37 weeks, twin girls, natural or section?

[amy15]

Oops, I skimmed over your post too quick, you are Dad. Welcome to fatherhood, take the OB's advice.

 

[tisrara]

@lisajcoleman1 You should listen to your doctor. If they think you need to have a c-section it is most definitely a safety issue for you or one (or both) of the twins. Twin births are unpredictable, so this is unhelpful advice at this point for you but I would say to be open to any birth scenario that means a safe birth for all three of you, and not worrying about wanting it to be “natural.”

 

[mrsladykat]

@lisajcoleman1 How many placentas? If only 1, then absolutely listen to your OB. If 2, then I'm not as familiar because my girls were MoDi

 

[nccountryboy]

@mrsladykat Came here to ask this. We were modi too and it’s way more risky.

Listen to your doctor…. Twin births are so much more complicated.

 

[lisajcoleman1]

@mrsladykat Two but thank you

 

[alexus711]

@lisajcoleman1 Baby A was head down, B was transverse (but they expected he’d be head down after baby A came out and he was). Apparently I was a “good candidate for a vaginal delivery” because I’d had a prior vaginal delivery. I’m really glad I followed my doctor’s advice and had the vaginal delivery because baby B spent a significant amount of time in the nicu (baby A came home with me a couple of days after delivery) and I was able to drive myself to the hospital to visit him.

Ask if there’s a doctor who might be comfortable with a second twin breech extraction. The way it was explained to me is that it’s not a common procedure and some doctors won’t do it. If you have a doctor who is comfortable with it, basically after baby A is born they just reach in and grab baby B’s feet and pull them out breech. I didn’t need one, but I was really worried about recovery from both a vaginal and a section because I know someone who had that happen and I had a wild toddler at home. So I was glad to have had the conversation.

 

[sepheeme12]

@lisajcoleman1 Trust the doctor. Twin B being transverse is pretty likely to end in a c-section. My boys were positioned the same way and I had a c-section at my doctor’s recommendation despite being absolutely terrified of surgery (and the c-section wasn’t bad at all - I was so scared beforehand but it turned out to be so easy).

I just want to give some unsolicited advice so feel free to ignore. Having a detailed natural birth plan is going to end in disappointment. Babies don’t follow plans, especially twins. Sticking to a birth plan against doctor’s recommendations is dangerous. In a high risk pregnancy/delivery (and twins are always high risk), your birth plan should be “get both babies out safely”.

My first pregnancy was a singleton. Textbook pregnancy, no complications. I had a birth plan: go into labor naturally, no epidural, walk around during labor, push on hands and knees. Well, that all went out the window. Baby decided to hang around an extra week and a half and his scan showed deteriorating placental activity, so I was induced. My body was stubborn and didn’t want to cooperate with be induced so I ended up in labor for 30 hours. Around hour 18 I was so tired and in pain I got the epidural. Couldn’t walk after that, nor could I push on hands and knees. Baby’s heart rate was dipping every contraction so I needed to be hooked up to the monitors constantly anyway. I managed to get him out without a c-section but my doctor said if he didn’t come within the next hour we’d be doing the surgery. I trusted her.

My baby was born completely healthy. My birth plan wasn’t followed at all. If it was and I wasn’t induced, my baby probably would not have survived.

Please trust your doctor. They’re the ones that do this every single day and have the experience. Remember that birth is a single event that brings the babies into the world, but then you get a lifetime with those babies and how they got here is irrelevant. Don’t risk that lifetime because of an imagined perfect birth.

 

[orchardllc]

@lisajcoleman1 I ended up delivering my girls vaginally at 32+5. Both were head down, but for the longest time before that Twin B was transverse. My impression from the OB was that some doctors in her group are comfortable delivering baby B breech, and others are not, and so it would sort of be "luck of the draw" based on who was on call when I showed up. So I wonder if some of this push from your OB is just because she is not personally comfortable with a breech delivery for B? Might be worth discussing further with her, because if that's the case, then C-section is probably the safer option.

 

[maraboo]

@orchardllc I got this same impression about the OBs in my office. I love all the doctors I’ve seen there, but only a handful of them are on board with attempting a vaginal delivery with one breech twin. My main OB was not one of them, and since my baby A was breech, it made sense to stick with the C-section (although I’d had an uncomplicated vaginal with my first/singleton and was not excited about the CS recovery).

I did make them check right before the CS to make sure baby A was still breech! He was, so we proceeded as planned, otherwise my doctor was on board with switching to vaginal.

I think it comes down to trusting your doctor’s medical judgement, and weighing your risk tolerance. It’s good to have it be a discussion and get the opportunity to weigh in, but ultimately the OB has trained for this and seen tons of outcomes, we’ve all just googled stuff. If you trust your doctor, let them guide the decision.

 

[michelett]

@orchardllc I just delivered my boys at 36+3, and i agree with this comment. I had a baby A head down, and baby B breech. I asked my MFM about delivery and chances of "vaginection" (dual delivery).

She referenced that usually vaginal followed by breech extraction was usually successful, provided that a doctor who had experience in breech extraction was present. I followed up asking what portion of doctors on rotation at my hospital were comfortable and mfm said majority of them do and the contingency in case one of those physicians wasn't present (they usually have one breech experienced physician on-call). She felt comfortable recommending vaginal delivery, and i agreed with her assessment of the situation, since more likely than not i would be in good hands.

Ultimately i did have a successful vaginal delivery, thanks to the experience of my delivery team. They obviously knew what they were doing, and breech extraction literally took them 2 minutes after i managed to deliver my baby A.

However, if the situation was different and only a few doctors could perform breech extraction, you bet i would go with c-section. So ultimately it depends on the hospital you're delivering at and your OBs recommendation.

 

[orchardllc]

@michelett Totally agree. If my girls didn’t have other plans (and B remained transverse) I probably would have opted for the C-section. I am thankful things worked out for a vaginal delivery, but my biggest fear was having to recover from both.

 

[calista]

@lisajcoleman1 Let me begin by saying this: all births are natural, unless you’re giving birth to a robot.

Mine were my 4th and 5th babies and were head down and transverse. I had them vaginally only because my OB was sure it would be safe, I had already had 3 vaginal deliveries. I 100% trust the doctor’s opinion on this, if your OB says you need a c-section, you do. You don’t want to endanger your babies. You also don’t want one vaginal birth and one c section because the second twin is struggling. Not safe and you have to recover from both.

Birth is about about the safety of the babies, please choose the safe route.

 

[calladus]

@lisajcoleman1 All birth is natural. It’s either vaginal or CS. Throw out the plan and rewrite it so it says “one healthy person goes in, three come out.” Vaginal birth isn’t a guarantee the recovery will be easy. You can end up with significant tearing and permanent pelvic floor dysfunction, incontinence, etc. follow the doctor’s recommendations. Birth is one day in your children’s lives.

 

[katrina2017]

@lisajcoleman1 this exact scenario happened to me. my didi baby girl A was head down, all positioned for vaginal birth. my didi baby girl B kept flipping from head down/transverse in my final scans. my OB said she was not comfortable naturally delivering vaginally if baby B was not head down. i respected that, as she had delivered many babies/twins, so i did have a c section at 38+2. the surgery recovery sucked (obviously), but she confirmed afterwards that a vaginal birth attempt would have just resulted in me birthing baby A vaginally and then baby B via c section. i wanted to have 1 recovery, not 2, so it worked out for us. we had unexpected health problems with baby B in the first 2 weeks of her life.. but i do not regret it. i know it’s so hard and frustrating to mourn your original birth plan/vaginal birth plan (i planned mine for months thinking i wouldn’t need a c section), but it was safer for the baby herself, so i had to trust in my dr. good luck, and you’re about to start a beautiful journey!

 

[lap4418]

@lisajcoleman1 My singleton was a vaginal birth. Twins were a planned c-section. My advice is to remember that the goal is to finish giving birth with healthy babies and parents able to care for them.

I have no feelings of disappointment or triumph about the c-section or my vaginal birth. I recovered well from both. As soon as the babies are here all that completely stops mattering.

I am wishing you a safe delivery with a healthy mom and babies. I would encourage you to rely on your medical team and focus on the ultimate outcome and less how you get there.

 

[seatpost12]

@lisajcoleman1 Exact same story here except I had IUGR with one baby so we had to induce at 37+0.
Baby A was born head first, and baby B was a breech extraction. I picked my doctor at 7 weeks because I heard she was pro vaginal twin birth. If you didn't have this conversation way earlier... I would say it's probably too late to try for something they aren't willing to do?
My friend is 20 weeks pregnant with twins. Her ob said he will only do c-section. At 20 weeks she's found another ob who will do it.

 

[fenix144]

@lisajcoleman1 I had similar situation with twins. Baby A head down, baby B transverse. After doing lots of research on multiple births, I switched from my normal OB to a high risk doctor with experience in multiples.

The research I read basically said the safety of a multiple birth via vaginal delivery is down to the doctor. Someone who has done it many times before will know how to do it and prefer vaginal.

I ended up delivering vaginally at 35 weeks. Baby B was in some distress after A was delivered, and the doctor utilized a vaccuum apparatus to suck baby B out while I pushed. Baby B was in NICU 3 days and we all went home together on the 3rd day.

My take is that if your doctor isn’t comfortable with vaginal, they are not experienced enough to do it. Seems you either need to do what the doctor is capable of or switch to a high risk multiples doctor who is experienced in vaginal delivery.

 

[scorpio61]

@lisajcoleman1 I have two sets of twins, had one vaginal with the same positioning as your twins. Then i had a c section with my second set. I cannot even express to how much better the c section was. Twin vaginal birth is awful. I had one singleton vaginally too, and with the twins, they make yoj deliver in the OR with the whole surgical team there cause so much can go wrong. And it’s just an awful environment to give birth in.

My OB had to literally shove his hands in me up to his elbow to move baby b around to come out. They were a whole hour apart.

And so much can go wrong. It’s truly dangerous. C section was super easy, and really the recovery was not much worse than the vaginal births.

 

[electric95]

@lisajcoleman1 Unless the person delivering you is comfortable doing a breech extraction and baby b is smaller than baby a do the c section. The thing y’all want to remember is if you can birth baby A fine but something happens with baby b you’re going to be healing from both a vaginal delivery and a c section, I had vaginal with my daughter and did a c with my twins - having gone through both the idea of having to heal doubly is absolutely horrifying to me especially now. I was terrified of having a c section but it honestly went really well - since it wasn’t emergent (which it would turn into it baby b gets stuck) I had time to wrap my head around and mentally prepare

 

[preston354]

@lisajcoleman1 For me and my 2 sets of twins, a c section wasn’t an option unless absolutely necessary. Both B babies had to be turned after A was delivered and then I just had to wait for contractions to do the rest. There’s a 51 minute difference with the first set and 38 minutes with the 2nd set