I can't decide between Nat. Birth and C-Section!

Hi

I am almost 35 weeks pregnant. Baby A is head down and ready to go while Baby B is breech. All along I have figured I would just try to go naturally. Today I had an apt, and my doctor said he needed to know what my decision was. I asked him what the chances are of delivering them both naturally. He said if it was my first labor about 20 to 30%, but because it is my second about 50% of a chance he can turn the baby.

I don't know what to do!! I really want to go natural, but I DON'T want to recover from both nat. and C-section. The fact is, if I have to have a C-section anyhow, then I may as well just to do that. I am really torn.

Has anyone had to do this? Has anyone tried to go natural and it worked? Tried and it didn't.

Any advise would be so helpful. I am a little worried now.

 

I tried, I had both girls head down and in PERFECT position and I still ended up with an emergency C section... But you know what? I am SO thankful I tried, I am so happy I got to have the whole labor experience instead of just going in and having it done. I felt cheated and upset for a long time after my girls were born, but now I am just thankful! As painful as the contractions were, as scary as things got for me, when my girls get older and ask, I can actually have a pretty interesting labor story to tell them I used to say if I had another I would have a C section, but now I know I would do a VBAC (if possible). Really though, its up to you, and how you feel, I personally enjoyed the whole labor process, I loved getting up every morning wondering (hoping) that that would be the day, ect. Ok really Im not this cheesy, just how I feel lol.

 

I've had both deliveries and it really is an easier recovery from the vaginal delivery. I too was told about attempting the vaginal delivery as long as baby A was head down, but may still need a c-section if they couldn't turn baby B. It's a tough decision. If you don't mind the idea of a possible emergency c-section, then I would attempt a vaginal delivery and hope for the best. It's not an easy decision and ultimately you have to do what you are most comfortable with. Good luck.

 

I had an ER c/s with my first after a 24-hr trial of labor.

I had an induced VBAC with my second.

I had a planned c/s with the girls (who were both vertex). I chose that because I do not go into labor well on my own, and the risk of rupture with such a large pregnancy (they had to take them at 37 weeks, 1 day, because I ran out of room and my cervix was long and not at all effaced or dialated) with pitocin was too great.

The recovery was easiest from the VBAC, but the recovery from the scheduled c/s was MUCH easier than the one after the trial of labor, and I was 11 years older and had two babies that time. I made that choice to avoid the risk of rupture because of my prior c/s, and also because I already knew what the recovery was like after a trial of labor, and did not want to risk that.

It's a tough call, though, especially if you don't have to worry about the risk of rupture.

 

Well, I would be torn on the subject, too. My doc told me that it was up to me in the long run - but because I birthed an almost 9 lb baby my first delivery and had only one small tear, the chances of me having a successful vag del were very high - if the first one was head down and the second one weighed more than the first... (I think that is what she said). She said she has had a lot of vag del for first and c/s for the second because the second one was in too much distress. My doc is big on being cautious and doesn't mind doing a sched. c/s for almost anyone. However, I REALLY want to try to vag del my twins if I CAN - but even if I was told 50-50 for success, I think I would probably got with the C/s just to be on a safer side.

 

I was in the same situation (A head down, B breech), and my OB also gave me a 50/50 change of delivering them both vaginally. I chose to have a c-section because I was scared of labor and I preferred to know exactly what would happen (insofar as you ever can) and when.

During the c/s, the doctor found that Baby A had her cord wrapped around her neck, and Baby B was wedged so tightly under my ribs that the doctor probably could not have turned her. So although I wound up wishing I could have delivered them vaginally, because the c/s recovery was harder than I expected, it also looks like I would have wound up with an emergency c-section if I had tried.

My SIL also just delivered twins -- hers were both head-down, so she was optimistic. But she did not go into labor on her own and did not respond to pitocin, so she also wound up with a c-section, although it was not "emergency" because no one was in distress (except my SIL after being in semi-labor for nearly 36 hours!).

Many women on this board have delivered twins vaginally -- but nearly everyone I know IRL has had a c-section. Maybe that's because most of the women I know are over 30 -- I'm not sure why that affects things, but it seems to.

Good luck -- it's a tough decision.

 

QUOTE(summerfun @ Jan 4 2008, 12:25 PM) [snapback]557426[/snapback]
I've had both deliveries and it really is an easier recovery from the vaginal delivery. I too was told about attempting the vaginal delivery as long as baby A was head down, but may still need a c-section if they couldn't turn baby B. It's a tough decision. If you don't mind the idea of a possible emergency c-section, then I would attempt a vaginal delivery and hope for the best. It's not an easy decision and ultimately you have to do what you are most comfortable with. Good luck.



so what exactly would be the difference between an emergency C-Section as apposed to a scheduled one? Is there a huge difference between the two?

 

Say you've delivered #1 vaginally and the doc isn't able to help you get #2 out without #2 being under too much stress - at that point, they will take you and give you an emergency C/S.

Scheduled C/S simply means you had already decided to have a C/S on a particular day or when you go into labor. Emergency refers to the fact that the C/S was necessary to help prevent the loss of a child... usually done last minute as a reaction to something that's already happened.

 

I have had both types of delivery.. and had a great natural... BUT I didnt mine the c section itself.. but I had a horrible recovery and a spinal headache that required a blood patch, not fun!

 

My twins were both vertex(head down) when I went in to deliver. I delivered Katelyn vaginally then had to have an emergency c-section for Jessica due to cord prolapse. There are just no guarantees even if both are in "perfect position" for a natural delivery as my OB said. No one could have predicted the cord prolapse and even a vertex twin B can move breech or transverse after twin A is delivered-my OB mentioned this and was prepared to do a breech extraction if it happened.

That said, it was really important to me to have a vaginal delivery. So, I am glad I attempted it and was successful even though I also had to have the c-section. This was my first and only pregnancy, so that came strongly into my decision making along with the way the girls were positioned. My OB was very positive about a vaginal delivery as long as twin A was head down.

I was induced at 38 weeks and my OB did tell me that there was a greater chance of needing a c-section with an induced labor vs. going into labor on your own. I had been 4 cm dilated and almost 90% effaced for 2 weeks when I went in and my body was just holding on. So, you might want to talk about options if you go into labor on your own vs. being induced.

Good luck with your decision.

 

My docttor asked me the same question this past week. Baby A and B are both head down and "ready to go", but I am going to try vg first and see what happens. I had my son vg (pushed solid for 6 hours) but I am still glad I held on and pushed through. In the end, it is a very personal dec. and of course you make all sorts of plans, but when you get in the moment everything can change!

Hope this helps.

Shannon

 

All these responses are so helpful. I am so scared!! I am TERRIFIED of having a C-section. I am terrified of trying to have a VD and still having to have a C-section. This is a much harder decision than i would have ever thought. Before I was sure I would only try natural, now presented with the facts and having to make a decision, well I'm not so sure anymore. It's great to read all of your stories. Thanks for sharing.

 

For me it would depend on the size of Baby B compared to Baby A. If Baby B is bigger then I would go for the c-section. If Baby B is smaller, then I'd do the vaginal birth. I found my c-section to be difficult to recover from while my vaginal birth recovery was a breeze but I wouldn't want to chance a twin vaginal delivery with a big breech Baby B.

 

QUOTE(Ali M @ Jan 5 2008, 06:44 PM) [snapback]559072[/snapback]
For me it would depend on the size of Baby B compared to Baby A. If Baby B is bigger then I would go for the c-section. If Baby B is smaller, then I'd do the vaginal birth. I found my c-section to be difficult to recover from while my vaginal birth recovery was a breeze but I wouldn't want to chance a twin vaginal delivery with a big breech Baby B.



Baby B is slightly bigger. Actually at 33 weeks they were both already 5.5 pounds. I couldn't believe it. They are BIG. My doc said if I went to full term it's very likely I would have 9 pounders!!!!

 

I wanted to avoid an emergency section because with it, you are put under general anesthesia --knocked out completely - because they don't have time to mess with making sure an epidural or spinal has taken effect. That's riskier for mother and baby.

I also didn't want the situation leading up to the emergency c-section --baby in distress, notably. One of my best friends went through this with her second DD and it was very frightening and traumatic.

I didn't go into pregnancy with my ideal birth experience planted in my imagination. I know that's really important for some women, but especially when faced with the decision the day they were born, I only wanted healthy babies, screw how they arrived in the room .

I did opt for a c-section, when faced with the choice of that or induction. As PP said, my upper baby was supposedly bigger, was definitely under my ribs and turned funny. I would have delivered vaginally or with c-section, I just didn't want to do both on the same day.

 

I am faced with the same decision and I am also terrified. If I had the choice (meaning if conditions were ideal) I would go for vaginal delivery. This is how I delivered my DD (with induction at 41 weeks) and I really like it. I am not in the ideal conditions, though. Baby A is vertex and B is transverse. Plus B is bigger than A, which is not favorable for a vaginal delivery. But the sizes from U/S can be off, so... I'll be 36 weeks next Tuesday and my doctor said I will be induced at 38 weeks if nothing has happened. But we will evaluate the situation and decide when it is time. I also don't want to have to recover from both types of deliveries, but I don't want to risk fetal distress for baby B.

BUT my doctor who is a peri in a teaching hospital told us that statistically the risk to the babies is not greater in a vaginal delivery than with a C-section.

About the question on ER vs scheduled C/S, effectively the issue is that for ER C/S they do a general anaesthesia because they have to make sure you won't feel anything and they don't have any time to waste, so you wouldn't see anything and your husband would not be allowed in the room.

I know I am not helping a lot, but at least you know you're not alone in this situation.

Good luck with your decision!

 

I'm making a very different decision for personal reasons, but just wanted to add the with an emergency c/s, the incision is different as well. In a planned section, the standard of care is a small, 'low transverse' incision. In an emergency (depending on how emergent, they will try to avoid this but it's not often a preference) they will do a larger, vertical incision. A VBAC (vaginal birth after cesarean) is only recommended with a low-transverse incision, so if anyone is planning on having more children and wants to try and deliver vaginally at some point later, please be advised that it is never recommended after a vertical incision due to the increased risk for hemorrhage/rupture in later labor and deliveries. Not trying to scare anyone, but it is just another major difference between emergent vs scheduled, in addition to the anesthesia issue. Good luck to anyone still making this decision!

 

It really wasn't even a decision for me. I just assumed throughout my pregnancy that as long as Baby A was head down, I would try a vaginal delivery. Alana (Baby A) was head-down from about day one and Alexis (Baby B) was breech through my whole pregnancy. The last few weeks, I could feel Alexis trying to turn, but she just didn't have enough room. I was induced at 37 weeks (just cervadil was enough, I didn't have to have any pitocin) and delivered both babies in about 30 minutes once they got me to the OR. As soon as Alana was out, they put the u/s wand on my belly and said, "She's vertex, she's ready to go." Alexis had just flipped right over for me and was delivered nine minutes later.

I don't know if that's at all helpful, but it is very possible to have a vaginal delivery if Baby A is head down. The way the docs explained it to me is that there is so much room left after Baby A is delivered, it is relatively easy to turn Baby B if that's what needs to be done. They also told me that I could even deliver her breech if I had to b/c everything would be so stretched from Baby A.

HTH! Good luck in making your decision!