37 weeks, twin girls, natural or section?

[albena]

@lisajcoleman1 Baby A was head down and Baby B was all over the place the last few weeks. My doc was very supportive and thought there was no reason not to attempt vaginal, but of course made sure I knew the risks. I would have never attempted vaginal if he wasn’t in favor of it.

I ended up delivering A vaginally and B c-section. It wasn’t so bad.

I picked my doc because I was having twins and he had a lot of experience with twins. I was confident in his decisions and that made the pregnancy/delivery less stressful.

 

[lostsoul1987]

@lisajcoleman1 This was exactly my case - twin A head down and twin B transverse. I was told there was a higher than average chance for a c section after my natural a day before I went in and decided I didn’t want to risk it. To me, everyone being safe was more important than trying for the natural birth and my discomfort with the surgery. They were willing to give it a shot if I was, though, so that came down to my own feelings. I didn’t bother with a birth plan myself - just wanted everyone out healthy and happy.

 

[passingthrough1]

@lisajcoleman1 Even if you plan for a natural birth it can’t be guaranteed. I planned for natural, went in and was dilated, water broke. I was still prepped for and delivered in the OR.

Twin A born vaginally, she took out her brothers umbilical cord, while I underwent a fast, painful, emergency c-section to get Twin B out before he suffocated or drowned.

My advice is to advocate for your wants but understand and accept that the need for safety of all involved outweighs that completely in the moment. Have an idea but don’t get hung up on what you want.

 

[shortyj74]

@lisajcoleman1 I would trust your doctor, but even then it’s just not always something you can plan out perfectly.

Both of my babies were head down so we were for sure going to try to do a vaginal birth and scheduled an induction date.

Then I fell down some stairs at 33 weeks.

Then I went into active labor.

Then I developed severe preeclampsia and pulmonary edema and had to have an emergency c-section 3 weeks before I was scheduled to be induced.

With pregnancy, and especially pregnancy that includes multiples, it really is just a matter of circumstance and you can’t really predict what will happen.
It’s good to have a plan but you might just become stressed out even more if things don’t go exactly the way you want them to, it’s good to be open to different things happening.

Either way, good luck!! I hope your experience is better than mine!!

 

[coffey]

@lisajcoleman1 TLDR; C-section was awesome even though I wanted to vaginally deliver. Could be awesome for you too.

Our plan was to try for a vaginal delivery and OBGYN was onboard. However, at 37 wk 3 days, Baby B was tracking like the size of a 32 weeker on ultrasound.

My provider was on vacation and the doctor covering her said we are having a C-section tomorrow morning. I asked if I could be induced and do C-section tomorrow AM if I don’t progress but the doc was concerned Baby B wouldn’t tolerate labor. Baby B was transverse and Baby A had been head down, waiting patiently to come out first.

C-section at 37 wk 5 days was ah-maz-ing. Came in rested, was awake, calm and comfortable for the whole thing, hubs got to go to Recovery with the babies while I was being sewn up. I had enough energy to work on nursing frequently and then hand feeding (literally with my pinkies and a syringe with an NG tube attached to squeeze donor milk out). I wasn’t exhausted, pain was manageable and within 4 hours of arrival to the hospital, we were back in my room getting to know each other.

The only downside was that my milk hadn’t come in but we used a friends frozen colostrum she pumped 6 months earlier. Saved Bany A from being transported to a different hospital with a NICU.

 

[redcliffesalvo]

@lisajcoleman1 We went c section because it was safer for the babies and we didn't want to have an emergency c section if something happened.

 

[clixmaster]

@lisajcoleman1 Twin A was head down and Twin B was transverse when it came time to give birth. I gave birth vaginally. I wish I had had a C section. Twin A came out fine, but Twin B could not be manipulated, and I could feel the entire medical team start to panic as they tried to get him out. Twin B came out foot first and thankfully he’s a wonderful 3 year old now, but I’ll never forget that feeling in the OR. It was incredibly upsetting and I don’t like to think about what might have happened if the process had taken even one more minute. Afterwards, my OB told me that my delivery had shaved years off her life. If your doctor is recommending the C section, go for the C section. Wishing you and your family all good things.

 

[repented797]

@lisajcoleman1 I had my twins both ways- one unplanned, unmedicated breech vbac since Twin A decided he was coming Right Then, two hours before our scheduled c-section, whether we were ready or not (precipitous labor was not a good time!).

We still did a c-section for Twin B because the risk of cord prolapse increases with a high, transverse baby and that's exactly what he was.

This is the time to listen to your doctor.

 

[bonjala]

@lisajcoleman1 I loved my c-section experience. I made it to my date on 38+1 with twin girls. In my case baby A was breech, so I didn’t want to risk it and I went with what my OB suggested. Everything was perfectly planed and everyone was nice and kind. My experience wasn’t traumatic, very little pain and I recovered quickly. I would do it again if I had to. We were able to film their birth and have the best care and attention. Baby B had liquid in her lungs and needed a CPAP machine and a few days of NICU time. I am glad we went with the c-section option since the beginning.

 

[onmywaytoglory]

@lisajcoleman1 If your doctor isn’t comfortable doing a breech extraction for baby B, that limits what your options are. The last thing you want is vaginal birth for A followed by c-section for B.

I went in with a birth plan of get my babies out safely with the least pain for me. I had A head down and B transverse and my doctor said she is super comfortable with beech extractions for baby B if needed and I was at Brigham in Boston so literally the best hospital in the nation for birth. It required I do an epidural which I wanted anyway. Tried to go vaginal but at 6cm my pre eclampsia got too bad and I had to do an emergency c-section. Because I had a loose plan, I was able to avoid a lot of fear or disappointment. We all made it though safely and I healed easily and without much pain from the c section.

 

[anna123]

@lisajcoleman1 Hello I had twin girls 3 years ago. The whole pregnancy I planned to go natural baby A was ready always head down while baby b was a flipper every week she was in a different position but I refused to want a csection. My water broke at 37 weeks I wound up pushing baby A out once she came out baby b got comfortable so 2 hours later they had to do an emergency csection I was upset at first but now when I think about it if I could do it over I would've went with a csection from the start. Down side was I didn't get to meet my baby B until 2 hours after she was born and we have no pictures of her birth but thank God my babies were happy and healthy!

 

[bigtom771]

@lisajcoleman1 I haven’t seen a comment about this yet, it when you do one birth vaginally and the other through c-section it’s called a double whammy.

It’s supposed to be incredibly emotionally and physically difficult for the mother. Beyond having the pain and necessary recovery to both exit points, many mothers will feel like failures even before they get hit with the horrible hormonal punch of ppd. Going into a c-section physically exhausted from delivery can’t be fun.

Our hospital only allows vaginal delivery from the surgical suite so it couldn’t have been uber crunchy if we wanted that. Baby a was breech and baby b was transverse for us so we had an unplanned c-section at 36+1 and mom was able to recover quickly. Our planned eviction was at 38 weeks.

 

[fab01]

@bigtom771 Interestingly enough for me, I actually never held the feeling of failure . A was a push , B was an emergency C section. My push only resulted in one stitch so recovery wasn’t as horrible even though I had both. My major regret here is that I missed Baby B’s birth because it all turned emergency. Thankfully my husband was there for immediate skin to skin but it still feels like I missed out

 

[apolalala]

@lisajcoleman1 I was in this exact position! When I went into labor (at 33 weeks) they gave me the option, and I chose the c-section.

Honestly, so so glad I did. Even as an emergency c-section (I had labored to 10 cm before they started), I was so thankful to have only one method to heal from as opposed to two - the fifty percent chance of having to finish with the c-section anyway was just not worth the vaginal birth.

With my most recent, I scheduled a c-section and it was honestly a dream. So easy, planned, relaxed, and all but the 20 minutes to close me back up (after a tubal) were frankly enjoyable.

Recovery has been easy as pie, and I would recommend it to anyone. I know not everyone has the same experience, but I really did enjoy the process.

 

[katrina2017]

@lisajcoleman1 I am 21 weeks with twins, so TBD for them. But I will say the planned c section had some major advantages over emergency c section. When our giant breech son was born, we had a say in how he was cleaned immediately, timing on clamming the cord, and even did skin to skin (while my dream of an anesthesiologist kept me from vomiting on the table!). My husband got to talk to him right away and he immediately stopped crying! In the chaos of an emergency c section, none of those nice things happen.

 

[mcb0805]

@lisajcoleman1 It sounds like your dr isn’t comfortable delivery vaginally in your case. Is there another dr in the practice you could discuss things with? Having a transverse Baby B absolutely doesn’t mean a c section is mandatory.

I was in a similar situation, A head down and B transverse. My dr encouraged a vaginal delivery (which was what I wanted) and was comfortable delivering breech if necessary. B ended up flipping head down before my induction at 37 weeks so ultimately positioning was a non issue and I was able to successfully deliver both twins vaginally.

 

[aksumite]

@lisajcoleman1 No one on the internet will know what's best for you better than your doctor.

That being said, my c-section was great. Procedure was an hour instead of who-knows-how-long in labour. I was up, walking around, and lifting babies the following day. And within a week, I was feeling pretty good. The only struggle I can remember was getting in and out of bed. I was out going for short walks by week two. Just stay on top of the pain meds for the first week and don't try to be a hero. I was disappointed to have a c-section when I first found out but looking back I was very happy with how it went.

 

[fab01]

@lisajcoleman1 My baby A was head down
My baby B was transverse.

I pushed baby A out at 1151pm

They tried to externally rotate baby B but he flipped back after both attempts. The second time, his HR dropped. He then turned into a c section

He was born at 1225am giving them separate birthdays .

Sometimes I wish I had looked at more well versed doctors as I’ve heard that if the doc has the skills they can still birth babies that way. Other times I think maybe a c section would have been the better choice.

I’ll never know though

My vaginal push gave me one stitch, the c section was more recovery. If I could have had both push babies that would have been more ideal but here we are

 

[beapilot]

@lisajcoleman1 Echoing much of what has been said, but it is extremely unrealistic to have a detailed birth plan, especially with twins. While I know how difficult it can feel when you can’t completely dictate the situation, this will be the case going forward with twins. Trust the doctor and go with the flow.

 

[notzri]

@lisajcoleman1 Speaking as a twin mom and anesthesiology resident who provides labor and delivery anesthesia, please only take the advice of maternal fetal medicine obstetricians with this delivery - no one on the internet can tell you what is safest for your baby's particular position, or what the OB covering your delivery is comfortable managing. For example, some OBs have experience attempting external cephalic version for twin B after twin A is out. Others don't. It only make sense to try this with someone who has experience and can do it safely. Also, even if planning for vaginal delivery, plan to deliver in an operating room at a hospital with an on-site NICU. Twin vaginal deliveries need to happen in an operating room where a STAT c-section can happen in minutes - the exit of twin A may cause immediate complications for twin B like cord prolapse where the umbilical cord gets kinked in the vaginal canal. There is no way to prevent or predict immediate complications like this even in the healthiest of twin pregnancies.

Please also get an epidural for your labor. The epidural isn't just for pain management - it's a way for a c-section to happen so much faster and more safely for mom and babies than crashing into a fully asleep c-section. Epidurals can be dosed with big gun numbing medications such that mom can be ready for a stat c-section in minutes, and minutes matter when the babies are crumping due to in utero issues. Imagine being without oxygen for 5 minutes vs 15 minutes. BIG DIFFERENCE.

That said, DEPENDING ON BABY'S PRESENTATIONS, vaginal delivery can be a safe option for twin birth. I had mine vaginal at 38+4 and it went well, albeit with a 3 liter hemorrhage that would have killed me if I'd been at home. Being in a hospital that could manage complications saved my life, and enabled me to go home the very next day feeling well.

In making your decision, please please get your advice from high risk maternal fetal medicine obstetricians, not from anecdotes. Things can go to shit very quickly in deliveries. Just yesterday morning I did a c/s for a triplet pregnancy where one baby died in utero and the others were delivered at 24 weeks. They were tiny and will be lucky to make it through without severe life long medical complications, if they even survive at all.

I wrote up my own birth story in a previous post. Wishing you a smooth delivery!