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Nowadays, it is not uncommon to automatically expect that you will deliver by cesarean section once you find out that you are expecting twins. It was not always like that, though. A new study reports that the c-section rate for twins has "dramatically" risen since the mid 1990s in the United States. Why?

There is no question that fetal position or other complications make c-sections necessary for twins, like for singletons, in some cases. The study, published in the journal Obstetrics & Gynecology, showed that the c-section rate for twins was 53 percent in 1995, but that it has risen to a whopping 75 percent in 2008!

This means that there was a five percent increase in twin c-sections each year, and that is something that can't be explained by a higher number of breech or transverse (side lying) babies or birth complications. Healthy pregnant women who were carrying vertex (head down) babies accounted for a large portion of the rise in twin c-sections.

Those women might not have any benefit from having a c-section, and it is important to remember that c-sections do carry medical risks for both mothers and babies. Dr Henry Lee from the University of California, San Francisco, who worked on the study, explained: "We know that sometimes they're appropriate and going to be beneficial... but in some instances there's no clear reason for them and it can potentially cause problems for the mother or baby."

Dr Lee added that the dramatic rise in the c-section rate for twin births "is not really explained by any kind of medical reason." What can you do, if you are expecting twins and would like to attempt a vaginal delivery? Our first and foremost suggestion is to find an OB who is on board with a vaginal delivery for healthy twins, if they are both vertex, or baby A is vertex and baby B breech. It is important to look at the doctor's twin c-section rate, and not just take their word for it when they say that "of course you can give birth vaginally if circumstances allow it".

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