Your medical circumstances

You may have certain medical conditions, which either existed before the pregnancy or have developed as a result, that make vaginal birth a high-risk option:

  • high blood pressure, pre-eclampsia, diabetes or problems controlling blood sugar levels
  • a heart problem or serious disability
  • low-lying placenta(s) or placenta praevia
  • some causes of third trimester vaginal bleeding
  • you have had a previous Caesarean section
  • your pregnancy is monochorionic (identical)

Your babies’ circumstances

There are many reasons why a Caesarean section may be the safest method of delivery for your babies. The chorionicity (how many placentas are present) of your pregnancy and presentation of your babies, as well as any conditions detected by ultrasound scan, are significant factors:

  • the presenting baby is breech (especially high risk in a
  • monochorionic pregnancy, more so if this is a first labour)
  • one or both of the babies has an underlying health problem
  • or fetal abnormality
  • one or both of the babies weighs under 1,500g, and
  • is either not growing well or has intra-uterine growthrestriction (IUGR)
  • the pregnancy is monochorionic (identical) and the babies have
  • developed twin-to-twin transfusion syndrome (TTTS)
  • the babies are showing signs of fetal distress
  • the pregnancy is monochorionic (identical) and monoamniotic (one single sac present).
  • This is an edited extract from One Born Every Minute: Expecting a Twins? by Professor Mark Kilby and Jane Denton (Quadrille, £25).Text © 2013 Mark Kilby and Jane DentonMore on Multiple Births