This is the 3rd episode of a four-part series covering complications at the time of vaginal delivery. This episode is brought to you by Leah Rusnell a fourth-year medical student at the University of Saskatchewan in Regina. The previous episodes discussed operative vagina delivery and the management of breech deliveries. This episode discusses the delivery of twins and the complications associated with them. After listening to this episode, you will be able to: 1. Identify the types of twinning based on chorionicity and amnionicity. 2. List the predisposing factors for a twin or multiple gestation pregnancy and associated risks for the mother and fetuses. 3. Outline a prenatal management plan for a twin pregnancy. 4. List the different types of presentations at the time of vaginal delivery. 5. Outline the specific considerations required at the time of labor and delivery of twins.