In uncomplicated twin pregnancies where the first twin presentation was cephalic, perinatal and maternal outcomes were similar whether the birth plan was for vaginal or abdominal delivery, a large study has found. Between December 2003 and April 2011, 2,804 women with twin pregnancies were recruited in 25 countries, including the UK. All 106 participating centres were staffed by experienced obstetricians with rapid access to operative intervention during labour. All pregnancies were otherwise uncomplicated and with the first twin presenting head first. All were randomised between the 32nd and the 38th completed week of pregnancy to either planned CS or vaginal delivery.