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Rarely twins have occured, but with the second twin outside the uterus, in the abdominal cavity. That would definitely require a Csection, putting mom and the first baby at a slightly higher risk of complications at the birth. Usually it only happens with people that have had abdominal surgery in the past and a "leak" forms, allowing fertilization. But as I said, it's rare, so most OB's don't even mention it.
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