Baby B breech--which is safer, vaginal or c-section

I need help finding some research about delivering a breech baby B. My Dr. will not consider a vaginal delivery unless both babies are vertex. I really, really do not want a c-section.
I had just taken his word for it that a c-section was the safest thing in this situation until I saw someone mention that there is research to show otherwise. Can someone point me to some evidence one way or another?

 

I can share my personal experience and beyond that I hope someone can give you a link to some actual research.

In my case baby a was vertex and baby b was breech from 20 weeks on. Every u/s we had checking growth always showed them in pretty much the same positions. My doctor encouraged a vaginal delivery saying that many breech baby b's turn after a is delivered and they have more space and also sharing encouraging information about breech extraction if it came to that. With all that being aid the morning I went into labor baby b was still breech, but baby a had shifted to be shoulder first and I ended up with a c-section even though our plan had always been for vaginal.

 

I am with you. At this point I am excited for the babies to come but very very sad about the c-section thing. My baby B as far as I know is still head up(he flipped at 32 weeks) and I am just not comfortable unless both are down.
I want more than anything to have a vaginal delivery with an outcome like my dd-no recovery, no pain after and up and going the next day.
I want to be 10o0% for the twins and not have any surgery of course.
I am just praying he moves-it can be done!

 

QUOTE(beachbum @ Nov 20 2008, 03:13 PM) [snapback]1079458[/snapback]
I need help finding some research about delivering a breech baby B. My Dr. will not consider a vaginal delivery unless both babies are vertex. I really, really do not want a c-section.
I had just taken his word for it that a c-section was the safest thing in this situation until I saw someone mention that there is research to show otherwise. Can someone point me to some evidence one way or another?



Actually look for my recent "Baby B flipped back to breech" thread. Someone posted the links to three VERY helpful articles about the best thing to do for a breech Baby B. (And the safest option is actually a vaginal delivery with a breech extraction!) BUT that's only the best option if you have a doctor who is trained in breech extraction; if they don't have the experience, a C-section might be safer. Anyhow, I'll find and "bump" the thread so you can check out those articles.

Best of luck!
(And I can relate: I really don't want a C-section either if I can help it!)

 

I bumped the thread for you, but here is the helpful post I was referring to:

CODE
I had a breech baby B and he was born by breech extraction, 4 minutes after A came out. My doc won't try external turning since it's more likely to put the baby into more stress. Breech extractions are quick and safe, but a lot of doctors are not well trained.

Research has also shown that breech extractions are safer.

http://cat.inist.fr/?aModele=afficheN&cpsidt=2911192

http://books.google.com/books?id=YXcCmcrUk...2&ct=result

http://books.google.com/books?id=zOfIHEqig...5&ct=result

 

My doc says he delivers most of his twins that way...with a vertex baby A, followed by a breech extraction. He said that he won't let me labor for the second baby and that he has the most success when he just reaches in and extracts the 2nd baby breech right away.

 

Just tonight my doc was talking about how it is absolutly no problem to deliver vaginally if baby A is head down and baby B is breech and that she always opts for vaginal over c if things are good. I would definitly talk a bit more to your doc. Good luck!

 

Today I went for my 32 week appt. Twin A my girl is still head down but Twin B my boy flipped to breech again! He was head down last time. I hope this boy will flip back head down and stay down!

I have the greatest OB though! He says that if he doesn't flip and stays breech he will go ahead and let me attempt the vaginal delivery that I want since this isn't my first pregnancy. After Twin A is delivered he says he can try to turn him and that he has does this many times. If not, he will try a breech extraction, if it doesn't work then C-section would be our next option. I pray he will flip back to head down though.

 

Here's an article I had in my bookmarks:

http://cat.inist.fr/?aModele=afficheN&cpsidt=18430083

 

Thanks for the info...I better get reading!

 

Rach1137 - I love how in your photo one baby is head down and one baby is head up - still!

 

hi
baby a is head down baby b is breech
i was told that i have to have an epidural, and as long as baby a is head down i can go for a vaginal delivery, and baby b can be delivered breech if need be, he said i have to have the epidural though incase baby b needs hel and the yhave to get him out now, im already set to do it, im all up for it, i have 2 other kids at home, i need to be able to move around, i would ask your doctor why they feel c section is the best option,

 

Best thing for everyone is a VB but ONLY if the OB has experience delivering 2nd twins breach. Personally, I would never try to convince a doctor to do a breech extraction if they weren't comfortable with it because to *me* that says that they don't have enough training to be confident in their skills.

But I would switch doctors in a heartbeat because it also says to me that it's a doctor who isn't necessarily trained well, isn't confident with twin births, isn't up on research, and/or is c-section happy. Not a good combo in my opinion...

FWIW my babies are A vertex and B breech/transverse and my doctor as well as all in his practice are trained in delivering a breech baby b and said it's considered the best way as long as there are no other complications and the doc knows what she/he is doing.

Links for you:

http://findarticles.com/p/articles/mi_m0CY...39/ai_112542267

http://www.suite101.com/blog/brendapreg/va..._birth_of_twins

I can get the original studies if you want with my academic access to the journals but can't provide links. Just let me know if you do!

 

I don't have any research but my own experience. I delivered my babies vaginally with A vertex and B breech. A was born and my labor stopped due to mag sulfate and a very stretched uterus. They upped the pit and waited...and waited...Dr even had time to go get breakfast. He came back, broke B's water and she was born butt first 2 pushes later...1.5 hours after her sister.

As PPs have said, I would not do this if your Dr is not comfortable. I felt very confident my OB had a experience with twins and breech. Not a lot, but enough. The benefits were worth taking the risk of one of each type of delivery.

 

I have no research info, just experience. I have a good friend who's breech baby b turned and followed, so I talked my doc into seeing if that would happen with my breech baby b. Yes, he turned and followed, but didn't drop. He had to be vaccuumed out, came out (doc's words) "very stressed" (meaning his apgars were 0,0), but pinked up with-in the first minute and was just fine after that!

 

copy.

 

i found out today on u/s that both my boys are breech right now.

 

I just asked my Dr. this question yesterday. She said that as long as baby A (my girl, Sophia) is vertex and larger than B (my boy, Jackson) than she has no problem doing a VB with him being breech. She also did say, she requires that I have an epidural though, because there is a very good chance she would have to reach in and pull Jackson out (ouch!). If Sophia is not bigger than Jackson the fear is that if he is breech his head will not be able to be pulled through. I agree with the PP though, that if your Dr. is telling you he is can't deliver a breech baby, he probably doesn't have the experience to do so. Good luck!