Shedding Light on the Risks of Being a Second Twin

March 2, 2007 — -- For twins, being the second born could mean a higher risk for fatal complications during birth.

In a nine-year study that followed more than 1,300 pregnancies in the U.K., researchers found that second-born twins have twice the risk of death during vaginal delivery when compared to the first born.

The findings attribute the increased risk to complications during labor and delivery -- including a lack of oxygen to the second-born child.

"Labor and delivery has some risk to it, and there's no question that risk is greater for the second twin and for the mother," says Dr. Steven Goldstein, professor of obstetrics and gynecology at New York University.

When delivered vaginally, the second-born child faces complications such as the separation of the placenta or a prolapsed umbilical cord -- both potentially fatal.

"The second twin is always harder to monitor," says Dr. Briant Herzog, an OBGYN at the Presbyterian Hospital of Plano, Texas.

"You need to follow the second twin with an ultrasound right away," to decrease problems, he says.

Additionally, whenever twins are being delivered vaginally, doctors must be prepared to do an emergency c-section.

This preparation will "absolutely decrease the risk of problems," says Herzog.

Generally, if the possibility exists for any problems during child birth, most physicians will opt for a Caesarian section.

"Considering how easily we elect for a c-section today," says Goldstein, "having twins is a very valid reason for having the procedure."

Herzog agrees, and adds that there is a growing trend in the United States to deliver twins primarily by c-section, rather than risk vaginal delivery.

"A lot of people won't do vaginal births for twins at all," he says.

While there may be some risk to the mother in performing a c-section, it is not comparable to the risk a second-born twin faces.

"The risk for the mother is very small," says Herzog. "There is much more risk to the baby from lack of oxygen."