If both twins are vertex...

I'm almost in my 35th week with di / di twins - Baby A is breech and Baby B is vertex. I know Baby A is unlikely to turn but if he does, I'm trying to decide if I want to deliver vaginally. I'm curious what people would do if both their babies are vertex - deliver vaginally or opt for a c-section?

If they're both vertex and I opt for a vaginal birth, my doctor said there's a 1 in 3 chance that Baby B will encounter problems and I would end up having a c-section anyway. He said the problems range from not decending to flipping around to the more serious risk of cord prolapse and oxygen deprivation. Needless to say, I was a bit freaked out, and I'm having a hard time weighing the risks and benefits. I really want to deliver vaginally but I can't deal with the thought of putting a baby at risk and I don't want to have to decide on the spot at the hospital.

 

We're definately going to attempt a vaginal delivery if Baby A is vertex (even if Baby B is breech). My OB is very much for attempting vaginal deliveries of twins (if presenting baby is head down).

I think the odds are pretty small that you'd need a c/s for Baby B if Baby A delivers fine (I don't know if I believe the 1 in 3 odds of needing a c/s for Baby B that your Dr gave). They have more room in there to turn head down once Baby A is delivered, or the medical team has been known to turn them.

But you need to do what makes you feel comfortable!

 

Please know I ask this from a place of complete lack of knowledge and not judgement, but....why is everyone so set on vaginal birth? Is a C-section bad for the babies? I guess my thoughts are that if a C-section is less risky, I want what's best for these two little peas, but I'd love to know the medical reason behind a preference for vaginal births.

 

1 in 3?! I have a hard time believing it's that high... unless he considers ANY turning rather than following right along to be a problem that would necessitate a c-section. My doc is highly experienced and was comfortable with breech extraction of B. My boys were vertex-vertex but the doc advised that when A is out, B will move and not always in the direction you'd like but that if he lost his way, she'd reach up there to align him to vertex (or breech if she couldn't get him to vertex) and then guide him out. I was informed by one of the hospital nurses that there are only two OBs at their hospital who will do that and the rest would section if B turned breech.

 

QUOTE(TwinsInFL @ Aug 29 2008, 09:36 AM) [snapback]953217[/snapback]
Please know I ask this from a place of complete lack of knowledge and not judgement, but....why is everyone so set on vaginal birth? Is a C-section bad for the babies? I guess my thoughts are that if a C-section is less risky, I want what's best for these two little peas, but I'd love to know the medical reason behind a preference for vaginal births.


You should start a new thread for this and then fasten your seatbelt because it's almost guaranteed to get heated. Or do a search and pull up the thread from the last time it was posted.

 

The way my dr tells it is there are a lot of possibilities. A lot can happen. But there will also be a lot of people there to help with what ever does happen. I would like a vag. birth 'cause my body is built for that, so if baby A is head down I'm going for it. Your dr. is probably just going through all the options with you and all the ways this can play out. That's what my dr did. Yes, you could end up with a vag, then a c-section. You could also end up with a breech extraction where they just reach in a grab baby B (although I don't know if all dr. do this....).

QUOTE(TwinsInFL @ Aug 29 2008, 08:36 AM) [snapback]953217[/snapback]
Please know I ask this from a place of complete lack of knowledge and not judgement, but....why is everyone so set on vaginal birth? Is a C-section bad for the babies? I guess my thoughts are that if a C-section is less risky, I want what's best for these two little peas, but I'd love to know the medical reason behind a preference for vaginal births.


What I've been hearing is that going through the birth canal helps with the baby's lungs. However, a c-section is usually just fine too.

 

1 in 3 sounds really high!

I think there is of course a risk, which is why most twin deliveries are in the operating room.

I wanted to go vaginally as long as Baby A was head down. AFter she came out, the doctors could "guide" the other baby into position!

Good Luck!

 

Edited to post my reply on other thread.......

 

QUOTE(TwinsInFL @ Aug 29 2008, 10:36 AM) [snapback]953217[/snapback]
Please know I ask this from a place of complete lack of knowledge and not judgement, but....why is everyone so set on vaginal birth? Is a C-section bad for the babies? I guess my thoughts are that if a C-section is less risky, I want what's best for these two little peas, but I'd love to know the medical reason behind a preference for vaginal births.


I guess I'm a little freaked out about the c-section recovery and how it will affect my ability to care for the babies - not being able to climb stairs for a month (we have no bathroom on our first floor!), not being able to drive for a month, not being able to breastfeed easility with an incision, etc. I delivered my daughter vaginally and it wasn't a breeze or anything but it's what I know plus I'm getting a little freaked out by the idea of being cut open while I'm awake (not the best way to look at it but I can't get past how crazy that sounds!). I had also heard that a vaginal birth helps removed excess liquid from the lungs that perhaps can be aspirated by the babies if they don't got through the birth canal. It's still really hard for me to understand what's best for the babies and what's best for my recovery so that I can care for them as well as possible.

 

QUOTE(debid @ Aug 29 2008, 10:38 AM) [snapback]953223[/snapback]
1 in 3?! I have a hard time believing it's that high... unless he considers ANY turning rather than following right along to be a problem that would necessitate a c-section. My doc is highly experienced and was comfortable with breech extraction of B. My boys were vertex-vertex but the doc advised that when A is out, B will move and not always in the direction you'd like but that if he lost his way, she'd reach up there to align him to vertex (or breech if she couldn't get him to vertex) and then guide him out. I was informed by one of the hospital nurses that there are only two OBs at their hospital who will do that and the rest would section if B turned breech.


You're right - the doc considers any turning to be part of the 1 in 3 stat. None of the docs in the practice appear to be comfortable turning a baby or delivering a breech baby. Sounds like they just don't do it very often! I'm suprised how many people have posted that their doctors will do it!

 

If my twin-a turns vertex I definitely want to try a vaginal delivery. He's breech right now, though, and doesn't have much room for turning.

 

I might ask him where he got those statistics. The risk is real but the numbers don't sound right. My boys are both head down and I haven't made the deicsion yet. My DH, OB and I are leaning toward the vaginal delivery if no complications develop.

 

Both of my Babies are vertex right now, Baby A has been all along and my Dr seams to think as long as Baby A stays Vertex we can attempt a vaginal birth, even if Baby B isn't vertex she said she's not too worried. We will deliver in the operating room, just in case we have to do an emergency C-section, but we're hoping for a vaginal birth, its a faster recovery.

 

If you can figure out how, start a poll asking those who delivered vaginally with Baby A vertex whether they had a c-section for Baby B. I'm sure you'll find out that the percentage of "double-whammies" is nowhere near 33%. It's more like 5-10%.

Most doctors will not jump to c-section once they've already delivered one baby vaginally. At that point, a c-section isn't as easy for them to preform because it requires a new set-up. The c-section push from a doctor is much more likely to come before birth or during labor. If the doctors need to turn a baby, they can do it the vast majority of the time.

 

I had a vaginal delivery, Baby B was breech. I think you should always opt for vaginal unless there are MEDICAL reasons to go for a c/s. So many doctors make us believe c/s are safer. It's not true. A vaginal delivery, also for twins, can be very very safe. I think the key is that so many doctors aren't trained enough to deal with a possible issue with baby B and therefore opt for c/s and tell you it's safer (which I guess it is in certain doc's cases). During a vaginal delivery fluids will leave the baby's lungs, less chance for respitory problems. Also c/s is MAJOR surgery ... it's not 100% safe (nothing is but neither are c/s).

The hospital where I delivered (largest in the Midwest) and my doctors had no problems delivering a breech baby B, as long baby A was head down. My ds was born by breech extraction 4 minutes after his sister (4 pushes for her). Very fast, uneventful and safe.

I believe you should always opt for vaginal UNLESS there are (medical) reasons to go for a c/s and in that case that's perfectly fine as well. Don't me wrong, I have nothing against c/s (and if somebody requires one, please go for it!), I just think they're "overused" and way too often marked as "safer".

I also found this and I guess the last sentence says it all. I truly believe that is the main issue here. http://findarticles.com/p/articles/mi_m0CY...39/ai_112542267

 

I'd love to have a vaginal delivery but my doc suggested it was much safer to just have a c-section. It might just be that the docs in her group aren't well trained to deal with a breech baby. In which case, she's right, it would be safer for me to have the babies by c-section than risk having them not know what to do if Baby B is breech. I'll quiz her a little more when I see her next week but I doubt I'll switch docs just to have a better shot at having a vag birth. Bummer.
Nicole
24 weeks with boy (di/di) twins

 

Well number one going thru the birth canal has benifits. I read it helps the esophagus close. Ironically my boyfriends cousin's daughter was born via c/s and her esophagus didnt close and she had to have surgery. Then at almost 10 months she had a leak and almost died.
There are other reasons too.
Plus who wants surgery? NOt me. I dont want to be cut. I dont want stitching and recovery time and to have to take it easy for 2 months b/c of the surgery while caring for 2 babies.

With my dd, I pushed, popped her out, and was in the shower the next morning and at the mall 3 days later in heels. You could never do that after a c-section.
It was so easy for me to care for her and now I will have 3 kids. I want a vaginal birth for the health of my kids, the experience of the birth itself(its amazing to push out your babies) and for a quick recovery so I can care for my kids.

But, I would not risk there health vice versa. If one is breech I will have a c-section b/c I will not risk oxygen deprivation for one second. So unless both babies are head down or close to being head down then I will opt for a c-section.

 

QUOTE(DLJ @ Aug 29 2008, 02:53 PM) [snapback]953806[/snapback]
I guess I'm a little freaked out about the c-section recovery and how it will affect my ability to care for the babies - not being able to climb stairs for a month (we have no bathroom on our first floor!), not being able to drive for a month, not being able to breastfeed easility with an incision, etc. I delivered my daughter vaginally and it wasn't a breeze or anything but it's what I know plus I'm getting a little freaked out by the idea of being cut open while I'm awake (not the best way to look at it but I can't get past how crazy that sounds!). I had also heard that a vaginal birth helps removed excess liquid from the lungs that perhaps can be aspirated by the babies if they don't got through the birth canal. It's still really hard for me to understand what's best for the babies and what's best for my recovery so that I can care for them as well as possible.


The actual surgery isn't bad at all (in my experience), and I didn't believe it myself until I went through it. I had my twins at 37.4 weeks and they had no issues at all right out of the womb - they roomed in with us from the start. They did have a little jaundice and the smaller Baby B needed to be under a warmer for a little bit on the first day because her temp got a little low, but they didn't have any breathing problems at all. I know a c/s isn't the way that a lot of women choose - I definitely wish I could have done a vaginal birth, but I don't think I would have ever forgiven myself if something did happen to Baby B. But I just wanted to share with you that if it comes to that, it's not so bad. The recovery isn't a walk in the park, but 2 weeks later, I'm feeling back to my old self again. I'd definitely have a lot of help around that first couple of weeks. And the more you're up and about, the more quickly you'll recover.

 

QUOTE
But, I would not risk there health vice versa. If one is breech I will have a c-section b/c I will not risk oxygen deprivation for one second. So unless both babies are head down or close to being head down then I will opt for a c-section.


I largely agree with you but I just don't think breech babies equal risk of oxygen deprivation perse. Research shows that breech twin B's do really well, not worse and/or better than c/s.

But agree with Nicole, in the end your doctor needs to be experienced enough to do it.