37 weeks, twin girls, natural or section?

[pneumachristian]

@lisajcoleman1 Baby A head down, Baby B transverse. I requested an induction, as I had had 3 previous vaginal births, and my OB requested an epidural and pushing in the OR. We also scheduled the induction for a time when she was sure to be on-call/in the hospital to oversee. We ended up delivering A vaginally but then having to c-section for B after the manual manipulation didn’t work.

 

[jconelea]

@lisajcoleman1 I delivered my mo/di twins vaginally (with a god sent epidural). Baby B was surprise breech, but I had switched doctors at 27 weeks to find an OB who would be comfortable delivering a breech baby B if needed. I didn’t have any complications and baby B was perfectly healthy. If your OB won’t deliver a breech baby B vaginally then the safest thing to do would be to have a c section. The last thing you want is to deliver one vaginally and then have an emergency c section. It’s a little late in the game to change doctors so I would just throw out your birth plan and do what you need to do.

 

[graceforyou]

@lisajcoleman1 Throw your birth plan out the window, listen to the experts.

 

[crinkle2]

@lisajcoleman1 The guidelines are if A is head down you can go for natural delivery even with B breech. There are risks to both breech delivery and c section. There is a good argument for scheduling a c section but it is also disturbing your doctor isn’t acknowledging acog guidelines do call for allowing natural delivery if twin A is head down regardless of twin B position.
You can’t know in advance the outcome of whichever way… will she hemorrhage with a c section and kids develop asthma later? Or Will breech baby B suffer anoxia if you do go for vaginal delivery? There are so many unknowns. I guess I pray your doctor has an honest conversation about the risks of both and you trust in the decision you jointly make

Edit: this is for di-di guidelines may differ if shared placenta

 

[jnel]

@lisajcoleman1 Your doctor will be the best to give advice

 

[davidnunes213]

@lisajcoleman1 I was induced at 37 weeks due to choleostasis with my first kids. Baby A was head down and baby B was transverse and went breech after A left. It was a pretty cool feeling the difference between cephalic and breech presentation

 

[zacharyrw]

@lisajcoleman1 I would say trust the doctor, but maybe the doctor can clarify why baby B can’t be born breech?

I gave birth to my twins with baby A head down and baby B came breech. I live in a very small city with a very good but very small hospital.
They needed to be sure that there were place in the nicu and also place for an emergency c-section (I mean ofc they would have performed it anyway but they like to have margins. Otherwise some other patient with less urgency would have to be rebooked or travel to a bigger hospital).
I was in luck and when I went into labor they thought the situation so good that I could try.
But if they would have said no I would’ve absolutely had a c-section just to not risk anything.

I hope you get the experience you’re hoping for but plans usually change when twins are involved.
Sounds like I got my sunshine scenario but I can ensure you other stuff surrounding my experience went down the drain.
So make sure you guys try to prepare yourself mentally for changed plans, just to protect your mental health.

 

[chews]

@lisajcoleman1 I’m surprised your OB is pushing for a CS if baby A is head down. I’m also expecting twins and have been told all along if baby A is head down I will be able to deliver vaginally. So my current OB doesn’t perform breech extractions (if baby B were to flip to breech) but my MFM assured me there are plenty of OBs who do and I care more about having a vaginal birth than about my current OB performing the surgery. If your OB is pushy I suggest asking around to find another one who feels comfortable delivering your twins vaginally.

 

[snowygurl6]

@chews This. I had a c section because baby A was transverse breech but I did my research first and chose an OB experienced in vaginal delivery of multiples. Her caveat: everyone healthy, baby A head down and baby B could not be significantly larger than baby A. She was fine to do a breech delivery of B if needed and had the experience to do it.

I went in with some advanced knowledge of this since I’m a baby A and was delivered vaginally, with my sister twin B being the breech extraction.

I was gutted when c section was the only option for my twins but I got over it. OP is so close to delivery I’m not sure I would be switching OBs. We had a great doula for the birth and she was even in the OR. No birth plan, just some birth preferences.

 

[chews]

@snowygurl6 I’m actually switching OBs at 36 weeks pregnant if Baby A flips back to head down (little rascal has been flipping weekly it seems like). My current OB is aware and understands vaginal birth is important to me so I have 2 appointments for next week - one with my current OB for a CS and one with the MFM who was recommended by my midwife for vaginal birth if the babies cooperate. We’re obviously going to only proceed if baby A flips back to head down and the MFM feels it’s safe, otherwise I’ll go with the CS.

 

[kind_widower]

@lisajcoleman1 Birth plan are a sure way for disappointment if you go to a hospital.

But I'm going to go against the group and say get a second opinion in a hospital which is friendly to natural birthing and delivering breech. We had a breech baby and all OBs told us C-section is only 'recommended' when baby A is breech. Baby B can be breech no problem. I don't know about transversal.

My wife and I had the above unfortunate situation. Baby A was breech, baby B was head down. Our original OB thus insisted on a C-section because of the risk of locked chin, but which is a rare occurance.

We went to a clinic recommended by our midwife, a clinic specialised in twins and breech birthing. They have a dedicated 'breech clinic' for breech babies and OBs experienced with breech. Even though they also thought a C-section was likely, they were open to trigger baby B and see if it would come out first, thus having a natural birth. Having done that, baby A still came first, but the OB noticed both babies were in their sack so there was no risk of locked chin. They proceeded with a natural birth: baby A breech, baby B head down. What an experience. The nurses still talk about it

 

[chews]

@kind_widower That’s great to hear your wife’s vaginal birth was successful with baby A breech! I have not heard of such a clinic. Did they perform ECV or did a breech extraction for baby A and delivered baby B normally?

 

[kind_widower]

@chews No. ECV they don't do because they could turn the wrong baby.

We were just very late in the hospital, or otherwise stated: labor went fast since it was our third and fourth baby. Baby A, our little girl, came with her sack, which exploded in the OB's face. Then came the second one. We had no medical intervention except a bit of oxytocin, sugar, and gas. And a small rupture. No epidural, we were too late for that.

 

[xuxu]

@lisajcoleman1 In my city there are big differences between hospital policies for twin deliveries - several are happy to do breach extraction for twin B, including the big world renown teaching hospital. So there are several legitimate, medical opinions on this, but ultimately you want a doctor doing only what they’re comfortable with.

Reading your post, my biggest reaction was that it’s important to trust your doctor, and if you don’t, you might want to find a new one (although it’s probably too late at this point?). Can you have more of a conversation with the doc, express your disappointment honestly and without judgment, and ask for more information for a better understanding?

 

[cjrwells]

@lisajcoleman1 I gave birth last week (UK) and my doctor was always happy for natural as long as Twin 1 was head down.

For me Twin 1 was head down and Twin 2 was breech and opted natural delivery and yes Twin 2 came out breech. 1 week on and so far so good but in 6 weeks they will both have a hip scan.

I had an epidural also to help with the positioning as it would have been incredibly uncomfortable otherwise!

 

[justyna]

@lisajcoleman1 I had a planned c-section for my mcda twins. When I went in both girls were head down, but twin B ended up flipping and came out breech. Like everyone else here has said, I would trust your doctor.

 

[nativenewyorker1980]

@lisajcoleman1 My B flipped multiple times between 35 and 38. I delivered vaginally ONLY because my doctor was confident with a breech B delivery. I'd had a previous vaginal delivery that went smoothly. My hospital required delivery in the OR just in case of C-section and a epidural unless you want to get out completely under in case of C-section.

If your doctor is not comfortable with a breech B, I'd absolutely just move to C-section. And throw out the birth plan. No plan, no disappointment.

 

[thelightheartedcalvinist]

@lisajcoleman1 My boys were both born breech.

 

[fenrix35]

@lisajcoleman1 My planned c-section at 37+2 with my twins was one of the best experiences of my life. I would never do it any other way of I had the choice. I developed pre-eclampsia and had a somewhat complicated/scary birth and recovery and it was still a great experience because the OR team was top notch and fully prepared rather than rushing to perform an emergency c-section (and I was fully mentally prepared too).

I know it can be hard to let go of your ideal birth plan, but life with multiples is kinda like that. Things will not always be how you imagined. My advice would be to listen to the professionals while allowing some space to grieve for what you wish could have been.

Another thing to keep in mind - I think it’s kind of rare for twin pregnancies to go past 38 weeks. So even if the c-section is planned for 9 days from now, it may he pushed sooner (mine was).

 

[jeshua]

@lisajcoleman1 This is just my personal opinion, but I think it’s great to have a general birth plan but to also be flexible and considerate of your situation.
I was adamant on having a natural birth, my situation absolutely did not call for it at all. I was quite delusional and in hindsight looking back I would’ve changed my mindset a lot sooner to be more flexible depending on what made the most sense considering the facts for my situation.
I think if your wife is healthy, babies are healthy and wants to do a natural birth & is ok with potentially having both a vaginal and csection in the case of an emergency, then why not? Then She should do it and her doctors should support her.
Doctors are so awesome and I’m so grateful for them, they have saved my life and my babies life. But often times moms who are pregnant with twins are discouraged from having natural births bc of the effort (of course stats too) that goes into it. I know 4 twin moms who all delivered natural, and no twin moms other than myself who had complications and a csection everyone else’s csection as planned, smooth and easy.