OB's opinions on vaginal vs c/s

Discussion in 'Pregnancy Help' started by Mommy2PJ, Dec 14, 2006.

  1. Mommy2PJ

    Mommy2PJ Well-Known Member

    Has anyone else's OB recommended that you schedule a c/s no matter what because of twins? I was very adament about not wanting an epidural with my son, cause I'm scared to death of them! I had a vaginal delivery with one shot of demerol and it wasn't nearly as bad as I thought it would be (at least compared to all the horror stories that first time pregnant moms get! lol)

    Anyway, I was really hoping to have a vaginal delivery again this time, and then found out it was twins and started asking my doctor about my chances for a vaginal delivery. She told me that somewhere around 80% of attempted vaginal twin deliveries end up in an emergency c/s for baby b... so then you have to recover from both, and it's stressful for babies and the doctor. So I kind of automatically said ok, let's do a c/s then, no matter what.

    But now I'm kind of thinking about trying the vaginal, but after she told me that, I'm kind of afraid to. I've been doing a lot of reading about which option is better, and I've seen the posts on here... I'm just curious if anyone else's OB is the same way - let's just schedule a c/s!
     
  2. Mommy2PJ

    Mommy2PJ Well-Known Member

    Has anyone else's OB recommended that you schedule a c/s no matter what because of twins? I was very adament about not wanting an epidural with my son, cause I'm scared to death of them! I had a vaginal delivery with one shot of demerol and it wasn't nearly as bad as I thought it would be (at least compared to all the horror stories that first time pregnant moms get! lol)

    Anyway, I was really hoping to have a vaginal delivery again this time, and then found out it was twins and started asking my doctor about my chances for a vaginal delivery. She told me that somewhere around 80% of attempted vaginal twin deliveries end up in an emergency c/s for baby b... so then you have to recover from both, and it's stressful for babies and the doctor. So I kind of automatically said ok, let's do a c/s then, no matter what.

    But now I'm kind of thinking about trying the vaginal, but after she told me that, I'm kind of afraid to. I've been doing a lot of reading about which option is better, and I've seen the posts on here... I'm just curious if anyone else's OB is the same way - let's just schedule a c/s!
     
  3. FirstTimeMom814

    FirstTimeMom814 Well-Known Member

    My personal opinion is that c-sections are major surgery and just because you are having twins is not justification enough. You will find plenty of moms on here that delivered both vaginally, myself included. If your babies are in cooperating positions then you should feel free to try a vag delivery. Both mine were head down, but my OB would of been fine as long as A was head down then he could do a breech extraction on the second. Some drs are not comfortable with breech deliveries so they will push for a c/s.
     
  4. KimC

    KimC Well-Known Member

    I am one of those that had baby a vaginal and baby b by emergency c-section. I would still have tried to have them vaginal. Also now day most doctors won't let you do a VBAC with any other children if you decide to go with a c-section. Good luck!
     
  5. kendraplus2

    kendraplus2 Well-Known Member

    Mine don't automatically suggest a C-section just because it's twins, but they do let me know that it's a possibility. As long as A is head down and B is smaller than A they will let me try for a vaginal and go from there. I think like most twin deliveries though I have to deliver in the operating room so in case there is need for an emergency C-section, everything and everyone is prepped and ready to go.
     
  6. Michelle B

    Michelle B Well-Known Member

    My OB's choice is a vaginal birth. Both A & B head down or A head down & B transverse/breech but a smaller estimated weight will get me a vaginal delivery. Otherwise a c/s is indicated. My OB said that at any time, no matter the circumstances, I can choose a c/s and she will go that route. Her preference is attempting a vaginal delivery if criteria are met.
     
  7. threetobe

    threetobe Well-Known Member

    Your OB sounds very, very different from mine. My OB will try vaginal if baby A is vertex. It doesn't matter what position baby B is in. If baby A is breech, then it's c-section.

    My OB also told me that there's always a chance of an emergency CS on baby B so for that reason she's encouraging me to get an epidural this time around, but that in her experience it's rare. She's skilled at extracting baby Bs vaginally under different circumstances -- she says sometimes she reaches in to reposition them, sometimes she delivers them breech. She wants me to be prepared "just in case" I'd need a CS on baby B but it's a rare occurrence in her practice. I don't know where your OB got that 80% statistic, but it doesn't gel with what I've come across or heard from my OB.

    ETA: my OB also told me that the size of baby B relative to baby A doesn't matter because by the time of baby B's birth I'd be fully dilated anyhow.
     
  8. MLH

    MLH Well-Known Member

    Nope, mine didn't really consider a c-sec unless medically necessary which I was happy with. I did go for a vaginal birth and did great with it. My Baby B was breech (A was vertex) and they both came out great. Baby B was actually 3/4 lb. bigger too! That sounds like a really high # (80%)...wonder if that's just in her experience or if that's national stats.


    quote:
    Your OB sounds very, very different from mine. My OB will try vaginal if baby A is vertex. It doesn't matter what position baby B is in. If baby A is breech, then it's c-section.

    My OB also told me that there's always a chance of an emergency CS on baby B so for that reason she's encouraging me to get an epidural this time around, but that in her experience it's rare. She's skilled at extracting baby Bs vaginally under different circumstances -- she says sometimes she reaches in to reposition them, sometimes she delivers them breech. She wants me to be prepared "just in case" I'd need a CS on baby B but it's a rare occurrence in her practice. I don't know where your OB got that 80% statistic, but it doesn't gel with what I've come across or heard from my OB.

    ETA: my OB also told me that the size of baby B relative to baby A doesn't matter because by the time of baby B's birth I'd be fully dilated anyhow.



    Exactly the same as my OB!!
     
  9. WEME

    WEME Well-Known Member

    My OB really encouraged me to try vaginally if both were head down (which they were). It didn't work out for me and after hours of labor, we ended up doing an emergency c/s for both. I can't compare it as I've never actually delivered vaginally, but my c/s was really no big deal and really easy recovery (and I'm a big wuss). Good luck!
     
  10. akameme

    akameme Well-Known Member TS Moderator

    My peri said she would consider vaginal if twin A was head down, but she is pretty pro c section.
    Well, twin A has been breech the whole time...and we are doing a c-section. And even if Twin A flips, I prefer a c-section at this point. After what will be close to 3 months of bedrest - i'm not up for hours of induced labor. And my baby B is smaller and we have been worried about him - so I dont want to risk him going into distress.

    Miriam
     
  11. Dianne

    Dianne Well-Known Member

    Wow 80%? My last rememberance of the stat was 5% although recently I read it might be up to 10%. I have never heard anything higher than 10%.

    My OB was similar to some of the others in that as long as Baby A was vertex we could attempt vaginal delivery. It was never a c-section all the way, it solely relied on if A was head down. He was so we went for it. Now, I am one of the 5-10% who had an emergency c-section for Baby B but like Kim, if put in the situation again I would still attempt vaginal if given the option.
     
  12. starchaser

    starchaser Well-Known Member

    I had both of my boys vaginally. My ob said that as long as baby A was head down, it was a go. He always stayed head down, but baby B was transverse. When I delivered A, my ob 'retrieved' B and I delivered just fine. I did have to have the boys in a prepped or, just in case. I wish you the very best of luck. Take care!
     
  13. hot2trottt4u

    hot2trottt4u Well-Known Member

    I was so afraid of having one vag and than needing an emergency section. So i was telling my ob that i would rather just have a section. He really wanted me to do vag and that he had done many breech extractions (sp?) if needed, I trusted him, and delivered 2 beauiful babies vag and am so glad that i did. It made my recovery so much easier.
     
  14. Mommy2PJ

    Mommy2PJ Well-Known Member

    Yeah, I have no idea where the 80% is coming from!! That just doesn't seem right. But apparently it's her preference to do a c/s. I also have a much smaller baby b as most of you know, so I'm a little worried about putting him through labor... but I guess we'll have to see as I get closer. I really just can't decide!
     
  15. jennlynnmahan

    jennlynnmahan Well-Known Member

    My OB will not do a vaginal with multiples....only a C-Section. He told me from day 1 that I would have a C-Section and it would be before 40 weeks no matter what. My aunt had a friend that attempted to have her twins vaginal and it resulted in the death of the second twin. I realize this is a very rare case and the doctor probably allowed her to try to push too long with the second instead of going to an emergency C-Section....but it has scared me enough that I don't want to even attempt a vaginal delivery. I am not looking forward to the actual C-Section, but it gives me some comfort to know that I won't have to have an emergency one. I have a few friends that had singletons and ended up with C-Sections after they had labored and pushed for hours.
     
  16. Sofiesmom

    Sofiesmom Well-Known Member

    My doc will definitely go for vaginal as long as baby A is head down. In my case, baby A was head down and baby B was breech. Baby A was born after 5 pushes, she weighed 7lbs11oz and baby B was born by breech extraction 4 minutes later, he weighed 7lbs10oz. He scored low on his first Apgar due to stress (5) but scored a 9 the second time. Both are thriving right now. There is no reason to have a c-section just because of twins, at least not if your doc and hospital are experienced enough to do a breech extraction if necessary.
     
  17. Babies4Susan

    Babies4Susan Well-Known Member

    My peri said that they would attempt vaginal delivery if baby A was head down and baby B was not substantially bigger than A. The delivery had to be in the O.R. with an epidural catheter in place, just in case it had to turn into a c-section.

    My babies never ever went head down, plus they came at 31 weeks, so I had a c-section.

    Honestly, I was terrified of the epidural too. But I had to have an emergency cerclage at 16 weeks, so I had to have a spinal at that point (or lose my children). It really, really isn't bad at all. I had no side effects or pain with it.
     
  18. Ali M

    Ali M Well-Known Member

    quote:
    Originally posted by Mommy2PJ:
    She told me that somewhere around 80% of attempted vaginal twin deliveries end up in an emergency c/s for baby b...


    That's just not true. I can't find it right now but I believe the statistic is that only 5% of twin deliveries end up with both a vaginal birth and a c-section. So, your doctor's numbers would imply that only a very small percentage of women try for a vaginal delivery in the first place. That's incorrect.

    When I found out it was twins, I assumed that all twin deliveries were by c-section so I asked my peri if we were going to schedule one. She said we could try for a vaginal delivery as long as Baby A was head down and bigger than my breech Baby B. I did end up having a c-section due to maternal complications during labor but it was for both babies, not just for Baby B.

    Although I do not have any numbers, I wouldn't be surprised if more twin vaginal deliveries end up with a c-section (not emergency though) than non-twin vaginal deliveries just due to the fact that twins get induced a lot. Induction can decrease your chances of a vaginal birth versus going into labor naturally.
     
  19. Sofiesmom

    Sofiesmom Well-Known Member

    Wanted to add, I needed to have an epidural (for the breech extraction and a possible emergency c-s) and delivered in the OR. My doc said that as long as Baby B wasn't more than 2 pounds heavier, a breech extraction would be fine. My first was over 9lbs, so anything smaller did not cause any problems in my case.
     
  20. Jude Rose

    Jude Rose Active Member

    Everyone else has pretty much covered the important stuff. i just want to add:

    -epidurals scare the &^%( out of me too

    -there can be side effects with epidurals, both to the babies and the mamas-if anyone wants links to studies, P.M. me. I don't think it's fair to talk about it openly here because so many of us simply have no choice

    -you can ALWAYS change OB's. It doesn't hurt to shop/call around. The hospitals within 1/2 hr of my house are C/S only for twins.. My hosptital and OB are an hour away, but it's worth it for me to at least have a shot at the birth I deserve.
     
  21. kimr

    kimr Well-Known Member

    In the beginning my ob was very pro-c/s it was almost like she was afraid to try a vaginal. Then around 28 weeks I was diagnosed with placenta previa and we were a definate c/s. We went to lamaze classes anyway and my dh and I were very laid back about the class because we kept on saying oh were having a c/s. The previa corrected itself by 32 weeks, but the girls were either vertex or transverse at every appt. So when one of the girls water broke around 34 weeks we were all set on having a c/s, then my ob did an ultrasound when she got to the hospital and they were in the right positions so she left it up to me as to what I wanted to do. I went with a vaginal (my dh almost collapsed when I answered!). But to this day my ob says that she should have just done a c/s because Natalie wasn't born until 45 hours after my water broke (not good!) and Brooke took another 3 1/2 hrs to push out after Natalie.
     
  22. Raneysmama

    Raneysmama Well-Known Member

    That 80% figure is definitely not true. I swear some doctors just throw stuff out there, thinking their patients will believe anything they're told. I agree with most of the other posters. A vaginal delivery can be attempted as long as the babies meet the proper criteria (position, etc.). However, for you, I would also take into consideration that you are borderline TTTS. I believe Dr. DeLia recommends a C/S for any TTTS pregnancy, as a safety precaution. Just something to think about/look into. You would definitely want the babies to be monitored closely, and there's something about clamping the first baby's cord immediately or something to avoid a trasfusion to the other baby? Sorry I don't know all the info about this right now. Congrats, by the way, on getting to the 24 week mark!!
     
  23. Mommy2PJ

    Mommy2PJ Well-Known Member

    quote:
    Originally posted by Raneysmama:
    That 80% figure is definitely not true. I swear some doctors just throw stuff out there, thinking their patients will believe anything they're told. I agree with most of the other posters. A vaginal delivery can be attempted as long as the babies meet the proper criteria (position, etc.). However, for you, I would also take into consideration that you are borderline TTTS. I believe Dr. DeLia recommends a C/S for any TTTS pregnancy, as a safety precaution. Just something to think about/look into. You would definitely want the babies to be monitored closely, and there's something about clamping the first baby's cord immediately or something to avoid a trasfusion to the other baby? Sorry I don't know all the info about this right now. Congrats, by the way, on getting to the 24 week mark!!


    Thanks!! I'm excited to be at 24 finally!

    Yeah, I think maybe she had it backwards or I misunderstood her or something... because I just found online that the statistic is around 10% nationally. I'm guessing maybe she isn't comfortable with a breech extraction, but to be honest, I'm not really either.

    At this point, I'm still leaning toward the c/s even though I never in a million years thought I would! But with the single placenta, the complications I've had and an OB that's not comfortable with the delivery... the c/s is probably best for me.
     
  24. momlissa

    momlissa Well-Known Member

    I'm not sure what my peri's viewpoint or feelings are about c/s vs. vaginal b/c I had a c/s with my daughter and made it really clear that I was planning on having a c/s again with the twins. I would have had a sched c/s even if it had been a singleton. I had a really positive c/s experience the first time and am hopeful that I will again.
     
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