Attempting vaginal delivery with twin B breech?

It's still early for me to be thinking about this, but I was discussing with my OB...he is all for my attempting a vaginal delivery if both babies are vertex (which I really hope to do!), but he is opposed to attempting it even if twin A is vertex and twin B is in any other position.

Is this common? This doc is a bit old-school, and older than some of the other OB's in the practice -- he's very conservative.

From what I've read here, doing a breech extraction on twin B if necessary is not that big a deal. Am I mistaken?

Anyhow. This might all be moot, depending on what happens later in my pregnancy -- but I hate the thought of not being allowed to attempt a vaginal delivery if there's a chance it could be successful.

Thanks for any thoughts!

 

My doctor said the same thing. I really do not want a c-section, but she also has discussed with me the risks associated with delivering a breech baby - in particular head entrapment - and it really scared me. So now I'm thinking the only way I will deliver them vaginally is if they are both vertex. I would love to kow if many mom's here delivered Baby B breech!
Good luck with everything!

 

My OB was of the mindset that as long as Baby A was head down then we could go for vag. We definitely have some TS mommies who have had successful breech deliveries and babies who have turned vertex once they got more space.

Becca, if this is a serious concern for you and you know there is no chance for a change in mindset with your current OB then you might consider finding another doctor who will work with you in the decision making. You really do have to be a team and if you are uncomfortable then now would be the time to make a change as it is more difficult to do that as you get later in your pregnancy.

 

I am seeing midwives that has an OB that I will starting seeing too eventually. I was told that he ONLY does a c-section if Baby A is breech. Even if Baby A is transverse, he will attempt a vaginal. No matter what Baby B is, he will go vaginal, so we are rooting for Baby A to be head down.

This is a huge reason why I am staying with them. I have had a couple of issues with them lately, so hopefully that is all over with.

April

 

My doc is also OK with vaginal delivery as long as A is vertex, regardless of B's position. It's very possible to find a doctor willing to go along with your desires for vaginal delivery in those circumstances - the key is finding one with enough experience to feel comfortable doing a breech extraction if neccessary - if the doc doesn't feel comfortable, then that's probably not who you want to do it!

The thing I find interesting about the stance your doctor has is that baby B's can go into any position after A is delivered... just because they are vertex at the start of labor is no guarantee that they'll stay there once all that space opens up. Seems to me like doing a vag delivery with a doctor so strict about baby positioning is really putting you at greater risk for a c/s, because if baby B moves after A is delivered then you're going to have a c/s rather than having a doctor who either feels comfortable doing breech extraction or trying to turn the baby en utero.

To find a doc who will let you deliver vaginally, try calling labor and delivery and see if the nurses there will give you some suggestions. They'll know who does it and who doesn't. Good luck!

 

My doc allowed me to go vaginal as long as Baby A was head down and Baby B wasn't more than 2 pounds heavier (they were 1 oz apart on every u/s and the day they were born). Baby B was breech and my son was born 4 minutes after my girl by breech extraction. They didn't even try to turn him, "just" reached in, grabbed him by the legs and pulled him out (epidural necessary). Very quick and safe if you are in the right hospital with the right doctors.

 

they size of twin B usually plays a huge roll in what position they find acceptable. It seems like most doctors don't want to risk a mom having 1 vaginally and then having to do an emergency c-section for the other.

 

My ob is willing to try as long as baby A is vertex....but she is very candid about the risks of that ending up in an emergency c/s. I hope your babies cooperate, and that you and your doc end up on the same page.

Reyna

 

My doc said that the hospital I am delivering at won't allow a vaginal delivery unless both babies are head down. Looks like a c-section for me because my transverse baby on top doesn't have room to turn.

 

quote:
Originally posted by mrsfussypants:
My ob is willing to try as long as baby A is vertex....but she is very candid about the risks of that ending up in an emergency c/s. I hope your babies cooperate, and that you and your doc end up on the same page.

Reyna


Ditto this...my baby A was head down, baby B was transverse across the top...my ob was pretty sure she'd either turn down once baby A was out or she'd be able to reach in and get her headed in the right direction...

 

My OB's entire office would do a vaginal delivery as long as A is vertex and B is not significantly larger than A. They were both vertex when I went in to be induced, so that wasn't an issue for us. I did end up with a vaginal delivery of A and emergency c-section for B due to her cord prolapsing, so there are no guarantees even if they are both vertex!

If you feel strongly about a vaginal delivery and want an OB willing to do a breech extraction of B-which seems pretty common in two of the major OB practices in my area-you may want to discuss this further with your OB or find someone willing to do it. My OB was the senior one in the practice and it was standard for him to do a breech extraction of baby B if needed. He would much rather do a vaginal delivery than a c-section if it is safe. A co-worker just had twins and hers were both breech, so she had to have a c-section but her OB would also have done a breech extraction of B if A had been vertex-though I think my delivery scared her a little.

 

I would try not to worry too much about it at this point. It is still pretty early and the babies will probably change positions a few times. I think it really depends on the doctor, each has his own views. My peri told me that if even one was head down they would have me try a vaginal delivery and then try and turn the other, if that didn't work then they would do a c-section. My ob told me that if even one was breech he would probably suggest a section, and in that case I would have the choice as to what I wanted to happen. Just make sure that you make your wishes clear and that you are on the same page with your doctors. When it comes down to it you will just want whatever is the best and the easiest on the babies. It will work out.

 

Hi!
Keep in mind your recovery. I understand that some docs will delivery vaginally if baby A is head down. But if baby b won't turn and they do have to go in and get him/her - then you have to recover from a vaginal delivery AND a c-section. My doc indicated that it wasn't very pleasant.