Editing Twin (section)

==Management of birth==
For otherwise healthy twin pregnancies where both twins are head down, a trial of [[vaginal delivery]] is recommended at between 37 and 38 weeks.<ref name=Bis2013/><ref name=NICE2011Chp5>{{cite web |author1=National Collaborating Centre for Women's and Children's Health |date=November 2011 |title=Caesarean section |website=NICE |url=https://www.nice.org.uk/nicemedia/live/13620/57162/57162.pdf |access-date=12 June 2014|pages=70–103|archive-url=https://web.archive.org/web/20111215223801/https://www.nice.org.uk/nicemedia/live/13620/57162/57162.pdf |url-status=dead |archive-date=2011-12-15 |publisher=Royal College of Obstetricians and Gynaecologist}}</ref> Vaginal delivery in this case does not worsen the outcome for the infant as compared with [[Caesarean section]].<ref name=Bis2013>{{cite journal |last1=Biswas |first1=A |last2=Su |first2=LL |last3=Mattar |first3=C |title=Caesarean section for preterm birth and, breech presentation and twin pregnancies |journal=Best Practice & Research. Clinical Obstetrics & Gynaecology |date=Apr 2013 |volume=27 |issue=2 |pages=209–19 |pmid=23062593 |doi=10.1016/j.bpobgyn.2012.09.002}}</ref> There is controversy on the best method of delivery where the first twin is head first and the second is not.<ref name=Bis2013/> When the first twin is not head down a caesarean section is often recommended.<ref name=Bis2013/> It is estimated that 75% of twin pregnancies in the United States were delivered by caesarean section in 2008.<ref name="pmid22015878">{{cite journal |vauthors=Lee HC, Gould JB, Boscardin WJ, El-Sayed YY, Blumenfeld YJ |title=Trends in caesarean delivery for twin births in the United States: 1995-2008 |journal=Obstet Gynecol |volume=118 |issue=5 |pages=1095–101 |year=2011 |pmid=22015878 |pmc=3202294 |doi=10.1097/AOG.0b013e3182318651}}</ref> In comparison, the rate of caesarean section for all pregnancies in the general population varies between 14% and 40%.<ref>{{cite web |url=https://www.bbc.co.uk/news/health-15840743 |title=Women can choose Caesarean birth |url-status=live |archive-url=https://web.archive.org/web/20120819201245/http://www.bbc.co.uk/news/health-15840743 |archive-date=2012-08-19 |work=BBC News |author=James Gallagher |date=23 November 2011}}</ref> In twins that share the same placenta, delivery may be considered at 36 weeks.<ref name="pmid27599496">{{cite journal |vauthors=Cheong-See F, Schuit E, Arroyo-Manzano D, Khalil A, Barrett J, Joseph KS, Asztalos E, Hack K, Lewi L, Lim A, Liem S, Norman JE, Morrison J, Combs CA, Garite TJ, Maurel K, Serra V, Perales A, Rode L, Worda K, Nassar A, Aboulghar M, Rouse D, Thom E, Breathnach F, Nakayama S, Russo FM, Robinson JN, Dodd JM, Newman RB, Bhattacharya S, Tang S, Mol BW, Zamora J, Thilaganathan B, Thangaratinam S |display-authors=6| title=Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis |journal=BMJ |volume=354 |pages=i4353 |date=September 2016 |pmid=27599496 |pmc=5013231 |doi=10.1136/bmj.i4353}}</ref> For twins who are born early, there is insufficient evidence for or against placing preterm stable twins in the same cot or incubator (co-bedding).<ref>{{Cite journal |last1=Lai |first1=Nai Ming |last2=Foong |first2=Siew Cheng |last3=Foong |first3=Wai Cheng |last4=Tan |first4=Kenneth |date=2016-04-14 |title=Co-bedding in neonatal nursery for promoting growth and neurodevelopment in stable preterm twins |journal=The Cochrane Database of Systematic Reviews |volume=4 |issue=2 |pages=CD008313 |issn=1469-493X |doi=10.1002/14651858.CD008313.pub3 |pmc=6464533 |pmid=27075527}}</ref>