Scheduled Induction VS Scheduled C-Section

[SIZE=12pt]Any thoughts of induction vs. c-section?

I have the opportunity to be part of a Term Twin Study which would place me into either one of those groups for delivery.

The study is for Full Term twins and studying which delivery method is better. Apparently in Europe, Twins are an automatic c-sxn. Many in the U.S.A are that way too. In Canada, they do delivery based on Babies' positions.

From my reading. It seems like inductions often end up in a c-section for the second baby. So it seems like just going straight to a c-sxn would be better (healing only 1 way?!)

Any thoughts?[/SIZE]

 

Hmmm. I guess I lean toward C/S for the very reason you stated. Maybe you should post a poll in the First Year forum to find out how many inductions turned into c/s.

 

Do you have to decide now? It would depend on the position of the babies at the end. If they were both head down, I'd go for the scheduled induction. I was told as long as Baby A was head down they could attempt a vaginal birth, but there would be a possibility for a c-section with B, I didn't get that far obviously, but I would elect for a vaginal birth over c-section anytime as long as the babies were in the right position.

 

I am European and I had several friends and people I know that had vaginal twin deliveries, so that's definitely not the fact for every European country. Especially my country has a very low c/s rate, extremely low epidural rate (10%) and a high home birth rate (30%) although twins are usually delivered in hospitals. So my country is way more "natural" than the US. But Europe consists of many many countries these days! ! My best friend back home had her twins via c/s because of their position.

I had a scheduled induction at 38w2d. Baby A was head down (which was the most important thing) and baby B was breech and born by breech extraction. As long as baby A was head down, baby B wasn't more than 2lbs heavier and the breech baby didn't seem to have LBW, my hospital / doctor goes ahead with vaginal deliveries. It's the largest birthing hospital in the Midwest.

 

Both of my babie were head down so I decided to try for the induction. After 13 hours of pitocin I had only dialated 1/2 cm. I really wasn't in hard labor at all though and was pretty comfortable most of the time. I ended up with a section and the recovery was harder than I had anticipated. I had a ton of breakthrough pain which was horrible but they were able to manage the pain with plenty of pain meds. I am really glad that I at least tried for the vaginal delivery because I think I would have always wondered if it would have been easier. I really think that if you can do a vag delivery go for it. I was a big worrier and wanted a c/s my whole pregnancy, but now after having gone through one I understand why people try so hard for vag. I was really happy with the way things turned out. Both of my peanuts were out and healthy within 2 minutes. So there really are pos. and neg. about both. Just thought I would share my experience.

 

My induction (2 head down babies) turned into a csection b/c labor was progressing slower than my pre-e was worsening. I think I would've ended up having them vaginally if not for the pre-e getting so bad.

 

If everything looks good and both of mine are head down, I would like to try vaginal. If there is any reason to think it won't work out, off to c/s I will go.

 

I was induced and had baby A vaginally and baby B via c-section due to cord prolapse. If I had it to do over again, I would still have attempted a vaginal delivery. Both babies were in perfect position for a vaginal delivery and there was no way to predict the cord prolapse. I had complications with both deliveries but the vaginal delivery was so much easier to recover from than my c-section.

 

From stats I've read around 47% of women who have induction wind up with c/s...that's about the odds of what twin moms have of having a c/s regardless of induction. So I would think with induction AND twins you might have a higher likelihood of c/s anyway...with those factors combined maybe a 60 or 70% chance of c/s for one reason or another. A big factor is whether or not you are favorable. If you google "Bishop Score" you should be able to find a nice little chart outlining what makes you favorable for induction.... dilation, effacement (softness of the cervix), previous vag deliveries, and other things go into this chart...if you have all this information on hand you should be able to figure out "how ideal" of a candidate you are for induction.... the score outlines what type of induction might be best for you....cervical ripening gels..or pitocin..etc... The lower your score the less likely you are to succeed at induction. but you never know. My twin sister was induced with her first child...she had every strike against her. her cervix was long and completely closed....she was 42 weeks...her baby still hadn't dropped... She was on pitocin for 6 hours, her water broken and still at a 2. They let her have an epidural at this point b/c they were prepping the OR for her to have a c/s... an hour after her epidural she was at a 10!! And pushed her dd out in less than half an hour. So you never know. Even her docs were shocked that she actually got a vag delivery!!

 

P.S. as a candidate now for vbac...I highly recommend going for a vaginal birth if you plan on having more kids. The struggle for getting your vbac is a lot harder than it is for getting your first vaginal birth... b/c of policies, etc. And in spite of the general notions about c/s and their safety, it still isn't an ideal situation to undergo major abdominal surgery repeatedly.

 

I was induced at 38 weeks. Both babies were head down, baby A delivered no problem, baby B had flipped & was breech by that point. I still managed to deliver without the c-section, by breech extraction. Not pleasant, but much quicker recovery time!

 

I had been wondering about this also. My twins are both head down, facing each other, in what my Dr call a 'text book' position. He seems to think doing an induction is the best but left the final decision up to me. I thought I may as well try an induction (assuming they dont come on their own this week). Dr also said that I will need an epidural sooner than someone with a singleton because they may need to manipulate the second baby after the first is born if he decides to change position. :blink: Sounds like fun.
I am actually hoping that I will go into labour on my own before my induction date. So much for twins being small and coming early.

 

Guys, if one of the babies is head down ( baby A) and one is bridge, baby A is going vaginally all right, but what they do about Baby B being bridge? how do you deliver baby in bridge position vaginally?

 

I plan on trying for a vaginal delivery as long as baby A stays head down. At the moment, both are head down but B tends to flip around a lot.

If the second baby is breech, the doctor puts a hand up into your uterus, grabs for the the feet and then pulls the baby out, feet first.

Twins are going to be hard enough to take care of, I'd rather not have to recover from surgery at the same time.

 

QUOTE(belinda07 @ Nov 2 2007, 01:20 PM) [snapback]478406[/snapback]
Dr also said that I will need an epidural sooner than someone with a singleton because they may need to manipulate the second baby after the first is born if he decides to change position. :blink:


I was definitely glad to have the epidural in place before my baby B had to be "manipulated"! :icon_eek: Hopefully, that won't be the case with you though!

QUOTE(allboys @ Nov 2 2007, 03:09 PM) [snapback]478581[/snapback]
If the second baby is breech, the doctor puts a hand up into your uterus, grabs for the the feet and then pulls the baby out, feet first.


Yep, that's what the doctor had to do, guided by another doctor with the ultrasound machine. With the epidural, it wasn't that bad & like you said, preferable to surgery! Good luck, you guys!!

 

I had a breech extraction for baby B, as mentioned earlier. I didn't feel anything (thanks to the epidural), and it was very quick and easy although my baby boy was in a little distress on the way out but he recovered very quickly. I've never been back in bed since they day I left the hospital, back to normal within a couple of days.

My situation was favorable for induction ... previous 9lbs+ child with a vaginal delivery, 4 1/2 cm dilated, effaced ... 4 hours after starting the Pitocin I was wheeled in the OR. They even had to turn off the Pitocin because my body had completely taken over, and went into labor "on its own". I guess they just had to push me over the edge ...

 

thanks for all your input thus far!

I'm hoping to go on my own. I'm still not sure about induction. But I suppose induction and csxn each have their own possible complications.