Anyone have a vbac after a csection with prem. twins?

I am 37 weeks pregnant and up to this point my doctors have been very open to a VBAC. Yesterday I had an appointment and the Doc is now stongly suggesting that I schedule a csection. His concern is that i had my twins so early (29 weeks). He said he was unable to find any studies to tell him if my situation would be as safe as other VBACs. I have been praying since I became pregnant that if there was any reason not to have a VBAC that I would get some sign. Now I'm wondering if this is my sign or if i should try to push for the VBAC. Has anyone had a VBAC after premature twins?? Did anyone else's doctor have this same concern??

Thanks so much for your help,

Karen

 

I know that they are other ladies who probably have some good information but I can't figure out how a premature c-section delivery would affect a VBAC unless you had some kind of trauma, emergency incision and that doc is concerned about that (or perhaps the other underlying reasons for the premature delivery). Not sure...I would ask your doc to elaborate on his reasons so you can both make an informed decision.

I had PTL at 32 weeks and c-section delivery at 36 weeks (of course, not nearly similar to your situation...but merely for example) and my doc is full steam ahead with a vbac if my body cooperates.

 

I agree with snoopy! There are certain criterias they are looking for. SOme reasons NOT to have a vbac would be if you:

• Tore from your c-section
• Went into labor and it didn't progress (and that was the reason for your c-section)
• Vertical incision inside & out
• HUGE 13+lb baby

If you answered yes to any of these possibilities, then you are probably not a canidate for a VBAC. BUT.. if you did not, then the doctor must review the surgical notes (if he wasn't the one who did it) and determine if there were any tears and such. But, just having preemies is NOT a good reason NOT to have a vbac!
There are risks of having a VBAC, but there are also risks of having a c-section. There are a lot of hospitals that refuse to do VBACs because of this risk, which is anywhere from 1-4% in most women, depending on the situation. It is MUCH better for your babies to come out vaginally! YOU should have an easier recovery with a VBAC!
I had one and I'd do it again in a heartbeat... even with another 10lbs of baby!!
HTH! We also do have a sticky on top of this forum if you want more information!

 

I didn't choose VBAC, but it was offered to me. I had preemie twins at 34 weeks....not quite 29 like your situation, but they were preemies. That's weird that VBAC has been an option to you and now they are thinking about changing their minds. I would have the dr. elaborate more for sure. Hope you get the answer that you want!

 

I have not had another pregnancy, but would like too- and have discussed it w/ my OB & Peri.

I had an emergency C at 32 weeks for my twins. The incision was large and although it healed well- they will NOT offer a VBAC on large emergency C-scars like mine. Though I have another health condition that req. a C-section no matter what- bu tmy OB covered it anyway just so I was informed that a VBAC was not in my best interest for future pregnancies.


BUT everyone is different, talk to your Dr. and see why they are changing plans!

 

My twins were not premature, but I did have an emergency c-section. I had a vertical incision (inside and out) and they will NOT let you do a vbac in that case.

 

I'm wondering if his concern is related to the size of your uterus when the twins were born. Do you have any idea what your fundal height was at that time? If it was less than 38, then maybe he is worried about the c-section scar already being stretched due to a larger uterus in this pregnancy.

I had my girls at 35 weeks and my fundal height was 47 at that time. So, even though I didn't have Dax until 42 weeks, my uterus still wasn't nearly as large as it had been with the twins. That means my c-section scar was under no additional stress.

I like to think of the uterus as a balloon. When I had the twins, it was blown up to 47 cm and they drew a 5 inch line on it (the incision). When I had Dax, it was only blown up to 42 cm so the line hadn't quite stretched to it's full 5 inches yet. In your case, if your uterus was only 37 inches when the twins were born, the 5 inch line on the balloon would be getting stretched past 5 inches with every additional week of your singleton pregnancy. Does that make any sense?

Does this mean you shouldn't have a VBAC? I would still go for it but I'd be open to the chance that a c-section might become necessary in the case of slow progression (something I don't think should matter in a "normal" birth). I am a staunch VBAC advocate but sometimes we just have to be flexible. Good luck!

 

I had a c-section at 36 weeks (not nearly as preemie as yours) but went on to have a successful vbac just under a year later. No complications from either.