twin delivery ?/situation

[BakersDozen]

My OB told me a few months ago that if Baby A was head down I could deliver naturally and give Baby B a chance to flip if not already head down. Yesterday, however, my doctor said that unless both babies are head down I get a c/s. I couldn't say a word as she was telling me, I was so shocked. For the twin mamas or those who know twin mamas, could you advise me on this? I do not want a c/s unless it is absolutely medically necessary! I'm 27 weeks and suddenly find myself panicking even more than I already was about the upcoming delivery.

 

My doctor's thinking is that while Baby B could turn it would be better to do a planned c/s than a rushed emergency procedure. I understand her reasoning yet I am struggling to accept it.

 

What are my options? Can I simply refuse the c/s? There is a hospital 1.5 hours away that has more "progressive" doctors/midwives where I could go yet I was hoping to avoid that kind of drive for both me and my labor team (5 additional people).

 

27 weeks and she springs this on me. :glare: I guess it could have been worse - I could have been 35 weeks or more.

[simka2]

I was in the position of twin A being down and twin B turning after his brother came out. It was fine. Now, I have a pain disorder that makes it so I have to get an epidural as soon as my water breaks (I do not dilate if I am in physical pain). I was very OK with this because "if" I needed an Emergency c-section the epidural was already in place.

 

 

My Dr. just made sure it was on my hospital charts to give me the epidural upon my water breaking or if they chose to induce.

[sbgrace]

My OB said as long as A was in position we could try vaginal and that is what we did. She did require an epidural line be placed so we could do a section quickly if needed without me being out. I think that was her standard practice with twin vaginal. My baby A was sunny side up with a hooked chin and finally we did do an emergent section. But he wouldn't have come out in that position twin or not. So I can't tell you how we would have worked out for us but only that my OB did allow labor with only baby A in position.

 

http://pregnancy.about.com/cs/twinsmore/a/aatwinlabor.htm This article seems to sum up my OB's position on the c section vs. vaginal decisions. You've probably got lots of room for both babies to be vertex by the time labor rolls around given all your prior births. But I hope your OB will reconsider.

Edited August 9, 2011 by sbgrace

[Unicorn.]

I see so many docs doing unnecessary c-sections even on singletons these days. I would go talk to the docs at the more progressive hospital. We lived 75 miles away from the hospital when ds was born. With the twins, we had a scheduled c-section. Mine were both sideways though.

[Mommyof4ks]

Call and ask if she changed her mnd or if hospital policy changed. Hospitals change their policies like the wind, and then you could decide to go with it or change hospitals. How frustrating to have to deal with this now.

[Melinda in VT]

I delivered twins with Twin A head down and Twin B . . . well, she was breech when I got to the hospital but went transverse during labor and then was delivered as a footling breach. (The nurse used ultrasound to display her on the monitor and the doctor reached in, grabbed her feet, and pulled her out.)

 

I was using a combined midwives/obstetricians practice. The doctor on call when I went into labor was the one who was the least happy with my no-epidural birth plan. She really, really wanted an epidural in place in case we ended up with a c-section and she insisted we deliver in the operating room instead of the standard labor-and-delivery room. She finally agreed to let me skip the epidural but she did make me sign several forms full of scary language about going Against Medical Advice and the risks of general anesthesia. I did have to have an iv inserted, just in case, but it wasn't connected to anything.

 

It was by far my best labor, and the only one I managed without drugs. (Twin A was the only one of my four kids who figured out he needed to be head down AND facing the correct direction, and it's truly amazing what a difference that makes in a labor.)

 

I am usually a complete worrywart and it's sort of out of character for me to take a risk, but I felt confident things would work out.

[wapiti]

My baby A was head down and baby B transverse. After baby A was delivered, the OB and resident turned baby B (from the outside and inside :001_huh:) to head down and then he was out in two pushes, less than 5 minutes after A. If she hadn't been able to turn him, they would have done the section immediately (it turned out that he was septic), but then, that's why twins push in the OR.

 

Maybe your doc is uncomfortable with turning baby Bs. I'd ask about the change in your doc's plan - there could be some reason (such as hospital policy, as mentioned above) or maybe your doc had a bad experience or something. Maybe the doc would agree to a compromise of vaginal delivery of baby A and section for baby B if baby B doesn't turn on his/her own within a certain time after baby A is out? You'll be in the OR already. The baby's position can be monitored by ultrasound easily in the OR (as was the case for me).

 

Congrats and good luck!!

[ChrisB]

My OB said as long as A was in position we could try vaginal and that is what we did. She did require an epidural be placed so we could do a section quickly if needed without me being out. I think that was her standard practice with twin vaginal.

This is my OB's standard practice too unless she feels a need for a c-section. I was able to labor until I was far enough along, probably a 6 or 7, and then I was given an epidural. Both babies were head down. After baby A was delivered, I had a nurse on either side holding my belly so that baby B wouldn't flip. Also, my OB was holding baby B's head while she made her way down for delivery once baby A was delivered. I'd say no scheduled c-section until you get closer to the due date and see how the babies are presenting. Babies flip all the time.

[justamouse]

Baby b for me was facing up, with her head under my ribcage. baby A had her head firmly wedged in my pelvis. :glare:

 

Baby A was born vaginally, and baby B flipped right around and down she came.

 

5 minutes. Easy peasy. Easiest birth I ever had (it was like birthing popcorn), even at 6 weeks premature, and I was able to bring them home right away as they were 4.2 and 5.2 pounds.

 

Get another opinion.

[ktgrok]

You do NOT have to consent. That is silly advice. IF baby B doesn't turn, a decent doctor or midwife can do a version. There will be TONS of room to do it then. Often an internal version, where they reach up and grab them, basically. Not super pleasant, but much much better than major abdominal surgery! Even if they can't flip the baby, a breech baby B is not a huge problem, as the cervix has already been opened by baby A's head. Again, an experienced provider shouldn't have a problem. But if they do, at that point a C-section could be done, but it wouldn't be an emergency, it would just be unplanned. No huge deal. At least then baby A would get the benefits of a vaginal birth, which are numerous.

 

My good friend was in this exact situation. They threatened, argued, and coerced her while in labor, up until she was pushing. She kept refusing the c-section. And thank goodness! Baby B turned all on her own after baby A was out of the way.

 

Contact your local ICAN group (International Cesarean Awareness Network) for a less knife happy doctor, and ask at a local moms of multiple group as well. They can probably direct you.

 

I'm so sorry you are dealing with this. The advice you are being given is not based on evidence, but on fear.

[Farrar]

My baby A was head down and baby B was a footling. Baby A was facing backwards though and at a funny angle, so he actually required manipulation to get out. However, his brother FELL out afterward. From everything I've read, a breech baby B is very unlikely to be a problem - they're typically smaller AND they often flip during labor.

 

I'd push for the delivery you want. If it can't happen for *medical* reasons, then that's something you have to live with, but this isn't medical, it's for the doctor's ease. Do you have a good doula? Mine had a law degree and she was a total... term I won't use on this board. :D

[Paige]

You do NOT have to consent. That is silly advice.

I'm so sorry you are dealing with this. The advice you are being given is not based on evidence, but on fear.

 

I agree!

 

My OB said we could do a vaginal delivery as long as Baby A was head down. Baby B's position shouldn't matter at all because nobody knows what he or she will do when Baby A comes out and there is all that new space! Even if Baby B is head down, my OB said it wasn't unusual for her to flip to another position after Baby A delivers. He said if Baby B wasn't head down that he would just grab her by the legs and pull her out. At that point, you are so dilated and stretched, he said it would be no problem.

 

If you have time and the other Dr won't consider a breech Baby B, I'd switch. If you don't have time (like you are delivering with a different Dr who wants to assert different rules) you can refuse. I delivered with a different Dr who wanted to assert different rules and it was no fun but much better to fight in labor rather than end up recovering from surgery! Also, I think most Drs will want you to have an epidural. My original Dr was cool with me not having one and I was not prepared to have it be an issue. The attending doctors were very much not cool with no epidural but I still refused.

 

After Baby A came out, they all jumped on my stomach to prevent baby B from turning. She was head down but they were still very apprehensive and anxious. They also had an ultrasound machine on me throughout the delivery of Baby A.

[BakersDozen]

Oh ladies, thank you! My OB kept saying that all she wants is two healthy babies and safe delivery so by the time I left I felt that if I challenged her decision I was putting my babies' lives in danger. I go in tomorrow for an u/s and will ask her point blank if her decision is firm and if so, I'll find another doctor.

[prairiewindmomma]

My ob delivers a lot of twins naturally. I'd do some calling around to see if you can find someone else. I switched obs and hospitals in order to find someone with a lot of experience under their belt...

[LaxMom]

Yeah, my baby A was head down, B transverse. After Holden was born, Quinn laid around in there, stretching out, wiggling around, etc, for an hour and 20 minutes. Then he decided to join the world, too. I think he was just happy that other guy who was squishing him left. :)

 

We agreed early on that there was going to have to be actual evidence in favor of a section at the time. Otherwise, it was my birth.

[ktgrok]

Oh ladies, thank you! My OB kept saying that all she wants is two healthy babies and safe delivery so by the time I left I felt that if I challenged her decision I was putting my babies' lives in danger. I go in tomorrow for an u/s and will ask her point blank if her decision is firm and if so, I'll find another doctor.

 

Typical guilt trip from the doctor! As if two healthy babies wasn't what you wanted too! I hate when doctors pull the dead baby card on you!

[1GirlTwinBoys]

My Dr. said that as long as baby A was head down, I could do a vaginal birth. My baby B was pulled out by his feet.:) Very easy delivery. I would not agree to a C-section so easily.

[Veritaserum]

Typical guilt trip from the doctor! As if two healthy babies wasn't what you wanted too! I hate when doctors pull the dead baby card on you!

 

:iagree: I once asked a nurse about the hospital policy on intermittent monitoring during labor. She flipped out and insisted that if there were a problem I'd have to have constant monitoring. I look at her and said that if there were a problem with my baby, I'd want continuous monitoring. Duh.

 

Anyway. I'm not a twin mom, but I'm a birth nut. ;) A breech twin B after a vertex twin A is not likely to be riskier than a c-section. C-sections have risks, too, so it's not like vaginal birth = very risky and c-section = totally safe. There are risks to both and you need to decide which risks are more comfortable to you. It's probably worth driving to the further, but safer, doctors and hospital.

[BakersDozen]

I started calling around already...2 out of 2 OBs say "no", only 1 left to go. :glare: I don't believe this!!!

[MamaChristina]

A friend of mine recently had twins. Both were breech, but the midwife was a very experienced one that had the backing of the senior doctor. He said he would allow it if the midwife thought it possible. She said she would do it as long as it was a water birth. That way neither baby would breath till it hit the air. Both were born breech safely and without any complications. They are beautiful.:)

[kchara]

My OB said that as long as Twin A were head down, he would deliver Twin B breech, but a lot of doctors don't have experience with breech births. I was blessed, he had delivered breech, and had even had experience with homebirths. He knew I wanted a natural birth. Hospital policy was that I delivered in the OR. I didn't want that, so I labored at home as long as I possibly could, then delivered 1/2 an hour after I got to the hospital. :) They weren't happy, but they got over it. It was hands down my easiest delivery, and my first natural birth. (Only completely natural birth, my next baby, and my youngest so far, had presentation issues and I needed help.) I would definitely keep looking around. Are there any midwives in your area that might be able to help you out?

[oneplustwoIdaho]

If you are willing to go into labor and see how it progresses, then I say you refuse to schedule it.

Mine had to be scheduled (issue with cords being nearly connected, etc.), but it is always best to let nature take its course. You will let them develop as much as possible if you wait for natural labor to start. I wish I had been able to let mine develop at least another week .

Also, my A was always head down and B transverse, but by the c-section time B had turned head down.

I hope you are able to come to an agreement that suits you with the Doc and hospital!

[craftyerin]

Ditto the others. I delivered a vertex baby A and a footling breech baby B five minutes later. No big deal. My OB did require an epidural and delivery in the OR, but I was OK with that. My labor was LONG and I was grateful for that epidural. Even delivering in the OR was no big deal. I pushed in my L&D room until baby A was crowning, then we wheeled my bed to the OR next door. I didn't move off of my bed to the OR table or anything. I just kept pushing and delivered babies!

[BakersDozen]

Heard back from third OB - what a joke. His response was, "I can't give you a definite "yes" or "no" because there are too many factors." When I specifically asked about Baby A being head down but not Baby B he repeated himself. I'm going to assume that means there is no way he will let me try to deliver naturally; he will string me along until the very end then drop the bombshell my own OB did.

 

So it looks like I'll be heading out of town. :glare:

[dani3boys]

I was in the same position as you were 13 years ago, and they were willing to let me try to deliver if baby B was still not head down. Luckily for me he decided to flip at about 35 weeks. It was a sleepless night when he did flip, but it made things much easier. I was induced at 36 weeks because twin A's heart rate kept dropping. They had me in sterile c-section room in case they needed to do an emergency c-section. Would they let you try to deliver, but have everything ready to go in case they need to do an emergency c-section? I would ask more questions, and try to find a way they could work with you.

[Sahamamama]

My OB told me a few months ago that if Baby A was head down I could deliver naturally and give Baby B a chance to flip if not already head down. Yesterday, however, my doctor said that unless both babies are head down I get a c/s. I couldn't say a word as she was telling me, I was so shocked. For the twin mamas or those who know twin mamas, could you advise me on this? I do not want a c/s unless it is absolutely medically necessary! I'm 27 weeks and suddenly find myself panicking even more than I already was about the upcoming delivery.

 

Don't panic, but be prepared. What your doctor is telling you is that you are going to have a C-section. My OB did the whole song and dance about Baby A being vertex and Baby B being breech... IMO, he NEVER intended to deliver naturally. Never. Most twin moms I speak with say the same thing -- all throughout the pregnancy, the OB reassures them that it'll be great to do it the mom's way, then BAM! Just at the end, the OB announces that "it would be best" to do a C-section. They plan this all along, IMO.

My doctor's thinking is that while Baby B could turn it would be better to do a planned c/s than a rushed emergency procedure. I understand her reasoning yet I am struggling to accept it.

 

I had a C-section with my firstborn because the OB didn't listen to a word I said (her foot was sticking out). :glare: It was so hard to accept that my voice as a mother was unheard. When the twins were on the way, I talked to a new OB, and he seemed so sympathetic, but like I said, it was an act. I know I sound bitter... I'm not, exactly, but it really did turn so suddenly into a 180 degree turnaround with the second OB. Yes, I was disappointed that he put his own interests ahead of our own, but that's the way it is.

 

What are my options? Can I simply refuse the c/s? There is a hospital 1.5 hours away that has more "progressive" doctors/midwives where I could go yet I was hoping to avoid that kind of drive for both me and my labor team (5 additional people).

 

You can't refuse as far as I know, once the doctor determines the babies are in need. With me, they "determined" that my water was low. :glare: They put me on pitocin when I was not AT ALL dilated. Talk about painful. My water broke, and was not low, apparently. :tongue_smilie:Then, of course, it was time to do a C-section. Afterwards, yes, it felt like the whole thing had been pre-planned. If I were you, I would look around, you still have time.

 

27 weeks and she springs this on me. :glare: I guess it could have been worse - I could have been 35 weeks or more.

 

We went to 38.5 weeks with the twins. :D Yeah, I know. Big. They were over 7 lbs. each, and healthy. In the end, that really is all that counts. I'm not sorry in some ways that they came the way they did, even though the recovery for me was a trial for a long time. For all that suffering, I ended up with two beautiful daughters (three altogether), and they are worth every bit of whatever it took to get them here.

 

:grouphug: Don't let them induce you if you are not dilated. Just my two cents.

 

 

[busymotherof4]

It seems to vary from area to area what is standard. Back in IN I knew 2 friends who had twins vaginally. I know for sure that one baby b was footling breech. Where I live now all Twins are delivered c-section. The few who had twins vaginally either did it at home or out of town.

I would check with the most local ICAN group. They usually can tell you who is comfortable delivering twins even if breech.

[Runningmom80]

It depends on the dr. Mine is a fertility specialist, so does a lot of twin births. He only required a to be vertex. She was, so I tried. I ended up with a c-section anyways.

 

 

I will say my ob was completely supportive of a vag birth. It was my baby girl who wanted to make things difficult :D

 

 

I have to admit, I was a little relieved to have a c-section. I was terrified of birthing A vag, and needing a c-section for B. My B was over a lb bigger than A, and sometimes the birth canal isn't ready for the bigger baby. Could you imagine?

Edited August 10, 2011 by Runningmom80

[simka2]

It seems to vary from area to area what is standard. Back in IN I knew 2 friends who had twins vaginally. I know for sure that one baby b was footling breech. Where I live now all Twins are delivered c-section. The few who had twins vaginally either did it at home or out of town.

I would check with the most local ICAN group. They usually can tell you who is comfortable delivering twins even if breech.

 

This concept floors me!!!! C-section was not even presented as an option for me, even with my disorder. Since I had delivered one vaginally it was that or an emergency.

 

Are c-sections for twins back in favor?

 

--this isn't really directed at this poster. Your post just kinda threw me ;)

[Murmer]

My best friend is being induced tonight for her twins. Her ob is letting her try vaginal since baby A finally turned even though baby B is breech. Her ob did say if both were still breech it would be auto c section. She did have to travel over an hour to find an ob and hospital willing to allow a vaginal twin birth...part of why she is being induced tonight.

[Molly]

One thing I have to ask, is have you delivered all your other children naturally? From my way of thinking if you have birthed 9 children naturally, there does not seem to be a medical reason to have a c-section at all. Yes, have them prepared in case something goes wrong, but planning it when it is not necessary is a no go in my mind.

 

Anyway, wishing you luck in your journey, and enjoy those wee blessings when they arrive.:D

[jenn-]

My OB was comfortable with turning B as long as A was head down. B's position prior to delivery doesn't mean squat because of the high chance B will flip however he/she wants as A exits. At 35 weeks 6 days, both my twins decided they wanted to go transverse on me after A had been in position for weeks and weeks. 3 days before the scheduled C, they decided to flip into position and the C was flipped into an induction (I have a medical condition that keeps me from being allowed to go into labor naturally).

[1GirlTwinBoys]

I forgot to mention that I was required to deliver in an OR with a full surgical team standing by. I didn't mind really. It just wasn't quite as intimate and private as when I delivered my baby girl.:)

[ktgrok]

This concept floors me!!!! C-section was not even presented as an option for me, even with my disorder. Since I had delivered one vaginally it was that or an emergency.

 

Are c-sections for twins back in favor?

 

--this isn't really directed at this poster. Your post just kinda threw me ;)

 

C-sections for EVERYTHING are in favor. My local hospital has a 40% c-section rate. So does the next closest. And then people wonder why women want home births. Blech.

[Osmosis Mom]

I had delivered four vaginally when I agreed to a c-section for my twins. One was perfectly head down while the other's head was near my belly bottom with her legs bent near A's head leaving open the possibility that she might stretch them as A was delivered, keeping her from getting an easy exit. We were in a remote hospital with no NICU and intensive care so the doctor did not want to take any chances. She offered to deliver me on the operating table (which I didn't mind), but she was truly not comfortable with it.

 

I ended up going against my natural inclination and opting for the -to me- safest solution for the babies and had a c-section. It was fine.

[BakersDozen]

One thing I have to ask, is have you delivered all your other children naturally?

Yes..well, all vaginally but not all "naturally" as I'm big on the epidural now. ;)

 

We were in a remote hospital with no NICU and intensive care so the doctor did not want to take any chances.

This is a huge factor for my doctor as well. Our nursery is only Level I so if something goes wrong it could be very bad.

 

I wish I could take all of you with me to my OB's office tomorrow and have you share with her your experiences. :) As I can't do that I hope I can at least have the courage to question her and not be intimidated into something I do not want.

 

You ladies are amazing, as always.

[justamouse]

We went to 38.5 weeks with the twins. :D Yeah, I know. Big. They were over 7 lbs. each, and healthy. In the end, that really is all that counts. I'm not sorry in some ways that they came the way they did, even though the recovery for me was a trial for a long time. For all that suffering, I ended up with two beautiful daughters (three altogether), and they are worth every bit of whatever it took to get them here.

 

:grouphug: Don't let them induce you if you are not dilated. Just my two cents.

 

 

 

Good LORD, I thought I had basted turkeys. :001_huh::001_smile: I honestly don't think I would ahve been able to walk wit 14 pounds of baby kicking at me. Two legs are bad-four was crazy!

[ktgrok]

Yes..well, all vaginally but not all "naturally" as I'm big on the epidural now. ;)

 

This is a huge factor for my doctor as well. Our nursery is only Level I so if something goes wrong it could be very bad.

 

I wish I could take all of you with me to my OB's office tomorrow and have you share with her your experiences. :) As I can't do that I hope I can at least have the courage to question her and not be intimidated into something I do not want.

 

You ladies are amazing, as always.

 

Well, given that c-section babies are MORE likely to have breathing problems...I'd be even more likely to avoid the section. If he pushes, and you feel intimidated, ask for the studies/research showing that surgery is safer for baby B, if that one is breech. He won't be able to find any.

 

I attended my friend's birth of twins, where the doctor tried to scare her into a c-section for hours and hours. Finally, she was fully dilated almost and the doctor told her she should have a c-section because her uterus was extended so far with twins, and her labor had been so long, that she was worried the uterus wouldn't clamp down fast enough after birth and she would bleed too much. I asked the doctor what the statistics were on amount of blood loss after a vaginal birth versus a c-section....she paused...then said, well...you usually lose more blood with the c-section. Um...yeah. She finally admitted she just had never turned a baby in utero before and was scared to try. Sigh. My friend told her to get another doctor then, but no one was available. At that point my friend told her "you don't have faith, but I have faith enough for both of us," and proceeded to push out both babies.

 

My point is they WILL give you bogus reasons for things, and will do it because at the end of they day either they are inexperienced, or because a scheduled in advance twin c-section is a lot faster and easier on them than a twin vaginal labor and delivery. Or becuase you are less likely to sue over a c-section, even one that goes badly, than over a vaginal birth.

Edited August 10, 2011 by ktgrok

[Farrar]

Can you ask around in your area? I had a planned homebirth - didn't end up happening - ah well - but my backup doctor was the doctor around here who's famous for letting everyone go vaginally. And he really did. I mean, forceps, but hey, still better than getting sectioned in my book. I feel like there's someone like him in a lot of areas, but you might have to look around.

 

ETA: If you can have a doula there (find one, afford one), I think your chances of avoiding a C-section go up immensely. The story above that Katie told about her friend is so illustrative. And it's so hard to say no to the DOCTOR when s/he's urging you to do it. You need a medical advocate you can say on your behalf, no, now is not the time for that intervention (or, yes, things are serious, do the c-section).

Edited August 10, 2011 by farrarwilliams

[Veritaserum]

Yes..well, all vaginally but not all "naturally" as I'm big on the epidural now. ;)

 

This is a huge factor for my doctor as well. Our nursery is only Level I so if something goes wrong it could be very bad.

 

I wish I could take all of you with me to my OB's office tomorrow and have you share with her your experiences. :) As I can't do that I hope I can at least have the courage to question her and not be intimidated into something I do not want.

 

You ladies are amazing, as always.

 

We'll be with you in spirit. :grouphug:

 

Seriously, though, who wants to recover from major abdominal surgery with TWO newborns AND the kids you already have? :svengo: Unless evidence clearly indicates significant medical benefits to c-section over vaginal birth in your specific situation, I'd push hard to avoid surgery.

[Osmosis Mom]

I want to add that I spent months agonizing over the decision to choose a planned c-section. I finally decided when I was something like 32 weeks + because my doctor was freaking out over my constant contractions. She offered that I could move to a hospital 2 hours away where they had the facilities to accomodate levels 2/3 of NICU. I had had low amniotic fluid and been on bedrest from week 25ish and had had a scare with heart palpitations as well. To me, doing a c-section was the prudent thing as well as the most unselfish. My other deliveries had been natural (except for a suction at first delivery) and medication-free. I chose a very low level of morphine for pain-killer (and still wished I had not taken it as I got severe side-effects from it). I was in labor when I went in for the c-section, quiet labor, but would have delivered very soon if gone for it. They came at 37.5 weeks, a few days before the scheduled section. One did have some slight breathing trouble at delivery and a couple of times after, but nothing the doctors worried about.

[wapiti]

Our nursery is only Level I

 

Where would you deliver if you go prematurely? (50% of twins are born prior to 37w; average is around 35/36w. Mine were 33 weekers, one was on a ventilator, etc.)

 

This alone would have me considering another hospital.

[Osmosis Mom]

Actually what I want to add is my own opinion. If the c-section is what you OB prefers, you live in a remote area, you want a safe delivery, then honestly relieve yourself of stress and go for it. Focus on the end result and not on what your ideal birth-situation looks like. You know very well as you get older and more experienced, then you also hear and learn of more actual stories, so be safe rather than sorry.

 

That's my opinion. I don't like it when people on this board strongly bash medical intervention (bash as it comes across in cyber-space that is). I used to be vehemently against planned c-sections. That is until I was in the situation myself and spent basically 30 weeks agonizing over the choice.

[CalicoKat]

My mom had twins. The first twin was born feet first, breech. And the 2nd twin was born head first 8 minutes apart.

 

Of course, she didn't know for sure that she was having twins. An x-ray two weeks before was done and the doctor said, "Hmmmmmmmmm. Couldn't be."

 

 

My sisters are 44 years old. :D

[BakersDozen]

If you can have a doula there (find one, afford one), I think your chances of avoiding a C-section go up immensely.

A midwife here will be a doula if need be. The OBs hate her (really, they do). She's one tough lady.

 

Where would you deliver if you go prematurely? (50% of twins are born prior to 37w; average is around 35/36w. Mine were 33 weekers, one was on a ventilator, etc.)

 

This alone would have me considering another hospital.

I can go 1.5 hours either north or south to hospitals with Level II+ nurseries. I prefer going north as I have many friends in the town and have offers for my entire family to come stay. If I go south (to Phoenix) there is nowhere for even my dh to stay except a hotel. I'm putting a call into the doctor up north to see if they will take me; if they don't I guess I'm stuck with Phoenix. We had already talked about me going to either location when I'm 34 weeks and just hanging out because I had my last baby at 37 weeks so the chances of me going early are pretty good (I was also exercising like a crazy woman with that pregnancy, even jogging at 34 weeks still!).

 

Actually what I want to add is my own opinion. If the c-section is what you OB prefers, you live in a remote area, you want a safe delivery, then honestly relieve yourself of stress and go for it. Focus on the end result and not on what your ideal birth-situation looks like. You know very well as you get older and more experienced, then you also hear and learn of more actual stories, so be safe rather than sorry.

Thank you for sharing your opinion honestly - I do appreciate it. I have the same thoughts in my mind although they are outweighed by my desire to birth these babies naturally if possible. I do hear the "stories" yet I hear more success stories with natural twin births than I do emergency c/s stories or bad outcomes. I do want a safe delivery yet I don't accept just yet that it means signing up for an automatic c/s.

 

I know myself, too, and if I went with the c/s and Baby A was head down I would be so angry with myself for not at least trying for a natural delivery. My emotions postpartum are scary and overwhelming as it is; I'm not sure how I would deal with the added feelings of guilt and regret that I am guessing I would feel. That's just me, though.

[HS Mom in NC]

A friend of mine delivered her twins (9lbs. each, 39 weeks and 1 day) at home with a midwife. Baby A was head down. Baby B flipped shortly on his own after baby A was out. Everything went very smoothly.

 

Deliver with someone who routinely does breech deliveries-even if you have to drive farther to see them. Anyone who doesn't routinely do breeches will be far more likely to "need" to do a c-section.

 

C-sections carry their own risks too.

Edited August 10, 2011 by Homeschool Mom in AZ
typos

[trishalinn]

I switched doctors at around 25 weeks because my doctor said she would only deliver the babies vaginally if they were both head down.

 

My second doctor said she would deliver them both vaginally as long as baby a was head down. She would do a breech extraction of baby b if need be. Unfortunately, both of my babies got themselves into a transverse position. Baby A had his back flat against my cervix, so there was no coming out other than via a c-section.

 

Also, I decided when I found out it was a twin pregnancy that I wanted to be at a hosptial with a NICU. I have a history of pre-term babies. All 4 of my kids have been born at 35 weeks. Glad I had them at that hospital, but thankful that we didn't need the NICU.

[Paige]

For the NICU, where does your current OB send her patients? It is my understanding that hospitals usually have a plan in place and they have a designated sending hospital. My OB had relationships with the OBs there and they coordinated and shared info even if they disagreed about what to do. Maybe that's just the way it was where we were. I knew from the start, for instance, that if I was preterm that I would go to a specific hospital. Doesn't your hospital provide life flights? I was life flighted to a hospital about 2.5 hrs away (with traffic) and I would honestly prefer it over driving or camping out down there. We made it in about 20-30min. It's hard for me to know for sure because I didn't have a watch and it was a blur. I felt extremely safe. I would not feel safe in a car and preterm heading an hour or more away. If you are preterm, you do not want to start driving anywhere- you want to get to the closest hospital so they can give you meds to try and stop it. By 34 weeks-35 weeks, you probably won't even need the advanced NICU unless there are other problems.

 

Also, if you are over an hour away, your DH should be able to stay at the Ronald McDonald House. The hospital social worker came to us right after we delivered to help set it up. It was a lifesaver! With 2 NICU babies, they will do everything they can to get you in a room. The RMH was very nice and I'm sure they are all kept up nicely.

 

I had a very unpleasant experience with the doctors where I delivered my twins. Unlike the previous poster, I do not have faith that they want to do only what is best for me and the babies. I know I was blatantly lied to and fed crazy extreme stories about what would happen because they wanted me to consent to things I wasn't comfortable with. If my OB hadn't spent so much time talking with me before I went to that hospital and if I hadn't had a doula who used to work at that hospital, then I'm sure I would have been scared and easily persuaded.

[Farrar]

I'm glad you'll have a tough lady on your side there to speak up for you!

 

Whatever happens, good luck. I can't imagine doing twins with such a big brood already! But having twins really is wonderful.

[CourtneyBrooke]

I switched doctors b/c one told me that if both babies were not head down, it was an automatic C-section.

 

 

When I did go into labor, Baby B was head-up. After baby A's birth, we watched on the ultrasound monitor as baby B flipped head-down!!!