Compared with other countries, the elective caesarean section rate for twins is relatively low in the Netherlands. Worldwide, there is an increasing trend toward performing more elective caesarean sections for women with a twin pregnancy at term, be it for twins with the first child in breech or in cephalic presentation. The results of the 'Twin Birth Study' indicate that a planned caesarean section does not improve outcome as compared with planned vaginal birth for twins with the first child in cephalic position beyond 32 weeks gestation. During the study, an experienced obstetrician was present during planned vaginal delivery and there was a possibility of performing a secondary caesarean section within 30 minutes. This study provides an additional argument to guarantee the aforementioned conditions in all hospitals where women plan to deliver their twins vaginally. However, the definition of an experienced obstetrician is subject to debate.