There is a body of evidence that the risks of vaginal delivery in twins is greater than that for singletons. This is particularly the case for the second twin. These risks need to be considered before planning a vaginal or caesarean birth.

Translating data to dialogue: how to discuss mode of delivery with your patient with twins. (2006-01)

Neonatal and maternal outcomes in twin gestations > or =32 weeks according to the planned mode of delivery. (2005-01)