author Dr. Jon Barrett, chief of maternal and fetal medicine at Sunnybrook Health Sciences Centre in Toronto.

A large scale randomized controlled trial
In order to determine the most favorable method of delivering twins, the researchers conducted a large scale randomized controlled trial. They studied 2,800 women pregnant carrying twins across 25 countries.

Among them, a total of 1,398 of the mothers-to-be (2,795 fetuses) were scheduled to have a C-section and 1,406 women (2,812 fetuses) were due to give birth vaginally. The latter could opt for a C-section for one or both babies if deemed medically necessary.

Observations by researchers
As expected 90 percent of the women assigned to C-section stuck to their original in the original plan and 10 percent delivered one or both twins vaginally. On the other hand, 40 percent of these women planning for a vaginal birth ended up delivering both babies by C-section while 4 percent delivered one each way. Both mothers and infants were tracked for 28 days after birth.

It was noted that only 2 percent of newborns died or had a serious problem. However, the manner of birth had no impact on the outcomes nor did it affect the rate of complications in moms.

Dr. Michael Greene of the department of obstetrics and gynecology at Massachusetts General Hospital in Boston stated, “These results do not indicate that all sets of twins should be delivered vaginally. Obstetricians exercising their best clinical judgment delivered both twins by cesarean section in nearly 40% of the women assigned to planned vaginal delivery, which undoubtedly contributed to the salutary outcomes. However, the results of this study suggest that a plan to deliver appropriately selected sets of twins vaginally is a reasonably safe choice in skilled hands.”

The findings were published in the New England Journal of Medicine on Wednesday.

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