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I have identical (monochorionic twins) and would like to try for a normal vaginal delivery but some of the doctors at the hospital advise c-section at 34+ weeks whereas others seem to be happy for me to go 37+ weeks and try for a normal birth if both twins are healthy and twin 1 is head down. Due to the differing advice, I am not sure what is best. Would you be able to briefly explain to me the benefits of a c-section over vaginal birth for this type of twins?

  I have identical (monochorionic twins) and would like to try for a normal vaginal delivery but some of the doctors at the hospital advise c-section at 34+ weeks whereas others seem to be happy for me to go 37+ weeks and try for a normal birth if both twins are healthy and twin 1 is head down. Due to the differing advice, I am not sure what is best. Would you be able to briefly explain to me the benefits of a c-section over vaginal birth for this type of twins?

The timing of delivery is very controversial, and is split between those that advocate Caesarean at 34 weeks to those that will allow a vaginal delivery at 37 weeks. This is because twin twin transfusion syndrome (TTTS) can occur late in pregnancy, and can be very serious-whereas delivering babies a little early (34-36 weeks) is very unlikely to lead to serious complications. Some doctors believe that TTTS is more likely to occur if you are in labour than with a Caesarean Section. Again, it is impossible to guide you precisely as your exact clinical circumstances are not known to us, but many fetal medicine experts in the UK would suggest delivery by Caesarean Section at 36-37 weeks as the most pragmatic compromise.
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