Goossens SMTA, Ensing S, Roumen FJME, et al. - Via performing a nationwide cohort study of women pregnant with twins who planned to deliver vaginally between 32 ⁺⁰ - 41 +6 weeks with the first twin in cephalic position, researchers sought to compare neonatal morbidity and mortality rates after actual 1) vaginal delivery (VD) both twins vs 2) unplanned Cesarean Delivery (CD) of both twins and 3) after VD of twin A and CD of twin B (combined delivery). Overall, 19,723 women were included; of these women, 15,785 women (80.0 %) delivered both twins by VD, 2,926 (14.6 %) delivered both twins by unplanned CD, and 1,012 (5.1 %) women delivered by combined delivery. Outcomes suggest a twofold increased risk of neonatal mortality after an unplanned CD of both twins vs VD of both twins. A sevenfold raise in perinatal mortality and a five-fold increase in asphyxia-related outcomes were observed in correlation with a combined delivery vs VD of both twins. After an unplanned CD of both twins, twin A is noted to be more affected, while after combined delivery, twin B is noted to be more affected.