37 weeks, twin girls, natural or section?

[lisajcoleman1]

Baby A is head down and ready to meet the world.

Baby B is transverse, laying on top of baby A.

Ob is insisting on a C section in 9 days.

There is a 50% chance baby B will be breech.

The doctor is adamant about the planned C section, because she wants to avoid the risk of baby B going into breech position after baby A comes out.

My wife and I are upset because we had a detailed natural birth plan.

Can someone weigh in with some wisdom on the risk of pushing for natural and declining the Doc’s recommendation for a planned C section?

Please and thank you

 

[bobfeed123]

@lisajcoleman1 I would trust the doctor’s recommendation. I did not have a birth plan with my twins because there are too many unknown factors.

 

[sussi]

@lisajcoleman1 First of all, going in with a detailed birth plan is a sure-fire way to make yourselves miserable and upset when anything/nothing goes "to plan".. you might want to open it up a bit. I've seen too many moms be upset instead of happy over their births because they didn't go according to plan. As long as everyone is safe and healthy, that's all that really matters. You can go in with some idea of what you want but I've found that babies (especially multiples!) are super unpredictable and you just have to go with the flow! Even if delivering vaginally, you will most likely be in the OR because they will be on standby for an emergency CS in case it is needed. This is common for a multiples birth!

I went in open to anything. A was head down, B was transverse basically up in my rib cage. We opted for a CS to make sure everyone, including me!, made it out healthy and safe (and the idea of the OB potentially having to "manually manipulate" B out made me nervous). I'm so glad we did the CS because after getting the twins + placentas out, my OB was able to see that my uterus wasn't properly contracting down and that I started hemorrhaging (the hemorrhaging was most likely due to the fact I had developed preeclampsia/HELLP and was on meds for that). They used a newly developed JADA device to help with my "boggy" uterus. I'm not sure what would've happened otherwise! I had a wonderful team and recovery wasn't bad at all.

My friend just had twins and she was able to have them vaginally! Her water broke at 36w. As soon as A was out, she had to push another 45 mins because B flipped and went up high.. once B was out, they were "stunned" because they had a cord wrapped around their neck. She only tore a tiny bit (the dr made a super tiny cut because they could tell B was stressed and needed to get out ASAP) but basically recovered super easy because of how well her birth went. She did have to go back into the hospital a few days after being discharged because she developed preeclampsia a few days later. She couldn't visit the babies in NICU while she was on the magnesium drip, but they did let her husband facetime them in. Life is so unpredictable and it sucks but you can't get too stuck in the details.

 

[abctradelinks]

@sussi Wanted to comment on this specific comment because the same thing happened to me after my C-section (with 1 baby breech and the other transverse). I lost half my blood and if I hadn't been in an OR, I would likely not have made it. OP, don't risk your partner or your baby's lives just because you have a 'detailed birth plan'. Most things you read about 'natural' birth (by which you mean 'vaginal' - a cesarean is not 'unnatural') are about singletons! Having multiples is a completely different story, physically. We're lucky to live in a time of so much medical advancement, if you trust your doctor I would listen to them

 

[matt97]

@lisajcoleman1 Echoing that having a detailed plan is setting yourself up for failure. Also, it’s vaginal (not natural) or c-section, there’s nothing “unnatural” about giving birth.

Having said that, if you are insistent about moving forward with a vaginal delivery, then there are some things to consider. Is there any signs of impending labor? Will there be an induction involved? If she needs to be induced to start labor, there’s a chance that she’ll never progress enough to attempt a vaginal delivery. Also induction meds put you at risk for hemorrhage, which is already higher for multiples given the weight the uterus has to bear.

Is she prepared to deliver one vaginally and the other c-section? Sometimes a spinal can not work correctly, so in an emergency situation, she may need general anesthesia- is that something she’s considered?

I had an induction at 37 weeks for rapid onset preeclampsia. I made zero progression in nearly two days. I had a c-section after that. Due to the induction meds and the big babies, I hemorrhaged a lot. I was fine because my team is great, but I was at higher risk because I attempted the induction. I wish I wouldn’t have. I really didn’t even care one way or the other but figured I’d give it a try since they were both head down.

 

[doodlum1]

@matt97 Thanks for the call out on the "natural" phrasing. So many multiple births are C-sections and most of them for reasons beyond our control so it's a little tone deaf especially here.

 

[matt97]

@doodlum1 So true. Also what used to be super “natural” was dying in childbirth and/or stillborns at much higher rates. Not really something I’d be interested in seeing return.

I’ve also been on the healthcare side of watching the outcome of some truly preventable fetal demises and maternal trauma that you can’t just wash from your mind ever. Some have given me nightmares for months after. Providers don’t want to see that outcome for patients.

 

[graceforyou]

@matt97 The double wammy

 

[overcoming1]

@matt97 Same. I was induced for almost 24 hours and barely progressed to a few centimeters. I then had an emergency CS where I lost too much blood and almost got a hysterectomy.

 

[xxmnbvcxx]

@lisajcoleman1 Our babies were presenting this way and I had a scheduled c-section for 37+1 that turned urgent at 36+5. No regrets! Our goal was all of us safe and healthy.

Also all birth is natural—vaginal and c-section.

 

[anna123]

@xxmnbvcxx I always thought a Natural delivery meant no meds?