Second-Born Twin Has Higher Post-Delivery Death Risk

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"Among twins born prematurely, the high risk of death due to prematurity probably masks the small additional risk of death due to complications of delivery for the second twin," the researcher added.

Whether a woman chooses to have a Caesarean delivery depends on the viewpoint of the individual woman, Smith said.

"This will involve her motivation to achieve a normal birth, her attitudes toward small risks of serious adverse events and her plans for future pregnancies. In particular, women planning many future births, and younger women, whose plans may be difficult to predict, may do better not to consider planned Caesarean section due to the effects of this on future pregnancies," he said.

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One expert believes that the risk of death of the second born twin is even smaller in the United States than in Britain.

"I would hate to see this study used as an excuse to have every mother with twins have a Caesarean section," said Dr. F. Sessions Cole, the director of newborn medicine and head of the neonatal intensive care unit at St. Louis Children's Hospital.

Cole said that most twins delivered at full term are delivered vaginally. "Having all mothers with twins deliver by Caesarean section would result in more risk to the mother than the small risks to the babies," he said.

Once the first twin is delivered, it is important to carefully monitor the second twin, Cole said. If there appears to be problems with the second twin, that baby may be delivered by Caesarean section, he noted. "That's the standard of care today."

Cole believes that the data in the study applies only to Great Britain. "There would be fewer such deaths in the United States," he said. "There is much greater monitoring attention given to the second twin in the United States, given the malpractice risk that any obstetrician faces when he or she delivers twins," he said.

More information

For more information on pregnancy, visit the American Pregnancy Association.

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